Referral-based specialties charge highest markups over Medicare rates

Diagnostic and interventional radiologists are among the specialists who, on average, charge the highest fees above Medicare rates, according to Johns Hopkins researchers.

Their study was published online Jan. 17 in JAMA.

A news release sent by Johns Hopkins to publicize the study says that, after anesthesiologists—who charge six times what Medicare pays—the other highest-markup specialists are interventional radiologists (4.5 times over Medicare), emergency medicine doctors (four times), pathologists (four times), neurosurgeons (four times) and diagnostic radiologists (3.8 times).

One problem explaining the effect: Patients tend to adhere to referrals for these specialties without checking to make sure they’re “in-network.”

The findings “suggest that patients should be vigilant in choosing doctors who are in their network whenever possible, and policymakers should find ways to protect patients from ending up with surprise medical bills,” according to the release.

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Dave Pearson

Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.

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