Groupon homepage By offering anupfront cost on a coupon site like Groupon, medical companies aremeeting people where they are. It helps drive prices down, allwhile marketing the medical businesses. (Image:Shutterstock)

|

Emory University medical fellow Dr. Nicole Herbst was shockedwhen she saw three patients who came in with abnormal results fromchest CT scans they had bought on Groupon.

|

Yes, Groupon — the online coupon mecca that also sellsdiscounted fitnessclasses and foosballtables.

|

Similar deals have shown up for various lung, heart andfull-body scans acrossAtlanta, as well as in Oklahomaand California.Groupon also offers discount coupons for expectant parents lookingfor ultrasounds,sold as "fetal memories."

|

While Herbst declined to comment for this story, her sentimentswere shared widely by the medical community on social media. Theconcept of patients using Groupons to get discounted medical careelicited the typical stages of Twitter grief: anger, bargaining andacceptance that this is the medical system today in the UnitedStates.

|

Related: A new way to promote health care pricetransparency: T-shirts

|

But, ultimately, the use of Groupon and other pricing tools issymptomatic of a health care market where patients desperately wanta deal — or at least tools that better nail down their costs beforethey get care.

|

"Whether or not a person may philosophically agree that medicineis a business, it is a market," said Steven Howard, who runs SaintLouis University's health administration program.

|

By offering an upfront cost on a coupon site like Groupon,Howard argued, medical companies are meeting people where they are.It helps drive prices down, he said, all while marketing themedical businesses.

|

For Paul Ketchel, CEO and founder of MDsave, a site thatcontracts with providers to offer discount-priced vouchers onbundled medical treatments and services, the use of medicalGroupons and his own company's success speak to the brokenness ofthe U.S. health care system.

|

MDsave offers deals at over 250 hospitals across the country,selling vouchers for anything from MRIs to back surgery. It hasexperienced rapid growth and expansion in the several years sinceits launch. Ketchel attributes that growth to the general lack ofprice transparency in the U.S. health care industry amid risingcosts to consumers.

|

"All we are really doing is applying the e-commerce concepts andengineering concepts that have been applied to other industries tohealth care," he argued. "We are like transacting with Expedia orKayak while the rest of the health care industry is working with anold-school travel agent."

|

A closer look at the deal

Crown Valley Imaging in Mission Viejo, Calif., has been sellingGroupon deals for services including heart scans and full-bodyCT scans since February 2017 — despite what Crown Valley'spresident, Sami Beydoun, called Groupon's aggressive financialpractices. According to him, Groupon dictates the price for itsdeals based on the competition in the area — and then takes asubstantial cut.

|

"They take about half. It's kind of brutal. It's a tough placeto market," he said. "But the way I look at it is you're gettingdecent marketing."

|

Groupon-type deals for health care aren't new. They weremore popular in 2011, 2012 and 2013, when Groupon and its then-competitor LivingSocial were attheir heights. The industry has since lost some steam. Grouponstock and valuation have tumbled in recent years, even after buyingLivingSocial in 2016.

|

Groupon did not respond to requests for comment on how manymedical offerings it has featured or its pricing structure.

|

"Groupon is pleased any time we can save customers time andmoney on elective services that are important to their dailylives," spokesman Nicholas Halliwell wrote in an emailed statement."Our marketplace of local services brings affordable dental,chiropractic and eye care, among other procedures and treatments,to our more than 46 million customers daily and helps thousands ofmedical professional[s] advertise and grow their practices."

|

In Atlanta, two imaging centers that each offered discountcoupons from Groupon said the deals have driven in new business.Bobbi Henderson, the office manager for Virtual Imaging Inc.'sPerimeter Center, said the group had been running thedeal for a heart CT scan, complete with consultation, since2012. Currently listed at $26 — a 96% discount — more than 5,000 ofthe company's coupons have been sold, according to the Grouponsite.

|

Brittany Swanson, who works in the front office at OutPatientImaging in the Buckhead neighborhood of Atlanta, said she has seenhundreds of customers come through after the center postedGroupons for mammograms, body scans and other screenings aroundsix months ago.

|

Why did the company choose to make such discounts available?

|

"Honestly, we saw the other competition had it," she said.

|

A lot of the deals offered are for preventive scans, Swansonsaid, providing patients incentives to come in.

|

But Dr. Andrew Bierhals, a radiology safety expert at WashingtonUniversity in St. Louis' Mallinckrodt Institute of Radiology,warned that such deals may be leading patients to get unnecessaryinitial scans — which can lead to unnecessary tests andradiation.

|

"If you're going to have any type of medical testing done, Iwould make sure you discuss with your primary care provider orpractitioner," he cautioned.

|

Appealing to those who fall into the Insurance gap

Because mammograms are typically covered by insurance, Swansonsaid she believes OutPatient Imaging's $99 Groupon deal is fillinga gap for women lacking insurance. The cost of such breastscreenings for those who don't have insurance varies widely but canbe up to several hundreds of dollars without a discount.

|

Groupon has long been used to fill insurance gaps for dentalcare, Howard said. He himself often bought such deals over theyears to get cheaper teeth cleanings when he didn't have dentalinsurance.

|

But advanced medical scans involve a higher level of scrutiny,as Chicagoan Anna Beck learned. In 2015, she and her husband,Miguel Centeno, were told he needed to get a chest CT after a lessadvanced X-ray at an urgent care center showed somethingsuspicious. Since her husband had just been laid off and did nothave insurance, they shopped online for the cheapest price. Theyended up driving out to the suburbs to get a CT scan at an imagingcenter there.

|

"I knew that CT scans had such a wide range of costs in ahospital setting," Beck said. "So going in knowing that I couldprice-check and have some idea of how much I'd be paying and alittle more control" was preferable to going to the hospital.

|

On the drive back into the city, the center called and told themto go straight to the hospital — the scan had discovered a largemass that turned out to be a germ-cell tumor.

|

Fortunately, Centeno's cancer is now in remission, Beck said.But their online shopping cost them more money than if they'd gonestraight to the hospital initially. The hospital gave them charitycare. And although Beck took along a CD of the scans Centeno hadfound online, the hospital ended up taking its own scans, aswell.

|

"You're trying to cut cost by getting a CT out of the hospital,"she said. "But they're just going to redo it anyway."

|

Kaiser Health News isa nonprofit news service covering health issues. It is aneditorially independent program of the Kaiser Family Foundation,which is not affiliated with Kaiser Permanente.

|

Read more: 

Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.

  • Critical BenefitsPRO information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.