Lung cancer is the leading cause of cancer mortality for both men and women in the US. Lung cancers are typically found at advanced stages, when treatment options are limited and as a result, mortality rates are high. Early detection is key with lung cancer, and recent studies have found a significant survival benefit to patients who have low dose CT scans to identify lung cancer at its earliest stages.
New Medicare guidelines will provide coverage to high-risk seniors for low dose CT screening studies, beginning in 2015. Many private insurers will also be covering the screening test for individuals who are at high-risk.
Over the past year, community hospitals in the Lower Hudson Valley have been courted by large, out-of-town health care networks, with many marching down the aisle to cast their future with giant health systems.
But these mergers may not lead to relationships that satisfy everyone.
Hospitals tout the benefits of joining bigger health systems as better coordinated health care and efficiencies of scale resulting in lower costs.
They can bring new services to an area – even areas like Westchester and Rockland already served by plenty of well-equipped and well-staffed medical centers. The consolidations also put hospital systems in a better position to qualify for a chunk of the $8 billion in Medicaid redesign money the state is doling out.
Should consumers shop for the best deals–or any deals–when it comes to their health care? Don’t miss this interactive video JournalCast, moderated The Wall Street Journal’s health columnist Melinda Beck and featuring a panel of health-care experts from across the country.
Video Panelists Include:
- Ardis Dee Hoven: President, American Medical Association
- Jeffrey Rice: President and CEO, Healthcare Bluebook
- Suzanne Delbanco: Executive Director, Catalyst for Payment Reform
The Wall Street Journal
It’s a simple idea, but a radical one. Let people know in advance how much health care will cost them—and whether they can find a better deal somewhere else.
With outrage growing over incomprehensible medical bills and patients facing a higher share of the costs, momentum is building for efforts to do just that. Price transparency, as it is known, is common in most industries but rare in health care, where “charges,” “prices,” “rates” and “payments” all have different meanings and bear little relation to actual costs.
Save big at independent facilities. Different facilities charge vastly different prices for x-rays and tests. For example, the average in-network cost of an MRI at a hospital is $1,145, but the average in-network cost at an independent radiology facility is just $560, says Kang. “The radiologist is the same. The only difference is where the procedure is done,” he says.
If you haven’t met your policy’s annual deductible, you could save $585 by going with the lower-cost facility. But even if you have met your deductible and you’re on the hook only for a 20% coinsurance payment, choosing the independent radiology facility could still save you $117 in out-of-pocket costs.
“When doctors order a lab test or an x-ray, they write a requisition form,” says Kang. “But as with a prescription, you’re free to fill it at any facility. People don’t understand that.”
Diagnostic radiology procedures have become a major target of Medicare reimbursement cuts. The impression is that these expensive tests are a chief contributor to the rising cost of healthcare. However, imaging costs vary according to where they are performed.
To understand where the imaging costs were the highest and how best to improve cost savings without limiting access to tests, researchers undertook an evaluation of Medicare Part B data to assess which tests were being performed, by whom, and in what settings.