By Lauren Weber
September
6, 2019
Emory
University medical fellow Dr. Nicole Herbst was shocked when she saw three
patients who came in with abnormal results from chest CT scans they had bought
on Groupon.
Yes,
Groupon — the online coupon mecca that also sells discounted fitness classes and foosball tables.
Saw 3 pts in clinic for
abnormal chest CTs BOUGHT ON GROUPON.
Evolution of my thoughts:
-What the $@&#? (*Google it*)
-hm actually priced pretty reasonably
-jeez if I ever need testing I’m going w/ Groupon, prob cheaper than insurance
US healthcare is bonkers
Evolution of my thoughts:
-What the $@&#? (*Google it*)
-hm actually priced pretty reasonably
-jeez if I ever need testing I’m going w/ Groupon, prob cheaper than insurance
US healthcare is bonkers
Similar
deals have shown up for various lung, heart and full-body scans across Atlanta, as well as in Oklahoma and California. Groupon also offers discount
coupons for expectant parents looking for ultrasounds, sold as
“fetal memories.”
While
Herbst declined to comment for this story, her sentiments were shared widely by
the medical community on social media. The concept of patients using Groupons
to get discounted medical care elicited the typical stages of Twitter grief:
anger, bargaining and acceptance that this is the medical system today in the
United States.
But,
ultimately, the use of Groupon and other pricing tools is symptomatic of a
health care market where patients desperately want a deal — or at least tools
that better nail down their costs before they get care.
“Whether
or not a person may philosophically agree that medicine is a business, it is a
market,” said Steven Howard, who runs Saint Louis University’s health
administration program.
By
offering an upfront cost on a coupon site like Groupon, Howard argued, medical
companies are meeting people where they are. It helps drive prices down, he
said, all while marketing the medical businesses.
For
Paul Ketchel, CEO and founder of MDsave, a site that contracts with providers
to offer discount-priced vouchers on bundled medical treatments and services,
the use of medical Groupons and his own company’s success speak to the
brokenness of the U.S. health care system.
MDsave
offers deals at over 250 hospitals across the country, selling vouchers for
anything from MRIs to back surgery. It has experienced rapid growth and
expansion in the several years since its launch. Ketchel attributes that growth
to the general lack of price transparency in the U.S. health care industry amid
rising costs to consumers.
“All we
are really doing is applying the e-commerce concepts and engineering concepts
that have been applied to other industries to health care,” he argued. “We are
like transacting with Expedia or Kayak while the rest of the health care
industry is working with an old-school travel agent.”
A
Closer Look At The Deal
Crown
Valley Imaging in Mission Viejo, Calif., has been selling Groupon deals for
services including heart scans and full-body CT scans since February 2017 —
despite what Crown Valley’s president, Sami Beydoun, called Groupon’s
aggressive financial practices. According to him, Groupon dictates the price
for its deals based on the competition in the area — and then takes a
substantial cut.
“They
take about half. It’s kind of brutal. It’s a tough place to market,” he said.
“But the way I look at it is you’re getting decent marketing.”
Groupon-type
deals for health care aren’t new. They were more popular in
2011, 2012 and 2013, when Groupon and
its then-competitor LivingSocial were at their heights. The industry has since
lost some steam. Groupon stock and valuation have tumbled in recent years, even
after buying LivingSocial in 2016.
Groupon
did not respond to requests for comment on how many medical offerings it has
featured or its pricing structure.
“Groupon
is pleased any time we can save customers time and money on elective services
that are important to their daily lives,” spokesman Nicholas Halliwell wrote in
an emailed statement. “Our marketplace of local services brings affordable
dental, chiropractic and eye care, among other procedures and treatments, to
our more than 46 million customers daily and helps thousands of medical
professional[s] advertise and grow their practices.”
In
Atlanta, two imaging centers that each offered discount coupons from Groupon said
the deals have driven in new business. Bobbi Henderson, the office manager for
Virtual Imaging Inc.’s Perimeter Center, said the group had been running the deal for a heart CT scan,
complete with consultation, since 2012. Currently listed at $26 — a 96%
discount — more than 5,000 of the company’s coupons have been sold, according
to the Groupon site.
Brittany
Swanson, who works in the front office at OutPatient Imaging in the Buckhead
neighborhood of Atlanta, said she has seen hundreds of customers come through
after the center posted Groupons for mammograms, body
scans and other screenings around six months ago.
Why did
the company choose to make such discounts available?
“Honestly,
we saw the other competition had it,” she said.
A lot
of the deals offered are for preventive scans, Swanson said, providing patients
incentives to come in.
But Dr.
Andrew Bierhals, a radiology safety expert at Washington University in St.
Louis’ Mallinckrodt Institute of Radiology, warned that such deals may be
leading patients to get unnecessary initial scans — which can lead to
unnecessary tests and radiation.
“If you’re
going to have any type of medical testing done, I would make sure you discuss
with your primary care provider or practitioner,” he cautioned.
Appealing
To Those Who Fall Into The Insurance Gap
Because
mammograms are typically covered by insurance, Swanson said she believes
OutPatient Imaging’s $99 Groupon deal is filling a gap for women lacking
insurance. The cost of such breast screenings for those who don’t have
insurance varies widely but can be up to several hundreds of dollars without a
discount.
Groupon
has long been used to fill insurance gaps for dental care, Howard said. He
himself often bought such deals over the years to get cheaper teeth cleanings
when he didn’t have dental insurance.
But
advanced medical scans involve a higher level of scrutiny, as Chicagoan Anna
Beck learned. In 2015, she and her husband, Miguel Centeno, were told he needed
to get a chest CT after a less advanced X-ray at an urgent care center showed
something suspicious. Since her husband had just been laid off, and did not
have insurance, they shopped online to look for the cheapest price. They
ended up driving out to the suburbs to get a CT scan at an imaging center
there.
“I knew
that CT scans had such a wide range of costs in a hospital setting,” Beck said.
“So going in knowing that I could price-check and have some idea of how much
I’d be paying and a little more control” was preferable than going to the
hospital.
On the
drive back into the city, the center called and told them to go straight to the
hospital — the scan had discovered a large mass that turned out to be a
germ-cell tumor.
Fortunately,
Centeno’s cancer is now in remission, Beck said. But their online shopping cost
them more money than if they’d gone straight to the hospital initially. The
hospital gave them charity care. And although Beck took along a CD of the scans
Centeno had found online, the hospital ended up taking its own scans, as well.
“You’re
trying to cut cost by getting a CT out of the hospital,” she said. “But they’re
just going to redo it anyway.”
This
story was produced by Kaiser Health News, an
editorially independent program of the Kaiser Family
Foundation.
[This
story was updated at 8 a.m. PT to revise a reference to the Mallinckrodt
Institute of Radiology.]
Lauren
Weber: lweber@kff.org,
@LaurenWeberHP
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