Tag Archives: Employer Based Health Insurance

Ridiculous Healthcare Pricing

All over the country people are commenting on the ridiculous pricing from healthcare facilities and providers.  Here is a recent example I came across:

Lab Bill

You’ll note that the gross price for these lab tests is $837.74 and the person was told their out-of-pocket¬†responsibility could be $109.85.¬† What is so amazing about this is I have heard of wellness companies that purchased lab services for their programs being charged $21 for a similar series, without the PSA, if the draw was done at a laboratory service center and $65 if the draws were done onsite at the employer.

So lets take out the PSA at $148.48/$19.47 and there you have it, gross pricing for these services is almost 33 times what they sell this service to wellness vendors on a wholesale basis (which obviously has a profit in it), and the person getting these tests could potentially pay four times that amount out of pocket with their PSA portion excluded.

I assume that the insurer, a major health plan, has a larger discount than that given to a wellness vendor. It will be interesting to follow this and see if the health plan pays any portion and what the final out-of-pocket is for the person. If it totals $21 I’ll eat my hat.

The markups in healthcare, which are driven by FFS pricing and payers who sell to employers based upon discounts off of charges has created a monster that is completely dissociated from reality.



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