What Is a Shoppable Service for Healthcare?

Comparing fees for many healthcare services is now easier. And understanding what a shoppable service for healthcare is may help reduce your costs.

You’ve probably comparison shopped, often online, for many different services, from lawn care to computer repair and everything in between. Unfortunately, shopping for one of the most important aspects of life, healthcare services, has traditionally been far more difficult.

In fact, you may not be aware there are shoppable services for healthcare because finding information about which services are, by definition, “shoppable,” and how to find and compare prices has often been difficult.

But comparison shopping for hundreds of tests and procedures is has become easier, and that could help lower healthcare expenses.

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What are shoppable services for healthcare?

A shoppable service is a medical service you can schedule well ahead of time, usually on an out-patient basis.

You can’t plan ahead for many health problems, such as a broken bone, heart attack, or other emergency. And you may have no idea you need certain tests, like an x-ray or blood tests, until your doctor suspects a problem during an exam and orders immediate testing.

Hundreds of tests and procedures, however, fit the definition of shoppable services. For instance, lab tests for a chronic condition or a cholesterol level check, colonoscopies, yearly mammograms, and imaging tests, like MRIs, CT scans, and echocardiograms, can all be scheduled on an out-patient basis.

If you have a high-deductible insurance policy, your insurer has in-network providers with varying co-pay requirements at different medical facilities — or you don’t have health insurance at present — it makes sense to compare prices. In fact, it’s a good idea for anyone watching their healthcare expenses to understand shoppable services because prices can vary significantly among medical facilities.

To make it easier to shop, a federal rule that went into effect in 2021 requires hospitals to list prices for 300 shoppable services for healthcare in an easy-to-understand and easy-to-access online format. A similar law requires health insurance companies to do the same.

Making comparing prices for shoppable services for healthcare easier

You can’t realistically shop for a healthcare service unless you are able to compare the price of a test or procedure to that of other providers offering the same service in your area.

According to the regulation, the Centers for Medicare and Medicaid Services (CMS) requires hospitals to list the prices for 70 specific shoppable services; hospitals can choose the other 230 they list. If a small hospital doesn’t provide 300 shoppable services, it still must list all the shoppable services it does provide.

CMS’s list of 70 services includes:

• Common doctor services like physicals and new patient visits
• Laboratory and pathology services
• Radiology and other imaging services
• Additional common medical and surgical procedures you can schedule ahead of time

Hospitals must also make public the charges they negotiate with insurance companies for these healthcare services (so you can know how much your out-of-pocket fee can be) and the amount the hospital is willing to accept if you pay cash. What’s more, charges that typically go along with a service — for example, a pathologist’s fee for examining a polyp removed during a colonoscopy — must be listed, too.

The CMS requires the information to be easy to understand, quick to locate online, free to access, and without any requirements to register, have an account, or enter a password. The list of prices must also be searchable in multiple ways, including by billing codes and descriptions of the type of service.

The required price disclosures aim to make shoppable services for healthcare truly “shoppable,” helping you make direct price comparisons to find the best choice for you.

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