Hospitals are driving up outpatient imaging costs!!!
What has occurred?
Hospital Joint Ventures: Many large hospitals have entered into joint ventures with diagnostic imaging facilities. These hospitals own a majority interest in the newly formed joint venture entities.
How does this impact my patient? How does this impact my practice?
Your Patient: Commercial insurance (BCBS, UHC, AETNA, CIGNA) patients end up paying at least 100% MORE in out-of-pocket costs via deductibles, co-insurance, HSA, etc. Some rates might be as much as 400% higher than Gateway’s rates. The increase in rates differs based on the CPT code and the insurance.
Your Practice: How many of your patients will not seek further treatment/surgeries as they cannot afford these higher costs? How will insurance companies rank your practice from a cost perspective?
How does this happen?
Hospital Leverage: Hospitals use their leverage to garner reimbursement rates that are significantly higher.
The Name: These joint venture entities use the name of the diagnostic imaging company that is the minority owner. As a result, most physicians and patients are completely unaware the hospitals actually own a majority interest.