In Ad Campaign, Blue Cross Asks Patients to Shop Around

Suppose you’re eying a new fence to keep your neighbor’s Pomeranian from violating your perennials. What’s one of the first things you’re likely to do? Search for the best deal.

But would you do the same for an MRI on that swollen knee? Probably not, even though the price of routine medical procedures can vary widely depending on where you go.

Blue Cross Blue Shield of Vermont says it’s time to fix this disconnect. An advertising campaign by the state’s largest insurer calls on Vermonters to become savvier consumers, framing it as a personal responsibility amid the state’s health care affordability crisis.

“Each of us can help lower the cost of our health care without sacrificing quality,” reads a full-page ad that ran in Seven Days and other Chittenden County newspapers this winter.

The campaign provides tips on how to maximize savings, such as requesting generic drugs and taking advantage of low-cost screenings and preventive programs. It also lays bare the significant difference between what the University of Vermont Medical Center charges compared with competitors in South Burlington, Rutland, Morrisville and other Vermont locales.

The insurer says an MRI at the UVM Medical Center costs it about $6,520 on average. That same procedure runs about $2,785 at Northwestern Medical Center in St. Albans and just shy of $1,800 at some small independent facilities, according to the insurer. Prices vary widely for other routine procedures, including colonoscopies.

A basic MRI at the University of Vermont Medical Center costs nearly $4,000 more than at a nearby independent imaging center.

Blue Cross says it wants Vermonters to know how these prices have contributed to the state’s highest-in-the-nation health insurance premium rates, while also providing them information they can use to make more cost-conscious decisions. It has set up a website, vtaffordablecare.com, to promote the message.

Blue Cross officials have tempered expectations for the campaign. Their goal is to raise awareness, and so they have not conducted any analysis of what kind of savings may be possible, according to Andrew Garland, vice president of client relations and external affairs.

Still, every person who decides to seek care at a cheaper alternative to the UVM Medical Center could have a small impact on future premium rate increases, Garland said.

“We’re all a part of a pool, and the more responsibly we collectively use the resources that are available for that pool, you know, the better off we all are,” he said.

The call to action comes as Blue Cross is attempting to crawl back from the brink of insolvency following years of major losses. The insurer has blamed its struggles on an unrelenting surge in the cost of claims, which it attributes largely to the care provided at Vermont hospitals.

The state’s 14 nonprofit hospitals are spending 53 percent more today — $4.28 billion — than in 2019, and they charge commercial insurance companies more to cover these growing expenses. The UVM Medical Center now ranks among the more expensive hospitals in the country, according to a pair of independent analyses provided to state regulators.

Hospitals say they must charge more than stand-alone centers because they have higher fixed costs, from running an around-the-clock emergency department to sustaining vital services that lose money, such as neonatal and psychiatric care. But the price tag for specific procedures depends on what they can convince insurance companies to pay.

UVM Health has a lot of bargaining power because it controls so much of the local health care market, and it has not shied away from throwing its weight around. It has sought to stymie competition by opposing the creation of independent facilities, such as a protracted regulatory battle over a proposal to build a now-opened outpatient surgical center in Colchester.

And the network has previously threatened to stop accepting Blue Cross insurance if the company refused to meet its rate demands, according to former Vermont Human Services secretary Mike Smith, who led a liaison group charged with independently vetting the UVM Medical Center’s fiscal year 2026 budget proposal.

The group was commissioned as part of a settlement between the Green Mountain Care Board and UVM Health after the Burlington hospital took in far more in revenue than what regulators had approved. Smith sat in on budget negotiations between the network and Blue Cross and observed what he called their “lingering animosity.”

“BCBS-VT stated that in the past they have been reluctant to negotiate aggressively with the UVMHN over prices,” Smith wrote.

Faced with the hospital’s threat to stop accepting Blue Cross insurance, the insurer has conceded to the network’s demands, according to Smith.

“Not providing care to BCBS-VT patients would be a disastrous situation for the insurance company and it would be an equally disastrous situation for the UVMHN,” Smith wrote. But ultimately, “those most adversely impacted are Vermonters who are burdened with increased insurance rates.”

The health network has disputed Smith’s characterization of past negotiations and, last week, declined comment on Blue Cross’ advertising campaign, saying in a statement that it supports patients seeking lower-cost providers. “We believe that hospitals and insurance companies have the responsibility to work together to bring costs down,” the statement reads.

Researchers estimate that up to 40 percent of health care visits are “shoppable” ones that can be scheduled well ahead of time. And the federal government has taken steps over the past decade to make medical billing more transparent; many online tools make it easy to compare providers’ prices. Yet people still rarely shop around for medical services.

One reason? They trust their doctors to know what’s best. A major study focused on more than 50,000 adults showed that people typically get their MRIs wherever their doctors recommend, regardless of the price. They are also more likely to get scanned in hospital settings if their doctors work for a hospital, as a large share of Vermont physicians do. The surveyed patients drove past, on average, six other facilities where they could have received the test more cheaply.

“The system is set up in a way to keep you in a particular lane: Your physician makes that referral, you sit back, and you wait for the letter to come in the mail,” Garland said. “It doesn’t even necessarily occur to you that there are other options.”

Also: patients don’t always feel a strong motivation to seek out cheaper care due to the nature of health insurance.

Say you’ve already hit your annual deductible, meaning your plan will pick up the tab for any further medical needs. You’re far less likely to care whether your MRI cost $2,000 or $6,000. But that $4,000 difference matters to the insurance company, which must take in enough through premium payments each year to cover the cost of claims.

“We have to pay for all of that care,” Garland said. “So, if we can find ways to spend less on that care as a community, we all save.”

People may be skeptical of cheaper options, even though research suggests there’s little correlation between price and quality when it comes to health care.

Prospective patients are often confused when they learn that an MRI at Vermont OPEN Imaging in South Burlington costs thousands of dollars less than one at the UVM Medical Center, according to owner Todd Kummer.

“A lot of times they’re like, ‘Well, what’s wrong with your service?’” Kummer said with a laugh. His typical reply: “Look online, look at our reviews. Everybody raves about their experiences. It’s the real deal.”

Alex John, a retired gastroenterologist who recently opened a new diagnostic imaging center in Williston, hopes to benefit from the spotlight that Blue Cross is training on independent providers. Vermont Diagnostic Imaging will offer scans and ultrasounds at a fraction of the prices that UVM Medical Center charges and will be able to get people in quicker, too, John said. He’s hosting a ribbon-cutting on Friday, January 16, and hopes to begin filling up its schedule from there.

“It’s an uphill battle, because people are entrenched in their practices,” John said. “But I know it can be done if you provide quality service.”

It’s not just independent practices that could benefit from more shopping around. State regulators have urged Northwestern Medical Center to more aggressively market its services, noting that many Franklin County patients seem to get routine care at the UVM Medical Center even though their local hospital offers much lower prices.

The Blue Cross campaign could spur more competition between hospitals, something Vermont has historically lacked, said Owen Foster, chair of the Green Mountain Care Board.

“We have health care regulation in part because we don’t have adequate competition,” Foster said, but regulation on its own is not enough. “Where we can use our levers to push and promote competition, we should.”

Blue Cross officials say it is too soon to know whether the campaign is influencing patient decisions.

Even if hundreds of people did choose to get their MRIs somewhere besides the UVM Medical Center this year, the hospital could try to simply raise prices next year to make up the lost revenue.

Garland wasn’t worried about that prospect. The hospital appears to share the goal of making health care more affordable in Vermont, he said. Plus, state regulators would need to approve future price hikes — and Blue Cross would then need to agree to pay more.

“And we’re not going to do that,” Garland said.

The original print version of this article was headlined “Manage Your Care | To lower health costs, Vermont’s largest insurance company is urging patients to shop around”

This article appears in The Wellness Issue 2026.