I believe that most lab professionals believe that key "customers" for hospital-based labs are the test-ordering physician rather than hospital patients. The major problem with this perspective is that we are now entering an era of consumer-dominated healthcare and high-deductible health plans. Healthcare consumers are going to be much more active in shopping for value and quality of services. This has major implications for hospital labs. This theme was picked up in a recent story from Dark Daily (see: Clinical Pathology Laboratories Stand to Benefit as Patients Gain Control Over Their Healthcare Spending Through High-Deductible Health Plans). Below is an excerpt from it:
Smaller clinical laboratories and pathology groups should benefit from shift toward consumer-driven healthcare. High-deductible health plans (HDHP) are increasing in popularity as more consumers opt for lower annual premium costs in exchange for larger out-of-pocket expenses. This shift in health insurance could result in direct benefits for smaller clinical laboratories and pathology groups as more patients have a choice in where they purchase medical laboratory testing services. From a policy perspective, employers and healthcare strategists hope that using HDHPs to engage consumers will help put market forces back into medicine. Because clinical laboratories and pathology groups increasingly find themselves excluded from provider networks, and fighting to keep access to patients, they should welcome the trend to consumer-driven healthcare. A logical response to the HDHP trend would be for labs to begin posting their lab test prices on their websites. It would be equally useful to also post quality-performance and customer-satisfaction survey results to allow consumers to make informed choices about the labs they want performing their tests.
The advice from the Dark Daily about how to appeal more to consumers is the following: labs... [should] begin posting their lab test prices on their websites. I am not so sure that this is a good idea, at least at the present time. The cost of lab tests in many hospitals is inflated far beyond that of competing labs in the community and on the web because of the cross-subsidization of other hospital units that run at a deficit such as intensive care. To emphasize this point, I only need to make reference to the web site of a company called Healthcare Bluebook that is oriented to reducing the cost of healthcare for consumers. Here's a cut-and-paste from the landing page on the topic of a complete blood count (CBC) (see: Complete Blood Count (CBC) With Differential - $20)
Cost Savings Tips And Financial Considerations
Lab tests can cost 3 to 5 times too much depending on the location of your test.
You can receive lab tests at various locations:
Hospital labs (often the most expensive)
Independent lab setting (often the best value)
In some cases you will also be charged for an office visit if you go to the doctor to have your labs drawn.
Always ask your physician to help you find the lab location that will provide you the best value.
In many cases you may be able to save several hundred dollars
Let me emphasize a few points from this quote:
- The recommended price of a complete blood count (CBC) is $20. I bet that there are few hospital labs that charge this amount for the test.
- It's emphasized that hospital labs are often the most expensive location for lab testing.
- The" possible savings" for lab tests when patients shop around is quoted as "several hundred" dollars. This would obviously be of interest to self-pay patients or those with high-deductible insurance policies.
- Patients are advised to: Always ask your physician to help you find the lab location that will provide you the best value. I have no idea how most clinicians would respond to such a question.
Hospital labs are not going to get any traction with many consumers unless and until their lab prices becomes more competitive. I don't think that this is going to happen soon because the price of hospital care is closely tuned to what the health insurance companies' reimbursement levels and not what consumers are willing to pay for the service out-of-pocket (see: Why the Prices Charged by Hospital for Inpatient Care Are Irrelevant; Comparing the Details of Hospital Charges in the State of Oregon; Greater Transparency for Hospital Charges Slowly Becoming the Norm).