NCPA - National Center for Policy Analysis

Costs of Many Preventive Medical Exams Vary as Much as 700 Percent

April 9, 2012

A new report shows costs vary as much as 700 percent for some preventive examinations, and as the federal health care law increases demand for those procedures, it can mean an increase in premiums if employees don't pay attention to those costs, says USA Today.

  • Over the past year, health plans and self-insured employers began paying for wellness exams -- diabetes screening, mammographies, Pap smears and colonoscopies -- as required by the law, without charging consumers a deductible or copayment.
  • But in looking at 15,000 consumers, a research group has found cost differences of hundreds of dollars charged for the same tests.
  • Colonoscopy costs, for example, ranged from $786 to $1,819.

The U.S. Department of Health and Human Services predicted a 1.5 percent increase in premiums because of the new exam requirements.  Doug Ghertner, Change Healthcare president, says consumers will see a direct correlation between premium increases and their choice of health provider.  The "consumer is typically isolated from the cost," he says.  "People think they have zero financial responsibility."

  • Several factors affect prices: whether a provider is in a rural or urban area; whether the service is performed at a hospital, a doctor's office or an ambulatory clinic; and whether a clinic specializes in a certain procedure, such as a colonoscopy.
  • As demand increases, prices may continue to rise, Ghertner says.
  • Companies need to make the cost information available and provide an incentive for employees to seek less costly care for equal- or better-quality services, he says.

Insurance providers have looked at the issue.  Rachelle Cunningham, Regence Blueshield spokeswoman, says the health care company has provided a tool for customers to compare costs.

Andy Webber, president and CEO of the National Business Coalition on Health, a non-profit that works for health care reform, says consumers don't even ask about price because they're getting the service for "free," but also because doctor's offices don't list prices.  Employers should be asking their health plans and making sure that information gets to their employees.

Source: Kelly Kennedy, "Costs of Many Preventive Medical Exams Vary as Much as 700 Percent," USA Today, April 6, 2012.

For text:


Browse more articles on Health Issues