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Rock-Bottom Cash-Only Imaging Prices Spread

May 30, 2012
Written by: , Filed in: Abdominal Imaging, Practice Management
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How much does an abdominal CT scan, with contrast, cost at a Southern California hospital? $4,423? $2,400? Or $250?

The answer: Any of the above, depending on how you pay. An article in Sunday’s Los Angeles Times details the spread of super-low cash prices for imaging and other health-care services—available only to patients don’t use their health insurance.

The Times cited the example of the Los Alamitos Medical Center in Los Alamitos, California, south of Los Angeles. On a state Web site where hospitals list the prices they charge for various procedures, the medical center says it charges $4,423 for the abdominal CT scan. Health insurer Blue Shield of California said its negotiated rate at the hospital was about $2,400. But when the Times called to ask about a cash price, the hospital said it was $250.

At Long Beach Medical Center in Long Beach, chief financial officer John Bishop said the hospital charges insured patients more to subsidize indigent care and low Medicaid reimbursements. He told the Times:

We end up being forced to charge a premium to health plans to make the books balance. It’s a backdoor tax on employers and consumers.

In 2010, Long Beach Medical Center charged 57-year-old hair salon manager Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. Snyder’s insurer, Blue Shield, has a negotiated rate of $3,497, but she still had to pay $2,336 of that. Then she learned that if she had paid cash instead of using her insurance, the charge would have been $1,054.

When she received a similar scan in 2009 at Liberty Pacific Medical Imaging in Long Beach, she had to pay only $660.

Snyder is suing Blue Shield, accusing it of unfair business practices, breach of good faith, and misrepresentation. A spokesman for Blue Shield said the suit had no merit and that the insurer, which is nonprofit, negotiates the best rates it can.

Cash discounts have spread in recent years, partly because of criticism and regulations over higher prices charged to low-income patients than to those with insurance. Hospitals, the Times said, see getting patients to pay upfront as a way to boost revenue by avoiding the costly and uncertain bill-collection process.

Paul Keckley, executive director of the Deloitte Center for Health Solutions, a research arm of the massive accounting firm Deloitte LLP, told the Times:

It frustrates people because there’s no correlation between what things cost and what is charged. It changes the game when health care’s secrets aren’t so secret.

Efforts in many states to force health care providers to post price lists for their most common procedures have met fierce resistance from the providers. “The insiders in the health care industry don’t want to lose control over this information,” Keckley said. “But price transparency is inevitable.”

We’ll see.

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Related seminar: Abdominal and Pelvic Imaging: CT/MR/US

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