US Hospitals Profit Billions from ‘Facility Fees’ for Routine Doctor Visits

Stock Image. (Photo by Adam Berry/Getty Images)

OAN’s Brooke Mallory
12:38 PM – Tuesday, March 26, 2024

By charging unwary patients so-called “facility fees” for routine check-ups at outpatient centers, American hospitals are profiting billions of dollars.

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In a recent Wall Street Journal article, the annoyance felt by many Americans who are unaware that they are being charged hundreds of more dollars that will go toward a hospital’s overhead is now being examined.

The Wall Street Journal and Daily Mail reported that as hospitals “continue a pattern of steady acquisitions of medical practices, the fees are becoming inevitable.”

The costs add hundreds of dollars to the overall bill of routine medical treatments like colonoscopies, heart tests, and mammograms.

Hospitals argue that facility fees are required to defray the cost of complying with federal regulations. Generally speaking, these costs entail charging an individual a ridiculous amount for simply using the room in which they see their physician.

One doctor claim stated that fees for outpatient services benefit hospital compensation for services like neonatal intensive care units.

A facility fee is typically added to four out of five medical invoices for heart exams in states like Maine and Ohio that are now routed to the biggest insurer in each state.

Hospital costs begin to reflect the fees associated with buying clinics and physicians. Long-term patients are left with the choice to pay the high cost or find a new provider when hospitals classify the formerly “boutique clinics” as extensions of their centralized operations.

According to the Journal article, non-admitted patients now account for at least half of hospital systems’ revenue. Those figures add up when considering the extent of hospital purchases in recent years.

“Medicare advisers said that the fees collected in 2021 allowed the government program to overpay by $6 billion for a slate of services,” Daily Mail reported.

Congressmen have also suggested capping the costs that Medicare pays.

A bill that would prohibit Medicare from covering hospital costs for chemotherapy and other medication infusions provided by physicians in clinics off hospital property was enacted by the U.S. House of Representatives in December.

In the ensuing ten years, the federal insurer would also save about $4 billion thanks to the change.

The American Hospital Association, a group that serves as a sort of spokesperson for major U.S. hospitals, opposes any charge caps proposed by Congress. The group claimed that those kinds of limitations would “rob hospitals” of the necessary money in a “cruel financial market.”

Meanwhile, certain states have intervened on their own. Clinics connected with the largest nonprofit health systems but not located on hospital campuses are not allowed to charge fees in states like Indiana. Preventative care visits and telemedicine fees have also been outlawed in other states.

Additionally, certain states mandate that hospitals inform patients of the costs in advance of scheduling an appointment.

Colorado hospitals will have to tell prospective patients about the costs starting in July.

“My father had hip surgery, and we were billed for an extra ‘attending physician.’ After 2 months of hounding them and threatening legal action, they finally admitted it was a med school student observing the procedure for a rotation. So, they expected us to pay for a GD student to watch and do nothing for the care of my father. NEVER trust a hospital or an insurance company,” one online user commented.

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