When an employee needs an MRI or CT scan, the hospital is the obvious choice. Walk down the hall, get the scan, done. Then the bill arrives and they owe $2,000 out of pocket.
That is why employees are skipping imaging. Not because they do not need it, but because they cannot afford it.
Employee imaging costs are driving both financial hardship for your workforce and inflated claims on your health plan.
There is a better option and most brokers will never mention it.
Why Hospital Imaging Costs So Much
Hospitals charge at their standard facility rate, which can run $3,000 to $5,000 or more for a single scan. Your plan absorbs part of that. Your employee absorbs the rest through their deductible.
An MRI at a freestanding center uses the same equipment as one at a hospital. The difference is entirely in what gets billed, and most employers have no idea they have a choice.
What Your Broker Is Not Telling You
Solutions to high imaging costs have existed for years. The reason most employers never hear about them: advisors do not benefit from showing you alternatives.
Negotiating a lower premium increase takes a phone call and a spreadsheet. It keeps commissions intact and requires minimal effort. Showing you a program that cuts imaging costs in half takes work, and most advisors are not doing it.
If your broker has never raised freestanding imaging centers, direct-to-provider contracting, or alternative funding strategies, ask why.
DSG’s Exclusive Imaging Network
We just launched an imaging network available exclusively to DSG clients. Thirty facilities across Texas.
What employees pay: Zero. No copay, no deductible contribution, no balance billing. They get the imaging they need without a second thought about cost.
What employers pay: 145% of Medicare, no markups, no surprises. An imaging service that costs $4,000 at a hospital costs roughly $800 through this network.
What that does to your stop-loss: Lower claims mean lower stop-loss premiums. When your employees stop generating high-cost hospital imaging claims, your plan history reflects that, and your stop-loss pricing follows.
This Requires Self-Funding — Here Is What That Means
This program requires a self-funded health plan. That stops some employers before they ask a follow-up question, so it is worth addressing directly.
Self-funding is not a large-employer play. It is a funding structure that gives you direct access to your claims data, control over plan design, and cost-containment programs that are not available inside a fully insured wrapper. If your premiums have been increasing at single digits year over year, your population is likely healthy and you are subsidizing carrier profits instead of keeping that money in your organization.
The imaging network can be added at any point during the plan year once you are self-funded.
Three Questions to Ask Your Broker
- Are you aware of lower cost freestanding imaging networks? If yes, why have you not brought this to us?
- Have you analyzed our claims to identify high-cost imaging utilization?
- What would it take to move us to a self-funded arrangement?
If the answers are vague or discouraging without data, push back.
Why We Built This
We saw the same pattern repeatedly. Employees avoiding care because of cost, employers paying inflated claims without knowing there was another way. So we built something specific for our clients.
Thirty facilities. Zero employee cost-sharing. Transparent pricing at 145% of Medicare. Meaningful claims reduction.
If you want to see how this works for your plan, DM me for more information.