Most health-related tests and procedures aren’t exactly what you’d consider to be small, everyday expenses, are they? No matter your health coverage, these are typically things we need to plan for in advance and factor into our budgets. So, if it’s common practice to shop around for other big purchases – I’m talking anything from a new appliance to a cross-country flight – why aren’t we doing the same for our health care?
In the realm of self-funded plans, we are doing those price comparisons. Together, we and our vendor partners are being proactive about investigating – and comparing – the costs of things like scans and surgeries, and we’re developing tools that allow members to do this homework, too.
Here’s what we’ve continued to find: there’s a huge cost variance in the same tests and procedures when they’re performed at different locations. More specifically, something as common as an MRI, CT scan or ultrasound is often billed according to one rate at a clinic, but may cost thousands more when it’s performed inside a hospital, and yet another rate at a different hospital or clinic.
These price discrepancies aren’t limited to big cities or concentrated in certain parts of the country … they’re happening all around us, everywhere.
How can we avoid them? The first step is to better educate the end user about the fact that this variation in health care costs does exist. As TPAs/ benefit administrators, we also need to establish partnerships and provide resources that help our members make the most informed decisions by shopping around to find the best care at the best price.