We know a lot of you are paying more for your medical bills with added ‘facility fees’. Some see hundreds of dollars in charges above your co-pay. Investigator Amy Davis has heard from a lot of you about these fees after the KPRC 2 Investigation earlier this month.
In this week’s Ask Amy episode, Amy talked to experts about these fees and what you can do about it.
You may remember, a Baytown area mom showed us her bills from Texas Children’s Hospital.
One $290 item is labeled ‘observation - treatment room’. Another $405 fee says it’s a ‘room, staff and supply charge.’
Facility fees are common at hospitals where patients are billed separately for doctors and specialists. But in recent years as hospital systems buy up doctor’s offices, they are adding these facility fees to regular doctor bills.
To talk more about these fees and what the average person can expect, Vivian Ho, Ph.D., joined me for an Ask Amy episode. Dr. Ho is the James A. Baker III Institute Chair in Health Economics, a professor in the Department of Economics at Rice University, and a professor in the Department of Medicine at Baylor College of Medicine. Ho’s research examines the effects of economic incentives and regulations on the quality and costs of health care.
She says hospitals are making a lot of money from these fees.
“You can look at the hospital financials for all of these different health care systems by year. And what you see are that the health care systems that are engaging in this charging facility, fees for doctors offices that are the largest, the most consolidated, they are making terrific profits, profits. They are they are financially very healthy. And it’s the smaller organizations, rural organizations that we should be worried about,” said Dr. Ho.
Dr. Ho: “You could be calling your doctor’s office and saying, I know I’m scheduled for this visit. Could you tell me whether you charge facility fees for your visits? And hopefully, they’re honest with you about that. In principle, some of them could, you know, some patients could try and switch to independent practitioners. That takes time as well. And maybe you have an established bond with your current physician and you don’t want to do that. So that’s difficult as well.”
Amy: “Right? I know from our reporting, some of the hospitals said that you could do a telehealth visit, but with some of these doctors, endocrinologists, and some of the specialists, that doesn’t always work. I mean, sometimes your child or you may need to actually physically see the doctor, but they said in telehealth visits they won’t apply these facility fees. And so, yeah, it’s like, so if you don’t go see somebody in person at all, we’re not going to charge you those. I also know Texas Children’s Hospital, was waiving the first, I think just because it’s new for them since these fees and a lot of their doctor’s offices, outpatient clinics started, they said that they were waiving not just across the board, but if you called and complained or called and asked about them, they would waive the facility fees the first time that they were assessed.”
Amy: “And then they also said that, hey, maybe they’re just noticing them because this is the first of the year and they still haven’t met their deductible, but once they meet that sort of pay out of your own pocket deductible, then your insurance company will pick these up. What’s the problem with that, though?”
Dr. Ho: “Yeah, I, I just find that so disappointing. You know, patients realize health care is complicated and it’s complex. And, you know, they are willing to pay more for a service that has higher value. But in this case, providers have just found a different way to collect more money. It is collecting a facility fee where there’s no additional value over and above what you were getting before when you were paying just the professional fee. It’s just not right. And you know, the example you know, you’re giving of telehealth. My son had strep throat a couple weeks ago. There’s no way they’re going to test for strep throat on a telehealth visit. And there’s so many different visits like that.”
SEE ALSO: ‘I would send my momma here,’ New 24/7 Emergency Room clinic, Top Care ER, opens in Houston Heights
Potential laws related to facility fees
Texas Senator Kelly Hancock also joined the episode to talk about a law he introduced at the state level that did not pass. (SB 1275)
“You know, initially it was from, freestanding E.R. that was charging, you know, for the facility. And then we noticed some of the hospitals were starting to do it. And, really, what it became is a kind of a post-Covid, way of improving profits, I guess, just additional charges that took place, you know, very similar to what we saw when we passed balanced billing, when we passed balanced billing all of a sudden, because we initially eliminated some of these charges related to, you know, different specialties. And all of a sudden, we began to see new charges pop up that, were being passed on to consumers. And we just felt like somebody’s got to protect this consumer. And so, we jumped in there.”
Hancock says in health care patients don’t have a lot of leverage.
“And so, they’ve got to have somebody willing to step up in and look out for them against some pretty mighty forces. When you’re talking about health care industry and insurance industry and, you know, we’re just we’ve been always been willing to do that,” said Hancock.
“Contact your elected officials. I mean, don’t just sit and take it. And so let them know. Let them know it’s an issue and help us build momentum to try to address this so that it doesn’t continue to grow and negatively impact, patients and customers.”
There is still a bill pending on the federal level related to facility fees. You can reach out to your elected official if you want them to ban these fees.
Find Your Members in the U.S. Congress | Congress.gov | Library of Congress
Who Represents Me? (texas.gov)
The Texas Hospital Association told KPRC 2 News the fees are necessary. They sent this document that explains that hospitals would have to reduce staff, cut services, and close outpatient clinics if these fees were banned.
See what area hospital systems have to say about facility fees.
WATCH: Full Ask Amy episode on facility fees