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Wednesday
May012019

Costs for exact same medical procedures vary dramatically in different hospitals, study says

STOCK PHOTO/Getty Images(NEW YORK) -- Go to Toledo, Ohio, and the median cost of a simple blood test will run you a reasonable $18. But what if you live in Beaumont, Texas? You'll be ponying up $443 -- nearly 25 times as much.

Those numbers come from a new study released by the Health Care Cost Institute on Tuesday. The institute created something they call the Health Marketplace Index, a measurement of how much a service costs using the sum of what an insurer covers and the patient's out-of-pocket expense. And it found wildly different prices depending on where in the country you go to get medical procedures.

The study looked at a number of procedures to come up with comparisons: two types of child birth (vaginal or C-section), two commonly performed lab tests (a blood test and a mammogram) and two types of office visits (for established patients or for new patients).

The study looked at 1.8 billion health care claims in order to come up with its statistics.

The discrepancies are, in some cases, shocking.

In the Bay Area, which scores some of the highest prices regardless of service, the median cost of a C-section was $20,721. In Knoxville, Tennessee, the exact same C-section has a median cost of $4,556.

In general, costs were higher on the East Coast and West Coast than in the middle of the country, but even that was no guarantee. While costs in Boston were 14% above the national median in 2016, Providence, Rhode Island, just 50 minutes south, is 12% below the national median.

San Jose, California, and Anchorage, Alaska, tied for the highest overall price level (about 82% over the median), while Baltimore had the lowest (about 26% below the median), according to the study.

Even going to different hospitals within the same metro area could vary. The lowest cost of a vaginal birth in the Boston-Cambridge region was $4,701 while the most expensive was $15,973 -- more than three times as much. In Tampa, Florida, a blood test can cost you $11 -- or $440.

There have been some incremental changes in helping patients learn what they will pay for a hospital stay. A new federal law went into effect in January that required hospitals to post the costs of medical procedures online.

But, as the HCCI study shows, you'll have to do a lot of compare and contrast work to know what costs are around the country.

The Department of Health and Human Services and the Trump administration have tried tackling the confusion around medical costs, though mostly with a focus on prescription drug prices. One of the propositions, made by HHS last October, would require drug companies to put prescription prices in TV ads.

"The HMI – Price Index is an important resource for stakeholders to establish and benchmark prices in their areas in order to more accurately identify the drivers of high (or low) local prices, and for national policymakers considering ways to reveal or impact prices," the study concludes.

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