(The Center Square) – So-called “facility fees” charged to patients at hospital-owned outpatient clinics prompted a spirited debate Tuesday before a state legislative committee.
“Restricting or limiting facility fees would jeopardize patient access to services, reduce hospital capacity to respond to emergencies and threaten the care of vulnerable populations,” said Josh Dobson, CEO of the North Carolina Health Care Association and former state commissioner of the Labor Department.
Rural areas in particular would be hurt if the facility fees were eliminated, Dobson said.
Peter Daniel, executive director at the North Carolina Association of Health Plans, disagreed.
“You are right to look at hospital facility fees in non-hospital environments,” Daniel told legislators.
The fees are appropriate for patients at hospital emergency rooms which are open 24 hours a day, seven days a week, Daniel said.
“They maintain trauma capacities, specialized equipment and standby staffing,” he said. “Facility fees were originally designed to help support these around-the-clock hospital operations that serve our communities.”
Hospitals are now charging patients facility fees for routine care in outpatient offices that operate during normal business hours and “look no different than the independent practices next door,” Daniel said.
He cited a patient receiving a routine ultrasound at a doctor’s office.
Before the practice was purchased by a hospital, the patient would be charged about $164 for each test, Daniel said.
“After the practice was acquired by a hospital system, a facility fee was added,” Daniel said. “The next visit costs $339, more than double for the same service, in the same building by the same physician.”
Every year, more independent medical practices are purchased by large hospital systems, Daniel said.
“As consolidation increases, facility fees become more common, and routine care becomes more expensive,” he said.
More than 20 states have enacted some form of facility fee reform, Daniel added.
Last year, a bill passed the state Senate that addressed facility fees in outpatient settings.
“We estimate that passing this policy would reduce health care costs for North Carolina families by at least $200 million a year, and that is a conservative estimate,” Daniel said.
Sen. Ralph Hise, R-Mitchell, lives 52 miles from the closest hospital.
He questioned why patients should pay a facility fee for a hospital that is far away and is “mostly inaccessible” on a daily basis to residents of rural areas.
The fees help pay for overhead costs as well as “nonphysician” costs of patient care, Dobson said.
