Price Transparency, Increased Cancer Screening Could Drive Down Costs

The health care industry, including the medical imaging sector, has been focused on reducing clinical expenses for both hospitals and patients. But how much do these exams truly cost?

NPR reported that a new law in Massachusetts, which went into effect in October, allows websites that mine medical data to reveal pricing for a range of services, such as traditional physical checkups and diagnostic tests to extensive blood work and digital imaging procedures. Health insurers are required to make all of their prices public ahead of appointments, rather than billing patients once exams have been completed and filed.

"This is a very big deal," Barbara Anthony, undersecretary for consumer affairs in Massachusetts, said to NPR. "We are letting the light shine in."

The online tools help patients calculate their costs based on the insurance plans they purchased. While it is critical for patients to understand exactly how much an MRI or CT scan will run them, the numbers are important for radiologists and practices, too. They can compare rates for their procedures to local competitors and adjust any protocols accordingly.

For example, in Boston, an MRI of the upper back can range from $614 to $1,800, depending on the facility. In this case, the most expensive procedure is done at Boston Children's Hospital, while the cheapest is available at New England Baptist, an orthopedics facility.

Knowing the true cost of various exams can help both patients and doctors make informed decisions on ordering tests that might be unnecessary. Eventually, these online tools could contribute to significant reductions in spending.

CMS approves CT lung cancer screening for seniors
Often, physicians who order special exams for patients who they believe are at high-risk for developing cancer. Until recently, however, Medicare beneficiaries were not eligible for CT lung cancer screenings, according to recommendations from the U.S. Centers for Medicare and Medicaid Services.

AuntMinnie.com reported that CMS has approved these procedures for Medicare recipients, citing scientific evidence that justifies screenings for high-risk individuals until the age of 74. The decision marks a major victory for patient advocates, as lung cancer is one of the most fatal malignancies in the U.S., killing more than 160,000 people each year.

"The time is now to move forward expeditiously in bringing the lifesaving benefit of lung cancer screening to those at risk – including our seniors. We are confident that the progress we have seen in the technology, protocols and the ability of radiologists to detect lung cancer at its earliest stage will translate into tens of thousands of lives saved," Laurie Fenton Ambrose, president and CEO of screening advocacy group Lung Cancer Alliance, said to AuntMinnie.com.

To be eligible for the procedure, patients must be 55 to 74 years of age, be asymptomatic with no signs of lung disease, have a smoking history of at least 30 pack-years, and either currently smoke or quit within the last 15 years. According to CMS, physicians who perform the exams must be board-certified, accredited and experienced in lung cancer screening reading.

In addition, any facilities that offers the tests have to maintain standards established by the National Lung Screening Trial. These institutions must have either participated in previous trials or be an accredited diagnostic imaging center with experience in low-dose CT. The NLST screened more than 53,000 smokers and, in 2010, reported a mortality reduction of 20 percent when cancers were detected with CT and treated.

The addition of CT lung cancer screening for Medicare recipients and pricing transparency could lead to significant financial benefits for both patients and doctors alike. The costs of health services might drop significantly as more individuals review prices before agreeing to exams.

Contact Viztek for more information.

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Ronny Bachrach

Marketing Director at Viztek LLC

Responsible for all marketing activities including, press, advertising, trade show coordination, website management, dealer and customer communications.