70% of patients pay some out-of-pocket costs for their neuroimaging: ‘Systematic changes are needed’
Neurology patients are paying more out of pocket for their MRI exams and office visits compared to 15 years ago, according to a recently published study. The findings underscore the need for broad changes to help alleviate these ballooning costs.
That’s what researchers at the American Academy of Neurology discovered after analyzing costs for more than 3.7 million privately insured people, imaged between 2001 and 2016. The authors found that out-of-pocket expenses for neurophysiologic testing, doctor visits and neuroimaging all increased over the study period and noted that patients are increasingly on-the-hook for a larger share of such costs.
Patients' MRI exam expenditures, for instance, increased from $84 in 2001 to $242 at the close of the study. And those with private insurance covered 7% of their exam, on average, at the study’s onset compared to 15% by 2016.
"This trend of increased out-of-pocket costs could be harmful, as people may forgo diagnostic evaluation due to costs, or those who complete diagnostic testing may be put in a position of financial hardship before they can even start to treat their condition," Chloe E. Hill, MD, MS, of the University of Michigan’s Department of Neurology, said in a statement. "What's more, right now neurologists and patients may not have individualized information available regarding what the out-of-pocket costs might be to make informed decisions about use of care."
For their study, Hill et al. used a large, privately insured claims database to assess inflation-adjusted out-of-pocket expenses for evaluation and management (E/M) visits, neuroimaging, and neurology testing. E/M visits accounted for a majority of services at 78.5%, with MRI making up 5.3% and electroencephalograms 4.5%.
Out-of-pocket costs varied across patients and tests, the authors noted, but patients’ share for each grew during the study period. For MRIs, 24% of people paid out of pocket in 2001, compared to 70% in 2016.
Additionally, those with high-deductible health plans were more likely to both be on the hook for a portion of their neurologic care and see those expenditures increase. In 2001, there were no people enrolled in such plans, but that figure rose to 11% by 2016.
It’s not a big surprise, as previous studies have shown the costs of neurologic medications are also rising. But it is concerning, the researchers warned.
"Costs have risen to the point where systematic changes are needed,” James C. Stevens, MD, President of the American Academy of Neurology, said. “These changes could include legislative action to place a cap on out-of-pocket costs. The American Academy of Neurology is advocating for such caps on out-of-pocket drug costs in Washington, D.C."
Read the full study published Dec. 23 in Neurology here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.