SOURCE: Castlight Health

Large Grey-Orange Logo

October 07, 2015 08:30 ET

New Study Finds Huge Price Differences for Mammograms & Other Critical Women's Health Procedures in the 30 Largest U.S. Cities

Second Annual Castlight Health U.S. Costliest Cities Analysis Ranks Prices for Common Medical Procedures and Includes First-Ever Look at Cost of Women's Health Services

SAN FRANCISCO, CA--(Marketwired - October 07, 2015) - Castlight Health, Inc. (NYSE: CSLT), the leader in enterprise healthcare management, released its second annual U.S. Costliest Cities Analysis, the only comprehensive look at what employers and employees actually pay for common healthcare procedures in the 30 most populous U.S. cities. This year, Castlight Health added a never-before-seen analysis of four women's health procedures to the study, examining the prices of OB/GYN follow-up visits, preventative gynecological exams, mammograms, and HPV tests.

In 2015, the study found that consumers across the country continue to pay wildly different prices for standard medical services -- ranging from primary care check-ups, to radiology tests and common blood work -- not just from state-to-state, but within the same city. The addition of women's health services to the U.S. Costliest Cities Analysis sheds light on the prices women and their employers have to bear just to stay healthy.

Most notably, the Analysis found:

  • Mammogram. Nationwide for a mammogram, a woman could pay anywhere from $43 to $1,898 for the test, a 44x difference. With some of the country's largest cities, the clear indication is that women in larger metropolitan areas are being charged wildly varying amounts for a critical preventative test. For example:
    • In Dallas, which has the nation's widest range, a woman could pay anywhere from $50 to $1045, roughly a 21x difference.
    • In New York City, the price can vary between $130 to $1,898, roughly a 15x difference. New York also has the most expensive mammograms in the entire country.
    • In Los Angeles, a simple mammogram could cost anywhere from $86 to $954, an 11x price variance.
    • The San Francisco Bay Area ranged from $129 to $860, a 6x difference.
  • OB/GYN Follow-Up Visit. Minneapolis and Seattle were the most expensive cities for an OB/GYN follow-up visit, and Phoenix and Las Vegas were the cheapest.
  • Preventative Gynecological Exam. The San Francisco Bay Area was the priciest for both a preventative gynecological exam and an HPV test, where it was on average 6x more expensive than Charlotte, NC for both.
  • HPV Test. In Philadelphia, the price of an HPV test ranged from $32 to $626, a 19x difference.

"These numbers are eye-opening. It's especially disturbing that women and their employers could be needlessly overpaying for mammograms and other critical health services. Despite mandated insurance coverage for certain services, evidence shows that women forgo basic preventative care due to cost considerations and that delaying preventative care can harm patient health and increase future medical spending,"(1)(2) said Kristin Torres Mowat, Vice President of Strategic Alliances and Data Operations at Castlight Health. "Overall, the data demonstrate that medical price variances continue to reflect larger systemic problems in the U.S. healthcare system."

Other highlights of the Castlight U.S. Costliest Cities Analysis include:

  • In New York City, there was an astounding 76x difference between what consumers paid to have the same lipid panel (cholesterol test) done, ranging from $14 to $1,070. That was the highest national range among the eight procedures. Over the past year, the average price of the test increased in all but one of the 30 cities, and increased a whopping 282% in San Francisco, 214% in Sacramento, and 198% in Pittsburgh.
  • In a majority of cities, the average price for the lipid panel, routine primary care exam, CT scan and MRI rose over the past year. During this time, healthcare spending outpaced inflation.
  • In Washington, D.C., the price for a head/brain CT scan ranged from $78 to $1,673, a 21x difference. However, with an average price of $592, the D.C. area was the least expensive for the procedure. The test was on average the most expensive in Indianapolis and Charlotte at more than $1,300. Both cities experienced more than 100% increase in prices over the past year.
  • In New York City, the price of a lower-back MRI ranged from $334 to $3,939, nearly a 12x disparity. Indianapolis was on average the most expensive ($2,307) and saw more than a 100% increase in prices over the past year.
  • In Chicago, the price to get a routine exam at a primary care physician was the widest of any city, ranging from $50 to $423, an 8x difference. The survey found that getting a physical was most expensive in Minneapolis and San Francisco, and cheapest in Miami and Orlando.

"This study has data that is vital to understanding how broken the U.S. healthcare system really is, and we sincerely hope that employers and consumers take note. The only way that employees and their employers can even begin to manage healthcare spend is by understanding how much it costs," said Giovanni Colella, M.D., co-founder and chief executive officer at Castlight Health.

Methodology

The primary source of data used for this analysis is medical claims data. Castlight Health augments this data with other data including: publicly available data, provider information, and actual provider rate sheets that list the negotiated price between a provider and an insurer. Castlight then applies proprietary algorithms to obtain the provider prices used for this analysis. Prices are defined as the employee cost-sharing plus the amount paid by the employer.

Castlight Health at the Upcoming HR Technology Conference

Castlight Health will be at the HR Technology Conference, taking place at Mandalay Bay in Las Vegas, NV from Sunday, October 18 through Wednesday, October 21, 2015. Visit the Castlight Booth #2120 for more information.

About Castlight Health

Castlight Health, Inc. (NYSE: CSLT) is a leader in Enterprise Healthcare Management. We believe great healthcare builds great business, and U.S. enterprises can gain control over the $620 billion spent annually on healthcare, transforming a crippling cost into a strategic business advantage. Recognized as a 2014 top software platform by the HR Technology Conference & Exposition, the Castlight Enterprise Healthcare Cloud enables employers to understand and manage their healthcare investments while helping employees make the best possible healthcare decisions. Castlight is a great place to work, honored with a Glassdoor Employees' Choice award and recognized by Rock Health for Diversity in Leadership. For more information visit www.castlighthealth.com. Follow us on Twitter and LinkedIn and like us on Facebook.

Copyright 2015 Castlight Health, Inc. Castlight Health® is the registered trademark of Castlight Health, Inc. Other company and product names may be trademarks of the respective companies with which they are associated.

(1) Friedman C, Ahmed F, Franks A, Weatherup T, Manning M, Vance A, et al. Association Between Health Insurance Coverage of Office Visit and Cancer Screening Among Women. Medical Care [Internet]. 2002;40(11). Available from: http://journals.lww.com/lww-medicalcare/Fulltext/2002/11000/Association_Between_Health_Insurance_Coverage_of.7.aspx

(2) Trivedi AN, Rakowski W, Ayanian JZ. Effect of Cost Sharing on Screening Mammography in Medicare Health Plans. New England Journal of Medicine. 2008 Jan 24;358(4):375-83.

Contact Information