February 3, 2015 – A new data brief from the Health Care Cost Institute (HCCI) examines how much consumer medical care prices vary for certain elective procedures and demonstrates how much consumers could save out of their own pockets by shopping for care. The HCCI analysis shows that consumer out-of-pocket spending for common health care procedures can vary from $10 to nearly $1,000 depending on the procedure.
Janet Firshein, 301-280-5701
Bethanne Fox, 301-448-7411
HCCI Data Show Potential Financial Benefits
Of Shopping For Health Care Services
Report Shows Out-of-Pocket Burdens Are Growing; Potential Savings Exist
Washington D.C. – A new data brief from the Health Care Cost Institute (HCCI) examines how much medical care prices vary for certain elective procedures and demonstrates how much consumers could save out of their own pockets by shopping for care. The HCCI analysis shows that consumer out-of-pocket spending for common health care procedures can vary from $10 to nearly $1,000 depending on the procedure. With overall out-of-pocket spending rising, the results show that there are real opportunities for consumers to save on health care if they have price information to make better decisions.
“Today, consumers are flying blind when it comes to health care prices. They don’t know what they are buying or how much it will cost,” says HCCI Executive Director David Newman. “This brief is meant to help consumers see not only how much they could have to pay out of pocket but how much they could save.”
The HCCI report is based on data from actual amounts paid for health care services and looks at two things: 1) the amount of per capita out-of-pocket spending rates at a national and state level; and 2) average differences in consumer payments nationally and in nine states: Arizona, Colorado, Florida, Georgia, Maryland, New Jersey, Ohio, Texas, and Wisconsin for a set of five common medical procedures.
HCCI looked at consumer spending variations for: office visit for the evaluation of a new patient, colonoscopy, cataract removal, lower leg MRI; and ultrasound for pregnancy. In 2013, on average, consumer payments for a new doctor visit varied by $19 nationally, as little as $10 in Arizona and $12 in Colorado, and as much as $35 in Wisconsin. However, variations were much higher for surgical procedures. Consumer out-of-pocket payments for cataract removal varied by $444 nationally. Within states, variations were larger: in Wisconsin, consumer payments varied by $989 and in Georgia, consumer payments varied by $490. The variation in consumer out-of-pocket payments for a lower leg MRI was $342 nationally; in several states, including Ohio, Texas, and Wisconsin, payments varied by more than $410.
HCCI’s data brief: Shopping for Health Care Makes “Cents” for Consumers highlights the need for understanding the prices of health care services. HCCI’s Newman says their data show how important price and quality information will be to help consumers shop in a more informed way.
According to HCCI’s report, in 2013, an adult consumer with employer-sponsored insurance (ESI) paid more than 15 percent of their medical bills out of pocket, about $700 a year. That’s up 6.9 percent from $662 in 2012. Although the burden is higher in some states and lower in others, there is a clear trend of rising out-of-pocket spending on health care.
“The lack of transparency of medical prices is a growing problem since consumers are financing a larger and large proportion of their care,” adds HCCI’s Newman. “Although the savings for a physician visit may be minimal, for other procedures like cataract removal or an MRI, the potential savings could be a substantial benefit to many households,” he adds.
Last year, HCCI announced it will be launching a new transparency tool that will provide national, state, and local information to help consumers shop and make more informed choices about how they spend their health care dollars. The first version of that tool – which will be available to everyone, regardless of whether they have insurance or who their insurer is – is slated to go live in early 2015.
HCCI’s data brief: Shopping for Health Care Makes “Cents” for Consumers and accompanying state and national data chart packs will be available here.
About the Health Care Cost Institute
The Health Care Cost Institute was launched in 2011 to promote independent, nonpartisan research and reporting on U.S. health care spending and utilization. For more information, visitwww.healthcostinstitute.org or follow us on Twitter @healthcostinst.