The Ask the Analyst series is a deep dive into the data by those most familiar with the CO APCD – the analysts themselves. We’ll hear about their experiences with recent analyses and answer any pressing questions that come up. Have a question for the CIVHC Analyst Team? Email it to firstname.lastname@example.org.
Featured Project: COVID Testing Price Variation
Analyst Name: Megha Jha
The purpose of this analysis was to understand variation in COVID-19 test prices for commercial payers across rural vs. urban counties, types of tests (PCR, Antibody, Antigen), in vs. out-of-network providers, and place of service (ED, outpatient facility, professional-administered).
What were your first steps when beginning this analysis?
The initial step was to find relevant COVID-19 testing procedure codes. Using American Medical Association’s (AMA) May, 2021 guidelines, we classified each code into various testing types, and ended up incorporating 28 codes in our final analysis.
Were there specific considerations you needed to consider based on the data?
In order to understand the actual cost of the test itself, we had to isolate the analysis to the codes for only the test, and eliminate payments that were made for other services that may have occurred during the same visit. In many cases, additional items are charged and paid for beyond the actual test cost. When looking at the data, it’s important to note that depending on the setting where the test is performed, other items such as facility fees and professional costs may also get charged.
What challenges did you encounter while performing the analysis? How did you overcome them?
The biggest challenge we encountered was to correctly categorize each COVID-19 test. Additionally, newer codes were added as COVID-19 pandemic progressed. Initially we started with eight codes divided into two test categories. But by the end of the study, we had to include 28 codes in three different test categories into our analysis.
Without delving into results, did anything surprise you about this analysis or the process of executing it?
Nothing surprised us during our analysis as we expected to see higher cost for out-of-network providers compared to in-network providers. However, within same network type, we did see large variation in allowed amounts for certain tests within the same region and setting.
What did you learn while performing this analysis?
I learned that tests cost a lot more when it’s an out-of-network commercial provider compared to an in-network’ one. Hopefully, this public report will encourage people to contact their health insurance company or shop around before going for a COVID-19 test to ensure they are going to a cost-effective location.
View our Publications page to access more insights from this project.