Dr. Murray Feingold: Hospital shopping for a bargain

Dr. Murray Feingold More Content Now

Most people, prior to buying something, look at the cost to make sure they are being charged a fair price. Or, even better, if they can find a bargain.

However, this type of shopping is difficult to do for patients trying to determine the cost of care in a hospital.

In an attempt to find out how much variation there was in the price of certain hospital services, researchers determined the cost of 10 commonly ordered blood tests in California hospitals. The number of hospitals involved in the study varied from 166 to 189, depending upon the specific blood test.

Tests included thyroid studies, blood counts, and lipid and cholesterol determinations. The results showed that there was a tremendous variation in the cost of tests between hospitals. The lowest rates were in government hospitals.

In eight of the 10 tests, the cost between hospitals varied more than 200 percent. This is in contrast, for example, to the cost of electronic goods sold in stores where the variation in costs is 12.5 percent.

In an extreme example, the cost of a lipid study in one hospital was $10 and in another it was $10,169.

With the information available to them, the researchers attempted to determine the reasons for the huge variability in pricing. Although they propose various reasons, they could not fully determine why there was such a disparity in prices.

The varying cost of blood tests is most likely a microcosm of charges for other hospital services. For example, what are the differences between hospitals in the charges for medications? I’m sure they vary substantially.

Although our first instinct is to compare managing a hospital with managing large corporations, this is difficult to do.

Hospitals have many more local, state, and federal regulations to abide by than do most big businesses. Just by instituting a new regulation, such as HIPAA, adds thousands of dollars to the hospital’s budget. If Medicaid decides to reduce payments for patient care, hospitals are faced with a significant financial loss.

However, by learning more about the financial management of hospitals, like how much they charge for blood tests, many unanswered questions are raised that need to be answered.


Massachusetts-based Dr. Murray Feingold is the physician in chief of The Feingold Center for Children, medical editor of WBZ-TV and WBZ radio, and president of the Genesis Fund. The Genesis Fund is a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.