Shopping for a CT scan can save $100 or more

When patients shop for lab tests, scans and other medical procedures, they save money – an average of $125 on expensive imaging services, for example, according to a study that evaluated consumer price comparisons for U.S. health services for the first time.
It’s a common-sense result that economists have long predicted, yet many U.S. doctors and hospitals have resisted price transparency that could have a meaningful effect on the nation’s health care spending. While consumers compared prices for some services, the study didn’t determine whether they could evaluate the quality of the providers when making decisions.
Workers who used a price-comparison tool from Castlight Health Inc. saved as much as 14 percent on scans and tests compared with those who didn’t, according to data published Oct. 21 in the Journal of the American Medical Association. Researchers said it’s the first scientific study of the savings potential from services such as those from San Francisco-based Castlight.
“In virtually all other areas of commerce, consumers know the price and much about the quality of what they intend to buy ahead of the purchase,” said Uwe Reinhardt, a health economist at Princeton University, in an editorial accompanying the study. Patients, though, go “blindfolded into the bewildering U.S. health care marketplace, without accurate information on the prices likely to be charged.”
The U.S. spent $2.8 trillion on health care in 2012, 17.2 percent of the nation’s gross domestic product, according to the U.S. Centers for Medicare and Medicaid Services. The study may have implications for workers as employers increasingly shift responsibility for shopping for health care coverage and paying for it onto their employees. Insurance plans featuring high deductibles and savings accounts – often called “consumer-directed health plans” – are becoming more common. Without tools to help employees shop for care, they’re little more than rationing, said Neeraj Sood, director of research at the University of Southern California’s Leonard D. Schaeffer Center for Health Policy & Economics.
“If those are the only two features, a high deductible and a health savings account, then there’s nothing consumer-directed about them,” he said. Sood was the senior author of the study, which examined a half-million workers at 18 large employers.
Castlight had sales last year of $13 million. Its 130 customers include Wal-Mart Stores Inc., according to data compiled by Bloomberg. The 18 companies included in the study weren’t identified.
Employees saved the most on expensive imaging tests, and much less on visits to the doctor’s office.
People who used the Castlight tool to price shop for lab tests saved about 14 percent on average, or $3.45 per test. Savings for advanced imaging services were 13 percent on average for people who shopped first, or $125. Savings for physician visits were just 1 percent, or $1.18, for those who shopped, suggesting that patients considered factors other than price when selecting doctors, such as convenience or familiarity, Sood said. •

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