‘Unsurprising and startling’: 'Shoppable’ radiology services sometimes 6 times pricier than Medicare rates
Prices for certain “shoppable” radiology services are sometimes 6 times higher than Medicare rates, according to a new analysis published Tuesday in RSNA’s Radiology.
The federal government recently started requiring hospitals to provide upfront pricing for healthcare services, with 13 specified in imaging. Based on a review of data from more than 2,000 hospitals, researchers unearthed widespread variation. The median price for mammography of both breasts, for instance, could run for $289, more than twice as high as the Medicare rate. And MRI of the spinal canal was 4.9 times higher ($1,311 vs. $269).
While some of the numbers are painful to see, researchers with Johns Hopkins and Michigan State University believe they’re necessary to help curb high costs in healthcare.
“By reporting the significant price disparities among shoppable services, our research will empower employers, payers and patients to demand changes,” co-author John Jiang, a professor at Michigan State University’s Broad College of Business, said in a statement. “It also confirms policymakers’ concern that lack of transparency has hidden potentially abusive price behaviors.”
For their study, Jiang and colleagues accessed data for shoppable radiology services by utilizing automated searching algorithms to scan online information. All told, the Turquoise Health tool skimmed 5,700 websites, representing about 94% of U.S. hospitals. As of Sept. 6, about 36% had reported the commercial negotiated price for at least one of the 13 services.
The disclosure rate was lowest for mammography at 30% and highest for CT of the abdomen and pelvis at 39%. MRI of the brain before and after contrast logged the highest median commercial price at $1,788—4 times above the Medicare rate ($446). CT of the abdomen and pelvis with contrast was second at $1,654, about 3.8 times higher than Medicare ($431).
In a corresponding editorial, noted radiologist and health policy expert Howard Forman, MD, MBA, called the findings “unsurprising and startling.”
“Now that we have the beginnings of more widespread transparency—even if still murky—what should we make of the wide variation in prices, negotiated and otherwise, for identical CPT codes?” wrote Forman, with Yale University’s School of Medicine. “Why should the performance, not the interpretation, of a single brain CT examination vary by 10-fold between the lowest and highest negotiated rates? These questions beget more questions, and radiologists and hospital leadership would do well to consider them seriously.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.