Neurological patients face the increasing cost of tests and office visits

MINNEAPOLIS – Just as with drug costs, the money people pay out of pocket for diagnostic tests and visits to surgeries for neurological conditions has risen over 15 years, according to a new study published online in the December 23, 2020 issue. Neurology®, Medical Journal of the American Academy of Neurology. The study, funded by the American Academy of Neurology, found that people enrolled in high-deductible health plans are more likely to have high out-of-pocket costs than people who have other types of plans.

“This trend of increased out-of-pocket costs could be detrimental because people may give up diagnostic assessments because of costs or those who complete diagnostic testing may be put in a financial situation before they even begin to treat their condition,” said study author Chloe E. Hill, MD, MS from the University of Michigan at Ann Arbor and a member of the American Academy of Neurology. ”Moreover, neurologists and patients may not currently have individualized information available on what the costs might be for making informed care decisions. ”

For this study, researchers examined out-of-pocket costs for visits to a neurologist and diagnostic tests commissioned by a neurologist over 15 years using a large database of private insurance. Costs for more than 3.7 million people are included.

The study found that an increasing number of people have been paying for diagnostic tests and office visits for years. The costs out of one’s own pocket are rising and vary greatly among patients and tests, Hill said.

For patients who had out-of-pocket diagnostic test costs, the average inflation-adjusted pocket costs increased by as much as 190% over the study period. The average cost of electronic pockets for electroencephalogram (EEG) tests, which can be used to diagnose conditions such as epilepsy, has risen from $ 39 to $ 112. For MRI scans, they increased from $ 84 to $ 242. Office visits increased from an average of $ 18 to $ 52.

Including tests and office visits, people who paid out-of-pocket expenses paid an increasing amount of total service costs on average. For example, people paid an average of 7% of the cost of an MRI at the beginning of the study, compared to 15% of the cost at the end of the study.

The percentage of people who paid out of pocket for tests varied from test, but all increased over the years. For magnetic resonance imaging, 24% of people paid out of pocket in 2001, compared to 70% in 2016.

People with high-deductible health plans were more likely to have out-of-pocket costs on tests and higher out-of-pocket costs. In 2001, none of the people in the study were involved in rejectable health plans. By 2016, 11% of people were involved in these plans.

Researchers have also found that out-of-pocket costs vary considerably. For MRI in 2016, people who paid the average amount paid $ 103, while people with the top 5% of the cost paid $ 875.

“This study adds extra weight to earlier studies by the American Academy of Neurology, which show that the cost of neurological drugs out of your pocket rises sharply, making people less likely to take drugs as often as doctors prescribe,” said James C. Stevens, Ph.D. Med., FAAN, President of the American Academy of Neurology. “Costs have risen to the point that systematic changes are needed. These changes could include legislative measures to limit out-of-pocket costs. The American Academy of Neurology advocates such limits on the cost of out-of-pocket drugs in Washington, DC.”

A limitation of the study is that the costs were examined for only one insurer, so the results may not reflect other private insurers or Medicaid.


The study was funded by the American Academy of Neurology.

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The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 36,000 members. AAN is committed to promoting the highest quality patient-centered neurological care. A neurologist is a physician with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease, and epilepsy.

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Neurological patients faced with an increase in the cost of no pocket for tests, office visits

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