One expert who was not connected to the study is skeptical about the practicality of additional training regarding the costs of imaging. “We have enough of a problem with teaching the appropriate imaging studies for non-radiologists that the financial aspects never reach the discussion,” Dr. Elliot K. Fishman of Johns Hopkins Hospital, told Reuters Health in an email.
He agrees, however, that “better ways to inform our colleagues and ourselves about the costs of imaging” are needed. Perhaps, Dr. Fishman suggests, institutions could develop computer-based training programs on financial issues in medicine and update them yearly to reflect changes in reimbursement.
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2 Responses to “Residents and Fellows Don’t Know Costs of Imaging Exams”
September 11, 2016
LouisThe authors don’t seem to appreciate that there is a difference between the “cost” of a study and the “price” of a study. Cost refers to the direct and indirect monies incurred in providing the good or service. Price is what the consumer is charged.
The cost of providing the service is typically heavily weighted by the fixed or allocated costs such as rent, heating, salaries, maintenance, insurance, depreciation. These costs are constants and are not influenced greatly by the number of studies performed, but are typically allocated to the department providing the service. The more studies the department provides, the smaller the allocated fixed cost per study. The variable cost of each study is typically quite small and includes consumables such as electrical kWh and intravenous contrast agents.
The price to the consumer of the study is somewhat influenced by the fixed and variable cost of providing the study but can vary widely due to differences between insurance plans which may pre-negotiate these charges. A Medicaid or Medicare consumer will pay a very different price compared to a self-pay or privately insured individual.
Part of the reason providers don’t know how much their patients are charged for radiology studies is because there is such complexity and variability to the pricing decisions that there is no correct answer to the question.
September 11, 2016
Jeff CortazzoThe problem isn’t the ‘cost’ – it’s the charges. Our community hospital has listed charges for all CT studies obtained from the ED of over $5000 each, with higher charges for any truncal scans with contrast. Of course this doesn’t mean that they get paid those amounts, but this is one quirk of the American medical charge/cost/billing system: they heavily discount charges for big 3rd party payors (Blue Cross, etc) and government payors (Medicaid and Medicare), but do not discount charges for those without medical coverage or insurance.