Strep Test Cost Confusion: A case study with details
Attached is another case study that reflects the utter confusion that healthcare consumers face… feel free to download. Page two is where the ironic humor is captured.
My favorite quote from a “supposed” physician in the case study who’s phone number was provided by the Insurer… “You have reached Veronica and ‘for the masters use…’”
SUMMARY
With the cost of healthcare continuing to grow, change:healthcare wanted to study a seemingly nondescript healthcare service as a snapshot indicator of how costs might impact consumers. We know that as companies shift a greater burden of the cost of employee healthcare to the employees – either through health savings accounts, high deductible health plans, or simply increased premiums — it’s important for employees to understand the impact of their healthcare purchase decisions. Consumers don’t appear to know the variations that exist in the cost of healthcare components. Our premise: if this is true for something as simple as a strep test – which families “purchase” many times during “the season,” — one can only imagine the cost variances for more significant tests, procedures and providers.
RESULT
Of the 13 providers contacted, two were incorrect numbers given by the insurer. One provider did not answer their phone. The staff member at a fourth location quietly suggested the caller take his wife to a retail walk-in clinic, which, according to them, would probably provide the least expensive care. A fifth provider said the caller had to first establish a primary care physician at their clinic before his wife could receive their strep test.
Of the other eight providers, the costs swung dramatically — and seemingly cavalierly — from a low of $50+ at one provider to a range of $152-$259 at another, a swing of 49%. The low was based on a sliding scale formula that involved family income/number of people in the household/and the specific services the physician would have to provide. The high cost provider was not explicit, except to say that the caller “would probably have an office visit around $150, plus $44 for the strep test.” At one point in that conversation, the cost hovered around $259.
Here’s the Case Study for Download… streptestcasestudy2.pdf
[…] The second survey involved looking at the cost of a simple medical test for streptococcus infection, the sort of thing anyone with a sore throat and a fever might need. Here, change:healthcare not only found wide price gaps among 13 different Nashville-based healthcare providers — all selected randomly from a list of general practitioners produced by a major insurer — it was actually unable to get information from five of them for a variety of reasons. (Two phone numbers were incorrect, one office turned out to be a sleep-disorder center, another suggested a walk-in clinic, and the last insisted that the caller select the doctor as a primary care physician before they’d provide the test.) The cost of the test ranged from a rough estimate of $50 to potentially as much as $259. The full study is available here. […]