{"id":2611,"date":"2023-07-05T11:19:56","date_gmt":"2023-07-05T15:19:56","guid":{"rendered":"https:\/\/pirg.org\/massachusetts\/edfund\/articles\/facility-fees-are-driving-up-the-prices-of-doctor-visits\/"},"modified":"2026-01-28T08:55:17","modified_gmt":"2026-01-28T13:55:17","slug":"facility-fees-are-driving-up-the-prices-of-doctor-visits","status":"publish","type":"article","link":"https:\/\/pirg.org\/massachusetts\/edfund\/articles\/facility-fees-are-driving-up-the-prices-of-doctor-visits\/","title":{"rendered":"Facility fees are driving up the prices of doctor visits."},"featured_media":48313,"template":"","meta":{"_acf_changed":false,"_yoast_wpseo_meta-robots-noindex":false,"_yoast_wpseo_meta-robots-nofollow":false,"_yoast_wpseo_opengraph-title":"","_yoast_wpseo_opengraph-description":"","_yoast_wpseo_twitter-title":"","_yoast_wpseo_twitter-description":""},"campaign_tax":[146],"display_option":[],"issue_tax":[],"person_tax":[225],"region_tax":[],"state":[2],"topic_tax":[120],"class_list":["post-2611","article","type-article","status-publish","hentry"],"acf":{"details":{"helper_taxonomies":{"topics":[120],"collection":false,"press_type":false,"person_type":false,"resource_type":false,"event_type":false,"campaigns":146,"department":false,"level":false,"states":[2],"act_option":false,"display_option":false,"primary":{"topic":120}},"featured_image":48313,"caption_override":"","excerpt":"Hospital facility fees are tacked onto bills for doctor visits. But why?","updated_on":"20260127","sidebar_action":[],"hide_hero_image":false,"sidebar_action_query_string":""},"helper_people_group":{"title":"Authors","entities":[{"type":"dynamic","dynamic_person":{"site":16,"people":"130"},"information":{"name":"","image":null,"role":"","biography":"","contact":{"twitter":"","facebook":"","email":"","phone":""}}},{"type":"dynamic","dynamic_person":{"site":16,"people":"16191"},"information":{"name":"Cynthia Ma","image":"","role":"Health Care Campaigns Intern, Summer 2023","biography":"Cynthia is a student at the University of Chicago. She is passionate about accessibility and fair pricing of health care for patients.<\/span>","contact":{"twitter":"","facebook":"","email":"","phone":""}}}]},"page_layout":[{"acf_fc_layout":"layout_wysiwyg","_acfe_flexible_toggle":"","component_wysiwyg":{"content":"Have you ever been charged more than you were expecting for a routine medical service at your doctor\u2019s office? If so, you may have been charged a facility fee. That\u2019s a charge added to your bill which was originally meant to offset the extra costs of \u2018maintaining the facility\u2019 of a hospital, covering expenses 24\/7 staffing and capacity for emergency care.\u00a0<\/span>\r\n\r\nWhile facility fees help fund necessary hospital services, these days, many people are seeing a facility fee tacked onto their regular doctor or clinic bills. Why? <\/span>Hospital systems are purchasing physician practices and clinics.<\/span><\/a> When these sites for regular visits are now owned by hospital systems, the hospital billing department may begin to institute an added \u201cfacility fee\u201d at those newly acquired doctors\u2019 practices. That means patients pay more for the same care they\u2019ve always received<\/strong>, even in the same building with the same doctor as before.<\/span>","":null}},{"acf_fc_layout":"layout_featured_article","_acfe_flexible_toggle":"","component_featured_article":{"article":[2947]}},{"acf_fc_layout":"layout_wysiwyg","_acfe_flexible_toggle":"","component_wysiwyg":{"content":"With <\/span>growing trends of consolidation<\/span><\/a>, patients may end up being charged a facility fee even if they never step foot in a hospital. As if healthcare isn\u2019t already expensive enough, patients might see these add-on charges for routine services, such as blood tests, x-rays, or even telehealth visits. Facility fees for outpatient services vary widely, but can be costly: one report found that <\/span>over half<\/span><\/a> of the states studied had average facility fees over $100. These costs add up quickly, and people that need regular care could rack up thousands of extra dollars for the facility in just a couple months. Even worse, patients are often unaware of this new fee until they receive the bill.<\/span>\r\n

Who pays for facility fees?<\/b><\/h4>\r\nMany insurance providers <\/span>will not completely cover<\/span><\/a> facility fees, leaving patients with yet another cost to bear. Even if insurance plans pick up the tab, we could see that cost passed along through an increase in our insurance premiums.\u00a0<\/span>\r\n\r\nThis problem has exacerbated with time, as more and more hospitals acquire physician\u2019s practices, allowing them to spring unexpected facility fees on patients across the country. As of 2023, nearly <\/span>four of five physicians (77.6%)<\/span><\/a> are now employees of hospitals or health systems and other corporate entities, and the consolidation trend continues. This is bad news for patients, as the likelihood of facility fees increasing costs for all consumers becomes an imminent reality.<\/span>\r\n\r\nIt\u2019s reasonable for a hospital to be able to charge enough to cover all its expenses. In some circumstances, when hospital backup might be beneficial even if the procedure doesn\u2019t require an inpatient stay, it might even make sense to charge a facility fee. But routine care, like an annual physical or other outpatient doctor visits, certainly should not carry the added costs associated with ICUs, or other hospital-specific staffing and infrastructure. We shouldn\u2019t be paying more for the same care, just because the clinic is owned by a hospital.\u00a0<\/span>\r\n

It\u2019s time to put an end to unjustified facility fees.\u00a0<\/b><\/h4>\r\nIf we don\u2019t stop this practice, patients across the country could be paying more every time they visit their regular doctor for no reason other than an ownership change of the physician\u2019s practice. In 2024, hospitals brought in over <\/span>$1.4 billion in facility fees in Connecticut<\/span><\/a> alone. But even though <\/span>states are starting to take action<\/span><\/a>, many reforms are too weak to adequately protect patients from unjustified facility fees.\u00a0<\/span>\r\n

Facility fees should never be charged for care that doesn\u2019t need the back-up services of a hospital.<\/b>\u00a0<\/span><\/h4>\r\nThere is no reason for patients or insurance companies to pay a facility fee solely due to a change of ownership in the physician practice. In fact, in a 2023 poll, nearly <\/span>3 in 4 voters (74%)<\/span><\/a> wanted policymakers to ban facility fees everywhere for outpatient, same-day services, regardless of the service or where care is being provided. In addition, billing restrictions on facility fees for routine care would have only a <\/span>very small impact<\/span><\/a> on hospital profits, meaning these reforms would protect patients without harming hospitals.<\/span>\r\n<\/span>\r\n

Read more: Hospitals cry wolf \u2013 banning facility fees won\u2019t bankrupt them<\/a><\/strong><\/em>\r\n<\/span><\/h4>","":null}},{"acf_fc_layout":"layout_wysiwyg","_acfe_flexible_toggle":"","component_wysiwyg":{"content":"In response to growing public awareness and pressure, states are stepping up. <\/span>Twenty-one states<\/span><\/a> now have laws targeting unfair facility fees, although many are very narrowly targeted or inadequate to fully address the issue. <\/span>Colorado prohibits<\/span><\/a> facility fees for care at outpatient locations, telehealth appointments, and preventative healthcare services, and established a Hospital Facility Fee Steering Committee in 2023 to evaluate the implementation and impact of facility fee reforms. Similarly, <\/span>Connecticut\u2019s relatively robust facility fee law<\/span><\/a> went into effect in 2024, prohibiting facility fees for many types of outpatient care and requiring annual reporting on what facility fees are charged. In addition, <\/span>the <\/span>National Academy for State Health Policy<\/span><\/a> has suggested a model act targeting facility fees based on location and service, urging states to <\/span>prohibit unwarranted facility fees<\/span><\/a> with reporting requirements and regulations.<\/span>\r\n\r\nThis progress is encouraging, but we still have a long way to go before all Americans are protected from unjustified facility fees. Health care charges should reflect the care received, not who owns the practice.\u00a0<\/span>\r\n

Have you been charged a facility fee? <\/strong><\/a><\/h4>","":null}}]},"yoast_head":"\nFacility fees are driving up the prices of doctor visits.<\/title>\n<meta name=\"description\" content=\"Hospital facility fees are tacked onto bills for doctor visits. But why?\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pirg.org\/massachusetts\/edfund\/articles\/facility-fees-are-driving-up-the-prices-of-doctor-visits\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Facility fees are driving up the prices of doctor visits.\" \/>\n<meta property=\"og:description\" content=\"Hospital facility fees are tacked onto bills for doctor visits. 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