Out-of-pocket costs jump for people with neurological disorders, study finds

Dec. 23 (UPI) -- Out-of-pocket costs for diagnostic tests and office visits for neurological conditions have increased by almost 200% in a 15-year period since 2001, according to a study published Wednesday by the journal Neurology.

Much of this rise in cash expenditures was fueled by people enrolled in high-deductible health insurance plans, who were more likely to have high out-of-pocket costs than people in other types of plans, the researchers said.

"This trend of increased out-of-pocket costs could be harmful, as people may forgo diagnostic evaluation due to costs," study co-author Dr. Chloe E. Hill said in a statement.

In addition, "those who complete diagnostic testing may be put in a position of financial hardship before they can even start to treat their condition," said Hill, a neurologist and professor of medicine at the University of Michigan in Ann Arbor.

Recent estimates suggest that some 100 million people in the United States have some form of neurological disorder, ranging from migraine and tension-type headache to dementia and epilepsy.

These conditions can be expensive to diagnose and treat, with an overall cost to the public of more than $750 billion annually, according to researchers.

For this study, Hill and her colleagues evaluated out-of-pocket costs for 3.7 million people across the country for visits to a neurologist and diagnostic tests ordered by a neurologist between 2001 and 2016. They used a large private insurance claims database.

Among those who had out-of-pocket costs for diagnostic tests, average inflation-adjusted expenses rose by as much as 190% over the 15-year period, the data showed.

Average out-of-pocket costs for electroencephalograms, or EEGs, which are used to diagnose conditions such as epilepsy, increased to $112 from $39 during that time, the researchers said.

For MRI scans, cash expenditures increased to $242 from $84 over the same period, while fees for office visits rose from an average to $52 from $18, according to the researchers.

Those who paid out-of-pocket costs spent an increasing amount of the total charges for the services, the researchers said.

For example, people paid, on average, 15% of the total cost for an MRI in 2016, compared with 7% in 2001, according to the researchers.

Among those who underwent MRIs, 70% paid out-of-pocket fees for the tests in 2016, compared with 24% in 2001, the data showed.

People with high-deductible health plans were more likely to have out-of-pocket costs on tests and to have higher out-of-pocket costs, the researchers said.

In 2016, 11% of the people included in the analysis were enrolled in high-deductible health plans, while none were In 2001, they said.

"Right now neurologists and patients may not have individualized information available regarding what the out-of-pocket costs might be to make informed decisions about use of care," Hill said.