Cash pay may be better option for insured patients

Hospital acquisitions and pricing may contribute to trend
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Individual patients may fare better financially if they pay for out-of-pocket for some services, rather than allowing their insurance to cover it, The Street.com has reported.

Patients who offer to pay cash--an option usually reserved for those who lack health insurance--may wind up paying just a fraction of the cost for the service if they used their coverage, according to The Street.  It noted that as many as 80 percent of Americans fail to meet their annual insurance deductibles.

"If you are like many consumers, you are a long way from meeting a deductible of $4,000 or $6,000, so using your insurance to pay for a $300 ultrasound instead of paying $111 yourself offers no financial gains," the article said.

The article did note that such a practice should be avoided for major medical procedures such as surgeries, which often involve multiple providers and services, leading to a far heftier bill than for a single test or simple in-office medical procedure.

The issue of pricing has come to the fore for ancillary services such as imaging, particularly as many hospitals have purchased imaging centers and other businesses--such as medical practices--and systematically raise prices. The impetus behind the purchases is increased competition among providers, particularly as healthcare delivery becomes increasingly more value-based.

Yet such providers are also often averse to publishing prices, because price transparency tends to drive down what they can charge for imaging. And consumers, even if they shop around for pricey services such as MRIs, may wind up with an image that is not good enough for their doctor to use.

To learn more:
- read the article

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