Nonprofit, public hospitals aren't the cheapest places to get a brain scan: study

For an individual with commercial insurance, nonprofit and publicly-owned hospitals aren't the cheapest places to go for a brain MRI, according to a study published March 21 in JAMA Network Open.

The study's authors said they were looking to determine what hospital factors cause differences in price variations for a common healthcare service after finding last fall that payer-negotiated prices for radiology services can vary widely, even within the same hospital.

The new study analyzed negotiated commercial prices and payer contracting data for a brain MRI among 2,630 hospitals that have complied with CMS' price transparency rule as of June 13, 2022. The data was sourced from Turquoise Health, and hospitals were excluded if certain information was missing.

"The notion is false that nonprofit hospitals or government hospitals are cheaper. Also, rural hospitals are very expensive," study author Ge Bai, PhD, professor of accounting and health policy at Baltimore-based Johns Hopkins University, told Becker's. "Commercial negotiated price reflects hospitals’ market power."

Four key takeaways:

1. For a brain MRI, nonprofit, system-affiliated hospitals in urban areas were contracted with a median of 11 health plans and charged a median commercial price of $1,900.

2. Within the same hospital referral region, nonprofit and public hospitals' commercial prices for an MRI were $387 and $537 higher than for-profit facilities, respectively.

3. Within the same health system, rural hospitals charged up to $363 more for an MRI than urban hospitals.

4. Within the same health system, state, or referral region, hospitals that are rural, that are contracted with more payers, or that have a higher proportion of Medicare patients were more expensive for an MRI.

The study's authors noted that the generalizability of results may be affected by some biases, including estimation errors and data reporting inaccuracies.

"Moreover, due to the lack of information on the applicable time period of each hospital price, it is possible that some prices did not reflect actual prices at the time when data were collected," they wrote.


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