Wednesday, August 24, 2011

Price List for Medical Tests

I am smacking myself on the forehead and saying, "Why didn't I think of this?"  Dr. Richard Parker, Medical Director at Beth Israel Deaconess Medical Center,  has sent out a list to his physician colleagues of 56 common medical tests and procedures.  What is revolutionary is that there are prices next to each item.  You non physicians may be surprised to know that we doctors have no idea what the tests or drugs we order actually cost.  Unless we get billed as a patient, we are as clueless as you are.

As I wrote before, the ostrich excuse just won't fly any more.  We all need to be aware of the cost of care and have skin in the game.  Some will argue that price can't be the only driver.  I've heard physicians say you can't compare one price to another because "quality" costs more.  I say prove it.  If you have a quality product or are a higher quality physician, show us the results.  What are your outcomes?  Is your customer service better?  Is it worth the higher cost you charge?  Let's be transparent and let the patient determine what something is worth.

Separate from physician fees, however, is the variability and wide ranges in costs of similar tests. I hear from my patients who have high deductibles and pay first dollar coverage for their health care.   I frequently order a screening Vitamin D test and found out the patient was billed as much as $200 for one test.  A colonoscopy can cost as little as $1100 and as much as $2600.  That is a huge price variance.  What about ultrasounds and MRI scans?  The variation in price is astounding.

Dr. Parker says he "wants doctors to think about the cost of the things that they are doing." "We're not saying don't give patients what they need" , says Parker.  "We'll fight hard to get them what they need, but please don't give them what they don't need - we just can't afford that anymore."

I have been calling for transparency in pricing for a long time.  Patients and Physicians need to know what things really cost.  Maybe I'll try what Dr. Parker did for my area...if I can find out the prices, that is.


oc1dean said...

But your vet will be able to tell you the prices for your dogs' procedures.

Anonymous said...

Thank goodness! Great news. Very funny, and true, that your vet can tell you what your pet's procedures cost.

Next is to get rid of the cost "estimates" for procedures. I had to pay $834 upfront (glad I have a small HSA from my work) for my colo, then the cost was less than that, so then I get a check from the medical ctr., which I then need to give back to the colo place. Ugh!


Anonymous said...

Whoops...need more coffee here. Then I am reimbursing my HSA (correction).

Anonymous said...

Great find Dr B ! This price comparison list for identical tests or services has got to be a possible business. Of course, we will need the lab or hospital charge in one column, and then health plan allowable in another. If we can compare prices of just about everything else we can buy, including pharmaceutical drugs, why not medical prices? Perhaps we can even get the plans, labs, and hospitals to advertise on the list! And no, I'm not being facetious.

Anonymous said...

I just went to my doctor the other day and didn't have any idea how much I was expected to pay at the end of the visit and it was more then I expected. Usually I call ahead to inquire, but was busy and forgot this time. It helps to have the price to plan finances ahead. Another problem if you don't know the cost how can you tell if an error happens and you are over charged?

I saw another physician who was a specialist with "quality" a year ago for the same thing but was charged $60 less for a routein exam from the specialist price compared to the internist's price. Both are good physicians. Usually I thought the specialists would charge more.

Rathnashikamani said...

The hidden costs make the patient forever sick!

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Ms. Happy said...

Great blog and well written. A price list would be so valuable to patients too. Imagine going into Safeway and not knowing the price of items you want to buy. Food is a "must have" as is health care. said...

Thanks for your article, pretty useful piece of writing.

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