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Patient’s Comparison
Shop For Imaging Services

The current economic downturn has millions of Americans clipping coupons and comparison-price shopping for everything from groceries to household goods. Many people, including employers, however, would be surprised to learn how much they could save on their healthcare bills if they also shopped around for medical imaging services.
An analysis of the Tri-State healthcare market shows that the cost of an MRI at an area hospital averages about 23% — or $500 — more than at non-hospital-affiliated radiology centers. Greater savings can often be achieved by checking into CAT scan costs. Independent providers typically offer about a 65% savings over hospitals on CAT scans, about $830 in savings per scan, according to market research.

Savings on medical imaging tests can lead to a significant reduction in overall healthcare spending, because imaging exams account for 10% of medical costs today (or $100 billion), according to the Chicago-based healthcare consulting firm 3rd Health. MRI, or magnetic resonance imaging, is most commonly used to provide a glimpse into the body to determine the condition of internal organs or damage to soft tissue. CAT scans, also known as computerized axial tomography, are performed to provide three-dimensional images of areas within the body.

Savvier Consumers

The demands on household budgets are prompting patients to become more informed consumers of healthcare services, carefully shopping for their medical needs without sacrificing quality of care. Many Americans now know the benefits of choosing generic prescription drugs over brand names, staying with in-network providers, and contributing to a health savings account.

That same attention to costs needs to be applied to imaging scans, insists Derek Van Amerongen, M.D., chief medical officer at Humana in Cincinnati, who recommends checking prices at non-hospital-affiliated radiology centers: “They typically provide imaging services at lower costs than hospitals and deliver the same or higher levels of quality and service.”

Imaging scans help physicians accurately determine treatment options and next steps. Dr. Van Amerongen says patients often simply rely on the imaging center referral made by their doctors. “Hospitals tend to be compensated by insurance companies at about twice the rate that private, independent companies are,” he says. “Hospitals often negotiate with insurers for higher reimbursement rates on their imaging services due to their large overhead and to compensate for accepting lower charges in other areas, such as indigent care.” Patients should be encouraged to be proactive and make their own choices when deciding where to get their imaging exam.

Insurers Provide Guidance

Health insurers will often work with patients to help them find quality imaging services at lower prices when consumers reach out to them. In addition to contacting insurers, hospitals, and independent companies themselves, patients can visit imaging providers’ websites for pricing details. Dr. Van Amerongen warns that when patients obtain hospitals’ prices, they should make sure the price quoted includes both the cost of the scan itself and for the reading of the image by a medical professional.

“There are two parts to an imaging service,” Dr. Van Amerongen points out. “Beside the scan, a medical professional has to read the image to diagnose the condition. Hospitals tend to only provide patients with information on the charge for the image. Patients need to make sure they get the price for both the image and the reading. Independent companies tend to offer what they call global pricing, which is one price that includes both charges. That is easier for the consumer to understand.”

ProScan Imaging is a non-hospital-affiliated radiology center network headquartered in Cincinnati. Stephen J. Pomeranz, M.D., CEO and medical director at ProScan, explains that more patients are asking about costs for scans. “Today’s patients are more informed,” he explains. “They want to know how they can save healthcare dollars. But more important, they want quality care.”

Quality Care

Cincinnati resident Julie Hawkins was told by her family physician that she needs an MRI, and she’s scheduled an appointment with a non-hospital-affiliated radiology center. “I called and got some pricing from hospitals and non-hospital-affiliated radiology centers because I have a $5,000 deductible with my health savings account,” Hawkins says. “I learned that the costs were every bit of half what was being charged by many hospitals. With the economy and rising healthcare costs, I need to play a more active role in selecting my medical care. I need to be aware of how I am spending my healthcare dollars.”

Dr. Van Amerongen also recommends that patients ask imaging providers about payment options up front as payment terms with many independent imaging centers can be negotiated: “These options can make the difference between a patient being able to afford the scan, particularly when the out-of-pocket expense is very high, as with a health savings account.”

According to Workforce Management, a recent PricewaterhouseCoopers survey confirmed that patients’ out-of-pocket expenses continue to rise. The survey shows that 20% of the employers polled have imposed an in-network deductible of $400 to $999 this year, up from 17% last year. Another 11% of employers have imposed a deductible of at least $1,000, up from 8%.

Hawkins knows that her share of her medical expenses is likely to increase every year, with employers shifting more of their healthcare costs to their employees. “I have to take greater control of my healthcare spending without sacrificing quality of care. I’ve had an MRI at a non-hospital-affiliated radiology center a while back, and I have also had an MRI at a hospital. The quality is the same.”

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