When a deal isn’t really a deal: Coupons for medical imaging

September 9th, 2019

If you buy something you don’t need at a high discount, does that make it a good deal? If you’re asking my father, who once bought three gallons of maple syrup in one Costco trip because it was “on sale,” he would probably say yes. But deals on wholesale grocery items are very different from deals on medical tests or procedures. As Lauren Weber recently reported for Kaiser Health News, patients are increasingly taking advantage of online deals for lung, heart, and full-body scans. 

Everyone can agree that there’s a lot of things wrong with our health system when patients are resorting to using Groupon, an online coupon website, for medical services. Some even see Groupon as an overall good for the system, because offering discounts cuts out the middlemen and gives patients more price transparency. “By offering an upfront cost on a coupon site like Groupon, medical companies are meeting people where they are. It helps drive prices down,” said Dr. Steven Howard, associate professor and director of the health administration program at Saint Louis University, in Kaiser Health News. Even doctors who were shocked that Groupon offered discounts for scans were impressed at how reasonable the prices were.  

It’s not surprising that Groupon is catching on in medicine. Nonprofits such as Clear Health Costs that crowdsource information about the cost of care have demonstrated that patients will shop around for the best price when given the right information. Models of care that charge a single membership cost and eschew insurance are also becoming more popular. The rise of Groupon further confirms that there is a great need for transparent pricing for medical tests and procedures. 

But what’s different about Groupon is that these coupons appear to be targeting asymptomatic patients for procedures they don’t need. By offering $26 heart scans (“a 96% discount”!), imaging centers are hoping that people will think, “Why not get a scan?” The problem is that these scans often lead to more unnecessary tests and treatments, that can cost patients much more than the cost of the initial scan. According to one recent study of “cascade” events after a pre-operative ECG, the cost of cascade procedures ended up being ten times that of the cost of the initial test. And that’s not including the time lost, added stress, and potential physical harm from having these unnecessary follow-up tests and procedures.

Don’t fall for the imaging bait and switch. If your doctor hasn’t recommended that you get a certain scan (and explained the costs and benefits clearly), and you have no symptoms, you can save even more money and stress by avoiding unnecessary scans altogether.