The latest quarterly Healthcare Transparency Index from health education and engagement platform vendor Change Healthcare shows nine medical procedures with high costs and price variances as high as 796 percent. Even within a given network, the organization says charges for pharmacy, medical and dental services often vary by more than 300 percent.
Imaging services were the leading potential area for cost reduction opportunities for plan sponsors and consumers. From an analysis of a database including more than 180 million insurance claims from Q4 of 2013, Change Healthcare found CT scans varied 796 percent from $307 to $2,747 per scan, with an average cost of more than $1,200. In addition, ultrasound costs cited in the report varied by 411 percent.
Report findings also included inconsistent pricing for vaginal and Caesarean section deliveries. Vaginal deliveries, ranging 189 percent from $4,359 to $12,613 per delivery, were labeled as a high-cost and high-variance service. Meanwhile, as the prevalence of C-section deliveries increases--60 percent since 1996, according to the National Center for Health Statistics--so does the variation in cost, which currently runs from $6,680 to $17,619 per procedure.
Five preventive services mandated by the Affordable Care Act and provided without charge to consumers were named in the report as opportunities for targeted interventions, particularly among the public and private insurers and employers who are now absorbing all costs associated with these tests and procedures. A standard office visit with diabetes screening ranged in price by 300 percent, while a mammogram screening showed a 193 percent price variation. Other mandated services included in the report include a screening colonoscopy (189 percent price variation), office visit with lipid screening (183 percent price variation), and an office visit with pap smear (93 percent price variation).
The source of the healthcare cost data is the aggregation of in-network medical and dental claims from credentialed providers across all Change Healthcare clients, which has geographic coverage that spans nationally and covers more than 7 million people.
The report can be downloaded here.
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