Patients with high-deductible health plans can save more money paying a discounted cash price than by billing their insurance for a colonoscopy, according to a three-hospital case study published in Health Affairs.
For the study, researchers sought to better understand how new data about hospital discounted cash prices may lead to patient savings. Under the new CMS price transparency rule, hospitals are required to disclose this pricing data.
The researchers noted that this new pricing data may allow consumers to shop for care, but said that widespread usability is still unknown. The study aims to start answering questions about usability.
For the study, researchers selected three hospitals deemed compliant with the CMS price transparency rule: Massachusetts General Hospital in Boston, the University of Michigan Health System in Ann Arbor and Vidant Medical Center in Greenville, N.C. The study authors specifically focused on posted cash prices and negotiated commercial and public rates for colonoscopy and magnetic resonance imaging of a lower limb joint, two shoppable and common procedures.
The study found that if hospitals honor posted discounted cash prices, insured patients in high-deductible health plans who need an outpatient colonoscopy may have saved as much as $569 at Massachusetts General, $1,715 at University of Michigan Health System and $761 at Vidant Medical Center by using the self-pay price instead of billing their insurance.
For the MRI, compared to the standard commercial rate, self-pay prices are $878 less at University of Michigan Health System and $304 less at Vidant Medical Center. The discounted cash price was higher than the standard commercial rate at Massachusetts General.
“While there are many questions yet to answer, we believe that discounted cash price could potentially be of great utility to patients,” study authors said. “As such, researchers and policy makers should not discount this new discounted cash price data and instead work to validate it.”