I keep a close eye on my medical bills. I know what my co-pays are supposed to be, and I make it a point to understand what I’m paying for. So when I received separate bills after routine visits to my cardiologist and rheumatologist, I honestly thought someone had made a mistake.
My appointment was in my doctor’s office. I never stepped foot inside a hospital; I didn’t have lab work, X-rays, or emergency treatment — yet one of the bills described charges as hospital fees.
When I called to ask about it, I learned there was a new culprit driving up prices in health care, something I had never heard of before: a hospital facility fee.
I had more questions, like: “What exactly am I being charged for?”
As it turns out, more and more people are asking these same questions. Across Florida and around the country, as physician practices are being purchased by large hospital systems, patients can find themselves paying an additional facility fee for the exact same office visit they have been receiving for years — often in the exact same building, with the exact same doctor and staff. The only thing that has changed is the owner of the practice.
In the end, my insurance covered most of the charges for my recent doctor visit. I ended up owing a little more than $100. But for me, this isn’t really the point.
Here’s what’s more important: If this happened to me, how many other patients are opening their mail and wondering why they are suddenly paying hospital prices for a routine doctor’s appointment?
Patients deserve better.
It’s difficult to understand why a routine visit to a doctor’s office should suddenly become more expensive simply because the ownership of that office has changed. It’s also unfair. For all these reasons, Congress should enact site-neutral payment reforms.
Site-neutral payment reform is based on a simple principle: if Medicare is paying for the same service, it should generally pay the same amount regardless of whether that service is provided in a hospital-owned outpatient department or an independent doctor’s office.
If I receive the same exam from the same doctor in the same exam room, why should the price change simply because the name on the building changed?
Florida has become one of the states where hospital ownership of physician practices has grown rapidly, and stories like mine are becoming more common. Consumer advocates have warned that many patients don’t discover facility fees until weeks after their appointment, when the bill arrives in the mail.
Transparency is important, but transparency alone isn’t enough. Even if every patient is told ahead of time that an extra fee is coming, they’re still being asked to pay more for the same routine care.
Policymakers should continue looking beyond disclosure requirements and consider broader reforms that align payments with services provided rather than the ownership structure behind them.
The Trump administration has already worked to expand site-neutral payment reforms. Senators Scott and Moody, along with Representatives Bean and Lee, should support this effort and act now to advance commonsense site-neutral payment reforms. It’s a real step toward making health care more affordable and ensuring patients pay a fair price for the care they receive, not for where they receive it.
Americans shouldn’t need an accounting degree to figure out why a routine office visit suddenly costs more than it did previously. And if sharing my experience helps prevent someone else from receiving an unexpected charge – or encourages lawmakers to create a fairer payment system – then speaking up is worth it.
Patients shouldn’t have to wonder whether they’re walking into a doctor’s office or outpatient department that treats them as if they were at a hospital.
The care should determine the price – not the ownership of the building.
Pete Sonich is a retiree living in North Fort Myers.
This article originally appeared on Fort Myers News-Press: Stop charging hospital prices for doctor’s office visit | Opinion
Reporting by Pete Sonich / Fort Myers News-Press
USA TODAY Network via Reuters Connect
By Pete Sonich | USA TODAY Network
