Many Americans are paying hundreds, even thousands of dollars more for healthcare than necessary, and routine doctor visits are sometimes followed by unexpected high bills.
Last year, KPRC 2 Investigates reported on this issue, exposing surprise facility bills for patients. Despite these reports, 2 Investigates reporter Amy Davis almost fell victim to the same practice.
A few weeks ago, Davis scheduled an appointment for her teenage son, who was complaining of hip and knee pain. The doctor ordered X-rays and directed them to the Memorial Hermann Imaging Lab in the same building.
It was late in the day, and the lab scheduled an appointment for the next morning. On the way home, Davis received a text saying, “Your expected prepay amount is $962.75.”
RELATED: Law requires medical fee quotes
The next day, Davis contacted her insurance company and found other imaging labs in her network not affiliated with hospitals. They scheduled an appointment and paid $102.
“I almost overpaid $860,” Davis said. “Even though I’ve done stories on these hospital-group facility fees, it’s getting more difficult for families to navigate doctor visits and healthcare without getting stung.”
Facility fees add hundreds to medical bills
Dr. Vivian Ho, chair of Health Economics at Rice University’s Baker Institute and a professor at Baylor College of Medicine, has researched these fees.
“Five years ago, urgent care centers offered lower prices. The problem is that healthcare systems are acquiring these centers and adding facility fees,” Ho said.
When a doctor’s office or clinic is owned by a hospital, patients can be billed hospital prices as if admitted to an emergency room.
Several bills aimed at regulating or banning facility fees were introduced in Texas this legislative session but failed to pass.
“And they’re expanding their reach even further into the suburbs so they can charge higher prices to even more people because their pricing power just becomes stronger, the larger they get. And the public does not understand it,” explains Ho. “Chances are, if you go to an independent facility, one not affiliated with any major healthcare system, a standalone MRI facility, your price is going to be cheaper.”
At the national level, the proposed Price Transparency Act would not ban facility fees but would require providers to disclose them clearly to consumers.
The Texas Hospital Association warned that banning facility fees could force hospitals to reduce staff, cut services, and close outpatient clinics.
Experts advise patients to ask clinics what they will be charged before visits and to contact insurance providers for lists of non-hospital-affiliated providers to compare prices.
Additional information and related stories can be found at:
- Texas Hospital Association’s 2023 Facility Fees Whitepaper
- Texas Legislation Targets on Abusive Facility Fees
To avoid surprise medical bills, patients are encouraged to seek cost estimates before appointments and research alternative providers.
