The Famous “Facility Fee”
Here is a great article in Medical Economics out the “facility fee” farce by Marni Jameson Carey. Read the metaphor in the beginning because it is perfect but the crux of the issue is this:
Every day, hospitals and health systems are buying independent doctors and turning them into employed physicians. When they do, hospitals tack a facility fee onto the doctor’s fee every time he or she performs a procedure. These fees add zero value, yet the law allows hospitals to charge them to “cover overhead.” These money-for-nothing fees are one reason hospitals can afford to pay doctors more than doctors can earn on their own, and lure them out of independent practice—a trend that is unhealthy for doctors and for Americans.
It looks like CMS is finally doing something to help this but it is a law that needs to be changed. The American Hospital Association is not just going to let that happen as they spent $22 million to get it to go their way in the first place. While we wait for that fight there are some things, in my opinion, that we can do:
- Find out who is charging these facility fees and don’t send patients there if possible.
- Get prices from places out of town so you can let patients decide if the cost is worth the ride.
- Support independent and DPC docs!
ANY OTHER IDEAS?
Get Dr. Farrago’s book on how to start your own DPC practice here on Amazon
Most of the specialists in my town are owned by the single hospital in town (which is turn owned by the large university hospital in the big city.) If a patient wants to see someone NOT affiliated with the local hospital then they have to travel about an hour away. Now you are talking about a doctor’s appointment taking most of a day instead just going down the street. The loss of income and cost of driving and tolls can eat into the monetary savings of going somewhere “cheaper”.
At Cedar Orthopaedic Surgery Center, Dr. Delcore combines the facility fee in a bundle with the surgeon’s fee, the anesthesiologist’s fee, and often the implant fee, as in case of a total joint replacement. However, his facility fee is just the cost of the surgical assistance and supplies. It is only a small part of the total combined fee. and the transparent cost (posted on the website), in many cases, is as much as 50% less than hospital charges for the same procedure.
Can someone explain why the insurances don’t offer more money for out patient docs to keep from driving us into the arms of the hospitals and their facility fees, where the insurances will have to pay even more?
Actually, I can explain that, sad to say. The insurance companies really don’t want health care to be less expensive. They profit hugely by keeping it expensive and as monopolistic as possible. Read the article in the link I am including entitled, “Have PPOs perpetuated the Greatest Heist in American History?” I can guarantee that it will tick you off. There is hope through organizations like the Free Market Medical Association.
https://www.forbes.com/sites/davechase/2016/09/05/have-ppo-networks-perpetrated-the-greatest-heist-in-american-history/#18710bca3330
This facility fee is exactly why I cannot get a good price on a colonoscopy for my patients. All the places I have tried to negotiate with have a facility fee more than the GI doc and anesthesia fee combined!