Patients drive past lower-cost MRI options even after price shopping
Patients saddled with high out-of-pocket costs and access to a price transparency tool still didn’t do much price shopping for their MRI exam, according to an analysis published in the Journal of Health Economics.
Health policy experts pored over data from a large, private insurer representing some 50,000 MRI scans. Each individual looked up prices before making their appointment yet, on average, drove past six providers offering a cheaper lower-limb exam compared to the location they were ultimately treated at.
Such MRI scans are among the least likely healthcare services to vary by quality, are somewhat expensive, and can be scheduled in advance, the authors noted. Therefore, they should be a top candidate for price shopping. But this proved to be far from the truth.
“We show that despite having access to a price transparency tool and often significant out-of-pocket cost exposure, patients consuming planned lower-limb MRI scans leave significant money on the table when receiving this undifferentiated service,” Michael Chernew, PhD, with Harvard Medical School and the National Bureau of Economic Research, and colleagues explained.
Each patient—ages 19-64—included in the study could personalize out-of-pocket searches under their private insurance plan. The median individual had 16 MRI provider options within a 30-minute drive of their home.
Participants contributed $306.86 toward their MRI, on average, Chernew et al. reported. And the average hospital-based exam came in around $1,475, with those performed outside hospital walls running $644.
All in all, if patients sought out lower-cost centers within the distance they had already traveled for an exam, they could have slashed their own expenses by $84.37 (27%) and helped insurers save $220.49 (40%).
It may be easy to pin blame on patients in this case, but Chernew et al. noted physicians must also be held accountable.
A “crucial” finding, they explained, is that in order to lower total MRI spending and their own cost burden, patients must stray from their physicians’ established referral pathways. Meaning such doctors are likely crucial to cut imaging spending, along with the payors incentivizing care.
“Though targeted programs and benefit designs such as reference pricing or rewards programs may alter treatment locations, our results suggest the need for policymakers and, in particular, insurers to incentivize physicians to make more efficient referrals, and for firms to steer patients towards physicians who make efficient referrals,” the authors concluded.
Read more from Chernew and co-authors 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.