For imaging, price transparency still absent

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Price transparency is an elusive object in Massachusetts, where a journalist could not obtain a clear price for an MRI, Kaiser Health News reported.

That is despite the fact hospitals in the Bay State will soon be subject to a new law intended to keep prices down by allowing consumers more access to cost data. Such laws could eventually spread to other states.

The journalist, Martha Bebinger of WBUR, tried to obtain a price for an MRI after suffering a series of migraines. She received quotes that varied widely, according to her account.

Massachusetts General Hospital quoted $5,315, but that was for an uninsured patient (Bebinger has low-deductible coverage). Shields, an independent laboratory chain, quoted between $2,000 and $3,600, depending on the use of dye contrast. However, its negotiated rate with insurers is a fraction of that rate, according to Bebinger.

Bebinger eventually obtained the test at Newton-Wellesley. The price for the diagnostic test was nearly $7,500.

"I wasn't ever able to find out how much of the charge for an MRI is based on 'real' costs--like cost of the machine or the salaries of the technician or doctor," Bebinger wrote in KHN.

According to new data from the Government Accountability Office, the mechanism of self-referring by doctors drives up the volume of such procedures. Those additional referrals cost Medicare about $109 million, FierceMedicalImaging previously reported.

And while Massachusetts law will eventually encourage patients to comparison shop, lobbyists for the hospital industry often fight price transparency measures in other states. In fact, only a dozen states have any form of hospital price transparency.

"We have the healthcare industry telling us to shop around, to be smart consumers, to make wise choices, and yet it's really difficult to do that, because we don't understand how hospitals set prices, and it can take hours to find a price," Bebinger wrote. "The whole pricing system seems very arbitrary. And we're left trying to make choices based on incomplete or wrong information."

To learn more:
- read the Kaiser Health News article

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