Rising out-of-pocket costs for neurological tests could lead many Americans to forgo them, researchers warn.
Their study, published online Dec. 23 in the journal Neurology, analyzed neurology care costs for more than 3.7 million people in a large private insurance claims database.
They found that average, inflation-adjusted out-of-pocket costs for diagnostic tests rose by as much as 190% over the study period.
Average out-of-pocket costs for electroencephalogram (EEG) tests -- which can be used to diagnose conditions such as epilepsy -- increased from $39 to $112, while costs increased from $84 to $242 for MRI scans. Out-of-pocket costs for office visits increased from an average of $18 to $52.
For both tests and office visits, out-of-pocket costs accounted for an increasing amount of the total cost of the service. For example, the cost of an MRI paid by patients rose from an average of 7% to 15% during the study period.
"This trend of increased out-of-pocket costs could be harmful, as people may forgo diagnostic evaluation due to costs, or those who complete diagnostic testing may be put in a position of financial hardship before they can even start to treat their condition," said study author Dr. Chloe Hill, from the University of Michigan.
"What's more, right now neurologists and patients may not have individualized information available regarding what the out-of-pocket costs might be to make informed decisions about use of care," Hill said in a journal news release.
The researchers also found an increase in patients who paid out-of-pocket costs for tests. For example, the percentage of patients who had out-of-pocket payments for MRIs rose from 24% in 2001 to 70% in 2016.
Out-of-pocket costs varied widely. For an MRI in 2016, the median amount was $103, but it was as high as $875 for some patients.
Patients with high-deductible health plans were more likely to have out-of-pocket costs on tests and to have higher out-of-pocket costs.
The number of patients enrolled in high-deductible plans rose from zero in 2001 to 11% in 2016, according to the study.
The U.S. National Library of Medicine has more on neurological exams.
SOURCE: Neurology, news release, Dec. 23, 2020