Patients' out-of-pocket expenses up 123% for some imaging modalities
Patients’ out-of-pocket expenses have climbed exponentially in recent decades, with some imaging exams costing 123% more today than in the year 2000 [1].
Mean out-of-pocket costs have risen by 89.8% from 2000 to 2019, with some exams hitting patients in their wallets more than others. This and other revelations, including what factors impact OOP expenses the most, were shared recently in the Journal of the American College of Radiology.
The new paper’s corresponding author Gelareh Sadigh, MD, with the University of California Irvine, Division of Neuroradiology, Department of Radiological Sciences, and colleagues explained that although increased imaging utilization has been a driver of rising healthcare spending, recent payment cuts have placed medical imaging at the bottom of the long list of contributing factors. Nevertheless, Sadigh and colleagues suggested that medical imaging still represents a financial burden to many patients, stating that “more recent concerns have been raised about how increasing co-pays and deductibles for imaging contribute to patient financial hardship.”
After analyzing 229,010 imaging-focused encounters, the researchers found that mean costs for mammography, general radiography and US increased 14.5%, 24.5% and 40%, while CT and MRI costs decreased by around 15%.
This did not, however, decrease patients’ OOP expenses. In fact, OOP expenses skyrocketed for all these modalities except mammography, for which a decrease in OOP costs was observed (this is likely attributed to more widespread screening guidelines and coverage mandates). The authors shared that mean OOP costs for radiography, US and CT/MR increased 81%, 123.2% and 61%, respectively.
Higher OOP costs were more common in younger patients, those without insurance and individuals with a history of cancer and other comorbidities. Older patients, racial/ethnic minorities, women and those on public insurance only (versus private) were observed to have lower OOP expenses.
Recent studies have shown that patients are increasingly worried about their OOP expenses, causing some to forego necessary imaging completely and others to go into medical debt to follow doctors' orders. The authors of this study highlighted several strategies to help mitigate the issue without sacrificing patient outcomes, including screening patients for financial fragility during the exam scheduling process. However, they maintained that more widespread efforts are needed to address the “financial toxicity” in these vulnerable populations.
The study abstract can be viewed here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.