By Consumers For Quality Care, on May 6, 2019
What should a metabolic blood panel, one of the most common medical tests, cost? How much will a consumer end up paying for the test? Unfortunately for consumers, both of these questions are often unanswerable according to a new analysis. The study, reported by The New York Times, highlights the overwhelming price fluctuations in health care.
The research found that metabolic blood panels can cost as little as $11 or as much as $952. In the Tampa, FL market alone, the price of the tests can vary by up to 40 times the cost of the least expensive test. Price swings that large are unheard of for other types of products.
“It’s shocking,” said Amanda Starc, an associate professor at the Kellogg School of Management at Northwestern, who has studied the issue. “The variation in prices in health care is much greater than we see in other industries.”
Beyond the large price variations, its often impossible for consumers to anticipate what the tests will cost before they are conducted. Due to negotiated insurance rates, list prices posted by hospitals’ websites often aren’t helpful indicators for what consumers pay at the end of the day. Instead, these negotiated rates are closely held secrets between insurers and providers.
Some insurance companies provide consumers with tools to help steer them away from the $450 test, but in many cases you won’t know the price your insurance company agreed to until you get the bill. If you have an insurance deductible, a $400 — or even a $200 — bill for a blood test can be an unpleasant surprise.
The study, conducted by the Health Care Cost Institute, found that the prices for one test or procedure can vary widely in different markets and that the prices between providers within an individual metro area can also widely vary. Because consumers continue to face higher deductibles and shoulder greater shares of their insurance costs, these price variations impact them too, not just insurers.
Economists say that competing market powers – due to both insurers and providers having large amounts of sway – contribute to the wide variance in pricing for even simple procedures like the blood test. Consumer advocate Jeanne Pinder says that the procedures with the most stable pricing are those that insurance does not cover, forcing consumers to pay cash price, like Lasik eye surgery, Botox, and teeth whitening.
“When you get into M.R.I.s, ultrasounds and blood tests, they are crazy,” she said. “The secrecy in pricing all over this marketplace encourages this behavior.”