Facility Fee Strikes Again


Here is a fun story that is becoming more and more common:

When a scab on Laura Wheaton-Werle’s son’s wrist wouldn’t heal, she suggested he visit his doctor. The doctor said it was nothing serious, but removed the lesion in his exam room.

Wheaton-Werle said she thought nothing more about it, until the bill arrived.

“That was $202,” she said. “That’s what I would expect from a physician,” she said.

What she didn’t expect was a second bill for $746 from Truman Medical Center, a hospital her son had never visited.

“When I called Truman Medical Center to ask them about this they said, `Well he came to our hospital,’”recalled Wheaton-Werle. “No he didn’t. He was at the doctor’s office.”

That’s when she learned Truman Medical Center owned the doctor’s office and considered it part of the hospital. The $746 bill was for something called a “facility fee” that goes directly to the hospital.

This is the sad future of healthcare.  Now you know why the door is open for CVS and Walmart to get into the game and compete.  And how sad is it when these patients get these bills, especially when their out-of-pocket deductibles is getting higher and aren’t covering these bills?

This story has now become the new but perverted twist on the line from It’s a Wonderful Life:

“The administrators says that every time a patient complains about a ‘facility fee’ it means that another doctor has whored himself or herself out to a hospital.”

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Facility Fee Strikes Again

  1. David Fitzpatrick
    May 19, 2015 at 10:07 am

    One has to ask, “Can I, as the doctor and owner of Small Town, USA clinic, charge a ‘Facility Fee’?” The answer to this is laughable (why cry?). We hear lots of static about the need for doctors is rural America. But the system is set up to drive those docs out of business and into the arms of blood sucking hospitals and corporate consortia. How can a solo practitioner afford the staggering and suspicious costs of EHR and not get a facility fee?

  2. Randy
    May 19, 2015 at 9:46 am

    I continue to be surprised at the government’s willingness to pay these facility fees. They greatly increase the cost of primary care, plus tilt the playing field away from self-employed physicians. I know the federal government has looked at this but I haven’t seen any significant moves away from reimbursing these fees. You have to wonder if this was part of the government’s discussion with hospitals in the lead up to Obamacare.

    There is a quote in the article which is spot on: “You are paying for those million-dollar administrators and that beautiful marble new building,” Rowe said. “That’s what you’re paying for.”

  3. Seneca
    May 19, 2015 at 8:28 am

    Interesting that Obamacare will actually bring some market forces back to the healthcare consumer–I’m sure many who were in favor of it didn’t see that coming! Hopefully, if this kind of thing happens to enough voters, there will be some call to change the compensation system from consumers and not just the few remaining doctors who are actually paying attention. I won’t be holding my breath.

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