New report shows state pathways to end hospital billing abuses stemming from consolidation

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BOSTON– Health care consolidation means more expensive bills for patients, not only because of higher prices, but also because of added facility fees — extra charges that patients usually have to pay for out-of-pocket that help big health care companies bump up their profits. MASSPIRG Education Fund’s new report, Outpatient outrage: Hospitals charge fees for care at the doctor’s office, released today, dives into why more BayStaters are seeing these fees on their medical bills, even though they were treated somewhere else. The report shows how facility fees contribute to higher costs for care and outlines solutions that states can provide.

“Just like any other bill, the price of your medical care should reflect the services you received. Health care facilities too often overcharge patients just because they can,” says Deirdre Cummings, MASSPIRG’s Education Fund Consumer Program Director. “Facility fees are intentional, additional fees. These seemingly random charges can confuse patients and make them worry about the uncertainty of medical costs.”

Facility fees cost anywhere between a few dollars and thousands of dollars, and are arbitrary. They can stem from a change in facility ownership rather than any change to medical care. In Connecticut, the state with the best data on the issue, total facility fee revenue in 2021 was more than $400 million dollars — around $400 per patient visit.

While some federal proposals address facility fees, so far, only state legislatures have taken concrete steps to curb this issue. Fifteen states have passed some form of legislation to restrict facility fees, collect data or educate patients about these fees. Massachusetts recently passed a law, though it does not go into effect until 2025, that requires patients to be notified about any such fees and the amount at the time of making an appointment. While that is a good first step, it is not enough. 

MASSPIRG has sent a letter to Governor Maura Healey asking her to ban these unwarranted fees and prioritize data collection on facility fee costs.

“Patients should only pay for the benefits they get, and providers need to be transparent about the fees they charge,” Cummings said. “Massachusetts should put an end to extraneous charges that have no relation to the care or treatment received.”