Charges Variation for a Basic Metabolic Panel – CPT 80048
Price Transparency is new, so we thought we’d look more closely at the impact of disclosing charges. After all, every industry must deal with the question of “price”, and it all starts at the “list price”.
Let’s look at a common diagnostic event performed in hospitals…a basic metabolic panel or blood test. A blood test is an economic, non-invasive starting point for diagnostics… everything from cholesterol, to liver function, to infections and so much more. Its diagnostic value is unquestioned.
What do they cost and how much does that vary around the country? The variation is striking for such a common, high volume, and well-defined test.
- The highest charges can be found in Colorado where for-profit hospitals charge $697.12
- The lowest charge can be found in Maryland where non-profit hospitals charge $24.48
- Government hospital median state-level charges are $127.70 with a 7x multiple from the lowest state to the highest state
- Non-profit hospital median state-level charges are $123.02 with a 13x multiple from the lowest state to the highest state
- For-profit hospital median state-level charges are $249.48 with a 24x multiple from the lowest state to the highest state
In the chart at the bottom, you’ll see the most common charge for each state for this single CPT code. It takes just 5 minutes for an automated machine to process a result for a basic lab panel. And that’s just one of 840 that make up 95+% of all Outpatient charges.
The pressure to rationalize pricing will be every bit as severe as the impact made by transparency in quality, outcomes, and safety. It’s a big deal…consumers, news organizations, and regulators will all pick up their bullhorns as they see fit.
To remain, or even be competitive, it is essential to know where you and your competitors stand in your markets and on the full panel of metrics that define value.
Franklin:BI will clarify that for you at the speed of thought.