Don't Get Scammed By Diagnostic Imaging Costs

The healthcare system isn't broken. The system is working exactly as intended. It was never designed to benefit patients.

Some say the U.S. healthcare system is a broken mess. That could not be further from the truth. The reality is that the healthcare system runs precisely for how it has been designed. Sure, it is a perverse mass of bureaucratic red-tape, lobbyist amendments, and glaring misalignments of profits versus patient outcomes. But profit was always the point. 

It is no secret that Americans pay more money for worse healthcare compared to other developed countries. We spend over 17 percent of our GDP solely on healthcare. In 2015 alone, healthcare spending rose 5.8 percent from the previous year to $3.2 trillion, or about $10,000 per person. It has not improved since then. What does $3.2 trillion of healthcare spending buy you in the U.S.? 

According to the Institute of Medicine, that amount of spending gets you a nation full of individuals with "shorter lives, poorer health." The average American life expectancy is more than a year shorter than that of their OECD counterparts. We rank 70th out of 132 nations regarding overall health and wellness. 

We are dead last out of seven industrialized countries studied by the Commonwealth Fund and last again amongst sixteen industrialized peers for preventable deaths. Nowhere is this glaring misalignment of profit and patient outcomes more apparent than in the pricing of essential medical goods and services.

Legal Extortion

In every extortion case, two essential elements must be present: a threat and a payoff. The payoff is obvious. Nearly every segment of the healthcare industry is experiencing record-breaking profits. The threat itself is hidden and implicit, but ever-present and very real. Not obtaining the essential healthcare goods and services can lead to sickness, suffering, and death. As a result, it is all too easy for healthcare providers to "adjust" their pricing to reflect the life-or-death nature of the goods and services they offer. After all, people will pay almost anything to get better or for their loved ones to have better healthcare.

According to a study by the American Public Health Association (APHA), over half a million personal bankruptcies filed each year are the direct result of debt accrued because of a medical illness. The study even went on to incriminate the Obama administration's landmark Affordable Care Act (ACA), often referred to as Obamacare, for failing to significantly reduce the number of personal bankruptcies caused by medical debts. The study attributed the failure to mitigate healthcare-related bankruptcies to inferior health insurance products, such as high-deductible, low-coverage plans, which have grown in popularity in recent years.

For most healthcare professionals and patients keeping an eye on the healthcare landscape, this was the predictable result of allowing the ACA to be written by and for insurance companies who have reaped record profits since 2010. The big healthcare insurers, Aetna, UnitedHealth Group, Anthem, Cigna, and Humana, raked in nearly $36 billion in profits alone in 2019. Despite COVID-19 and resulting payoffs to hospitals and patients, insurers still doubled their earnings in the second quarter of 2020 compared to the same quarter last year.

The MRI Rip-Off: Anatomy Of A Scam

To understand just how brazenly extortionate the U.S. healthcare system has become, it helps to look at one specific healthcare segment that most Americans have some experience with: diagnostic imaging. Almost everyone has or will have to get an x-ray, MRI, mammogram, or CT scan at some point in their lives. Whether to visualize a broken bone, locate a tumor, or identify a hidden illness, diagnostic imaging exams are a foundational healthcare service. 

More than 3.6 billion diagnostic imaging exams are performed annually. In the United States, patients undergo 40 million MRIs every year. Diagnostic exams, such as MRIs are performed in hospitals, outpatient clinics, and specialized diagnostic imaging facilities every day and form an essential part of every healthcare provider's general practices. Yet, these commonplace 15-minute examinations often result in massive medical bills in the tens of thousands of dollars.

No rhyme or reason explains the wildly variable prices patients are expected to pay for MRIs and other tests, and that is precisely the problem. Almost all aspects of the healthcare process are designed to keep consumers in the dark. First, consumers are rarely told about MRI pricing or why they are being sent to a specific hospital or clinic. For their part, consumers rarely ask since most patients trust their provider or assume that their scan will be covered by insurance. Unfortunately, even patients with insurance often have cost-sharing responsibilities and are unpleasantly surprised by a ridiculous bill months down the line.

To make matters worse, many MRI providers negotiate their prices with hospital chains and insurance companies. These negotiated prices are considered trade secrets that are jealously guarded against public scrutiny. Opaque pricing practices make shopping around more complicated and make it easier to funnel consumers towards more expensive options.

Finally, the biggest trick in the book is to overcharge for incidentals. While most patients assume that the cost of an MRI includes time on the MRI machine, the technician's time, and the radiologist's time, what they don't know is that many incidentals also get rolled into the total cost. Many of these incidentals are never itemized, and thus, are hidden from scrutiny. 

Hospitals and clinics will charge contrast dyes, needles, image reconstruction, supplies, medications, laboratory tests, and many other so-called incidental items related to the procedure itself. This is where the really absurd markups come in. While most healthcare providers try to keep their pricing charts a secret, patients' bills reveal a world of preposterous upcharges. This includes $15 for Tylenol, $50 for a pair of latex gloves, $10 for a paper cup, or how about $629 for a Band-Aid! We have even seen $24,000 dollars paid in a health plan for CT contrast.

4 Ways to Avoid Getting Ripped-Off On Your MRI

Healthcare is expensive. Even with insurance coverage, deductibles, co-pays, as well as rising insurance premiums can take a big bite out of your wallet. When it comes to most non-emergency medical services, it pays to follow some basic rules: don't go to the hospital, shop around, negotiate your bill, and try to pay in cash. 

Your MRI or imaging scan can cost as little as $250 instead of $4,000 or higher by following four basic rules.

1. Don't go to the hospital for diagnostic imaging

Medical services that take place in hospitals will inherently be much more expensive. Hospital resources, such as imaging equipment and a radiologist's time, are limited. As a result, hospitals often charge an enormous premium. MRIs could run several thousand dollars. In stark contrast, the same examination performed in an outpatient facility or imaging clinic could cost you ten times less. Instead of scheduling a diagnostic procedure at a big-name hospital system, go to a specialized imaging clinic. This is the easiest way to save loads of money.

2. Shop around

Many diagnostic clinics offer standard imaging services such as MRIs. Before selecting which one to go to, you will want to shop around and get pricing quotes from a few. Shopping around will allow you to compare costs and prevent an unexpected surprise in the future should you receive an unexpectedly high medical bill. Doing a little research to get a better sense of what an MRI will cost in your area will go a long way towards avoiding an unexpected bill.

3. Negotiate the bill 

Many imaging facilities, especially privately-run clinics, will and do negotiate their bills. Depending on your situation, there is often room to negotiate the bill. Always closely study any statements you receive - particularly if they are itemized. You'll want to pick up the phone or reach out to clinic administrators directly about each part of the bill. Ask about specific bill items. It also helps to ask open-ended questions such as whether or not waivers, discounts, or relief plans are available.

4. Pay in cash

Direct pay for medical services is becoming more and more popular. Not only do direct-pay models cut out the hassle of dealing with insurance intermediaries, but they can also save consumers money. Many clinics and providers offer a cash discount to patients who can afford to pay out of pocket. Better yet, most clinics that take cash also provide payment plans to help break service costs down into digestible chunks.

Directly paying for your imaging exam benefits the imaging clinic as well. Direct cash payment means that doctors don't have to go through the hassle of dealing with bureaucratic insurance administrators. It also cuts down on administrative costs freeing up doctors to do their jobs.

The Solution: Green Imaging

Green Imaging is the leader in easy, affordable medical imaging. In 2020, we were the winner of the HealthValue Awards by ValidationInstitute. While many patients end up paying $1,200 to $7,000 for a hospital MRI, ours cost $250 to $950. Yes, you read that correctly. How do we do it?

Rather than adding new brick and mortar imaging centers, we purchase unused capacity at existing imaging centers at a substantial discount and pass those savings to individual patients and employer-funded health plans. Our images, reports, invoicing, and records are all electronic, with no film or paper waste. 

We provide centralized access to over 1,000 centers nationally, saving patients untold hours in aggregate shopping for high-quality care at affordable prices. The result ---- you keep more "green" in your bank account!

Learn more about Green Imaging by visiting us at https://greenimaging.net. Our process is simple, and we have transparent pricing.

by Dr. Cristin A. Dickerson, MD

Dr. Cristin A. Dickerson is the founding partner of Green Imaging. Dr. Dickerson was born and raised in Texas. She is a graduate of Baylor University and the University of Texas Medical School at Houston where she was elected to Alpha Omega Alpha Honor Medical Society. Dr. Dickerson did a clinical internship at St. Joseph Hospital in Houston and her radiology residency at UT Houston where she was a chief resident, with extensive training in cancer imaging at MD Anderson Cancer Center.

Dr. Dickerson practiced for 13 years at the Diagnostic Clinic of Houston where she served as a two-term president of the 50 physician clinic. Her clinical interests include oncologic (cancer) MRI and CT and PET/CT, breast imaging, and cardiac screening. 

She founded Green Imaging to provide affordable, high-quality medical imaging for uninsured and high deductible patients in Houston and rapidly expanded the company to provide services throughout most of the U.S. and to employer-sponsored health plans. She loves being able to provide quality services to patients who otherwise couldn’t afford it and providing significant imaging cost savings to patients with healthcare coverage and their employers without compromising quality.

Dr. Dickerson is passionate about spreading the word that patients and employers do have great new nontraditional healthcare coverage options in the emerging alternative healthcare market.

Visit us at https://greenimaging.net