Shopping for an MRI
Most of us comparison shop when we need a new appliance, computer or car. But for the first time, I've tumbled into the new experience of comparison shopping to find the best deal on the cost of my medical care. I have been utterly shocked by what I've discovered so far.
With a weeks-old Health Savings Account, my doctor determined I needed a diagnostic MRI of my head to identify the cause of a recent bout with headaches and facial numbness. The nurse referred me the lab they usually use in an adjacent building. With a $2,500 deductible, I knew I'd be covering the MRI cost from my HSA, so I needed to find out just how much this was going to cost me.
When the lab told me it charges $2,500 for the type of MRI I needed, I briefly lost my ability to breathe.
With a few more questions, however, I found their insurance company "negotiated rate" was $1,500. But, if I just wanted to pay cash and file my own insurance paperwork, the price was a mere $1,000. For that $500 savings I was more than willing to get a stamp and an envelope and fill out forms.
Taking this hunt a step further, I got the name of a second lab from the doctor's office. Lab B was just a couple of miles away and offered the same selection of diagnostic MRIs, X-Rays, mammograms, etc. as Lab A. A call and a transfer to an extremely helpful operations director for pricing and I found the self-pay (cash) rate for the appropriate MRI was $600. Yep, $600. This was sounding like a fire sale bargain since I started out nearly two grand higher. Then "Joan" told me the negotiated insurance company rate was just $613 (radiologist's fee included), meaning if I paid just $13 over the cash rate, they would file the insurance paperwork and the expense would count against my deductible. They even agreed to let me split the cost over two payments.
When I shared with Joan my outrage over the huge disparity in pricing for the same test, she informed me that if I were to get the MRI across the street, inside the hospital itself, I could expect to pay between $3,000 and $4,000 dollars. So the price range is $600 to $4,000 for an MRI in the same North Dallas neighborhood.
If you must pay part or all of your medical costs through high deductibles, low deductibles, or with no insurance at all, the time has come to start asking questions, making calls and exploring options.
I can't make a dent in national health care policies but what I can do is make a huge difference in what my health care costs me this week and the next year, by shopping around for the best medical option available. I would urge you to pipe up to your doctor, pick up the phone and do the same. It's not as much fun as computer shopping but a great deal more important for you and your family in the long run.
One more piece of evidence that the behavior of patients is different when they are paying the bill.
Try “Shopping for Surgery” and check prices, outcomes, and service levels at hospitals outside the U.S. The world is not flat, and in your situation neither is the neighborhood.
As more people experience high deductables, and higher copayments and as more people acquire HSAs and HRAs, I think we may start seeing a real market develop for this type of medical service.
In all probability, MRI centers will start competing based on price. Then, as john Goodman predicts, they will compete on quality as well. This should go a long way toward solving the problem Gina Kolata writes about.
Two years ago I had the eye-opening opportunity to shop around for the true price for an MRI of he knee. Frustrated by the lack of transparency and unwillingness of providers and my insurance plan to tell me my out-of-pocket price for an MRI, I decided to do something. I developed http://www.outofpocket.com, a community search engine to help consumers look up prices for health care services, compare what other consumers paid for similar services and find the best value – before visiting a provider. Because insurers and providers do not publish prices in a meaningful way, the initiative relies on consumers to post/share prices they paid for actual services, to share with other consumers. It’s a “compare & share” directory of prices for routine health care services including MRIs, x-rays, mammograms, lab tests, vaccinations, office visits, dental and vision services.
I invite you to visit http://www.outofpocket.com and welcome any comments you would like to share.
Mona Lori
Founder
http://www.outofpocket.com
Business Week has never been very friendly to consumer driven health, but a recent article by Lauren Young is a step in the right direction. She starts out with an anecdote about a Tom Billet who needed an X-ray for a torn Achilles tendon, so shopped around and saved $360. All because he has an HSA. It goes on to describe "the good, the bad, and the ugly" of HSAs.
That’s great! Where can I get more information?
At my facility we charge only 500 dollars for a non contrast MRI study. It is a special reduced rate for patients who pay out of pocket. We usually ask that the patient pay this up front but we will accept a payment plan. We do this and offer the best MRI in the world – 3T MRI which generally costs more – because the machines cost 3 million dollars – because we care and we focused our entire facility to reduce our own operating costs. We have low overhead so we can pass that on to the intelligent and discerning patients. http://www.mriconsultants.net
As a family doc in Tennessee, I encountered this problem in my practice. After 20 years, I decided to try and make a difference with high costs to cash paying patients by starting my own company that negotiates these deals—-Samaritan Diagnostics, sdsaves.com. We have centers in the Dallas/Fort Worth area and our services and locations are expanding every day.
>> One more piece of evidence that the behavior
>> of patients is different when they are paying
>> the bill.
Or another piece of evidence that medical care providers are willing to rape the system and over-charge when they CAN but they are reasonable with prices when they have to be accountable to a person. Not sure how that is the customer’s issue to be singled out for with your finger wagging.