This is one of many irrational economic aspects of health care in the US. The price for the exact same service can be very different depending on if it is delivered in a physician’s office, a hospital, a hospital outpatient department, a free-standing surgical center, and so on. Medicare, for some bizarre reason has encouraged this by paying more for a service in a hospital outpatient department than a doctor’s office. So of course the consequence has been that hospitals buy physician practices, call them hospital outpatient and charge for the same service. Really smart policy. And if it really costs hospitals more to deliver a service, then tough, people should be encouraged to use the lower-cost provider, which benefits them and their health plan. Hospitals are big and ought to be able to figure out how to be cheaper. A brief from the Employee Benefits Research Institute discusses the cost of this practice to employers and consumers. (EBRI Brief)
Employers and workers would save $11.2 billon if the pricing differential were eliminated for just 25 services examined in the report. 80% of the savings would go to employers, who are paying most of the price. Savings for lab services could be as much as 69%, 56% for scanning, like x-rays and 36% on specialty medications. The brief has some other good information regarding employer-based health plans, which still cover the most Americans.