Imagine this: you visit a familiar clinic for a routine checkup, only to be hit with a bill hundreds of dollars higher than expected. This isn't a billing error – it's the harsh reality of "facility fees," a sneaky tactic hospitals are using to inflate outpatient costs.
Tim Ebel's story exemplifies this growing trend. A visit to his ear, nose, and throat specialist at an Ohio clinic resulted in a surprise second bill for a whopping $645. This wasn't for any additional service – it was a fee for simply using the clinic's facilities, owned by a hospital system, even though Ebel never set foot in the hospital itself.
This is the insidious nature of facility fees. Hospitals are tacking on these charges to routine outpatient care delivered in clinics they've acquired. What was once a minor annoyance is now pervasive, raising costs for colonoscopies, mammograms, heart screenings, and other widely used procedures.
"You're not getting anything extra," says Loren Adler, a health economist. Patients are essentially footing the bill for the hospital's overhead costs, including regulations and maintaining expensive units like neonatal intensive care.
Hospitals defend the practice, claiming facility fees help offset these costs and ensure continued high-quality care. However, critics argue these fees are unjustified and lead to inflated medical bills. In 2021 alone, Medicare likely overpaid billions of dollars due to these fees.
The real catalyst behind this surge in facility fees? Hospital consolidation. Hospitals are on an acquisition spree, snapping up medical groups and clinics. Once acquired, these facilities become extensions of the hospital system, allowing them to charge patients facility fees.
This consolidation gives hospitals more control over costs and patients. They can now designate a wider range of services as "hospital-based," justifying facility fees for procedures that were once considered outpatient.
The impact on patients is undeniable. A simple chemotherapy treatment in an off-campus clinic now often carries a hefty facility fee. Data shows these fees on chemotherapy bills have doubled in the past decade.
Rebecca Smith, a breast cancer survivor, experienced this firsthand. After her clinic was acquired by a hospital system, her routine monitoring visit skyrocketed from $76 to $400 due to a facility fee. Despite facing mounting medical bills and debt collectors, she refused to pay, highlighting the financial burden these fees place on patients.
The good news? Change is on the horizon. Policymakers are starting to take notice. A recent bill proposes eliminating facility fees for some off-campus treatments, saving billions of dollars for Medicare patients.
However, the fight is far from over. The hospital industry fiercely opposes such limitations, arguing they would cripple their already strained finances.
The future of patient costs remains uncertain. While a legislative solution shows promise, urgent action is needed to curb the rampant use of facility fees. Patients deserve fair and transparent healthcare pricing, free from hidden charges and surprise bills.
