Lin Trevor, Margo Curtis E
Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, USA.
Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, USA.
Cureus. 2024 Nov 21;16(11):e74173. doi: 10.7759/cureus.74173. eCollection 2024 Nov.
Objectives To determine if direct-to-consumer (DTC) laboratory testing is less expensive for patients, as is generally advertised, and whether it has any role in managing uninsured or underinsured patients. Methods The costs of six commonly ordered laboratory tests were obtained through two major DTC laboratories and compared with 42 physician-ordered, hospital-based laboratories in Florida. The costs of DTC tests were also compared to concurrent reimbursements from Medicare and Medicaid. Results The costs of DTC tests were generally lower than the mean insurance-negotiated hospital-based prices and much less costly than physician-ordered tests for patients without insurance. Charges were greater than reimbursements from Medicaid and Medicare. The inter-hospital variation in the pricing of laboratory tests was remarkably wide for both insured and uninsured patients. Conclusions Charges to insured patients for physician-ordered laboratory tests tend to be higher than those offered directly to consumers, but out-of-pocket costs will vary depending on deductibles and co-pays. DTC costs would be substantially less for uninsured patients when ordered by a patient under the supervision of a physician.
目的 确定直接面向消费者（DTC）的实验室检测对患者来说是否如普遍宣传的那样费用更低，以及它在管理未参保或参保不足的患者方面是否有任何作用。方法 通过两家主要的DTC实验室获取六项常用实验室检测的费用，并与佛罗里达州42家由医生开具医嘱、基于医院的实验室进行比较。DTC检测的费用还与医疗保险和医疗补助的同期报销费用进行了比较。结果 DTC检测的费用通常低于保险公司协商的基于医院的平均价格，对于没有保险的患者来说，其费用比医生开具医嘱的检测要低得多。收费高于医疗补助和医疗保险的报销费用。对于参保和未参保患者，医院间实验室检测定价的差异都非常大。结论 医生开具医嘱的实验室检测向参保患者收取的费用往往高于直接向消费者提供的费用，但自付费用会因免赔额和共同支付而异。在医生监督下由患者进行DTC检测时，未参保患者的费用将大幅降低。
