Saturday
April 27, 2024 
Congress must hold hospitals accountable for unreasonable charges with site neutral payments.
Not too long ago, a patient of mine said they wouldn’t be getting a procedure I recommended at an earlier visit.
The patient had been ambushed by so many hospital fees and charges that they now avoided going for routine tests, recommended procedures and basic care at anything remotely tied to a hospital.
This patient needed the procedure to see if they had a medical condition with potentially life-threatening risks — a procedure they were willing to forgo because of hospital fees.
This patient isn’t alone. Too many doctors and health care providers have heard similar stories and we’re extremely concerned. Nearly 40% of Americans say high health care costs have caused them or a loved one to delay treatment. And hospital bills are a growing part of the problem, burdening six in 10 people with staggering medical debt in 2022.
A wave of hospital consolidations and mergers is driving this problem. The U.S. House has taken steps to rein in unreasonable hospital charges, by passing the bipartisan “Lower Costs, More Transparency Act” in late 2023. Legislators and policymakers must now finish the job.
Physicians across the nation have been calling on Congress to pass site-neutral payment legislation, for good reason: Patients should pay the same price for the same service, regardless of the location.
In recent years, large hospital systems have been busy buying up independent physicians’ practices. Today, over half of physicians are employed by hospitals and health systems.
Following such acquisitions, larger hospital systems offer the same health care services, at the same location, but at higher costs. For a patient, the doctor, staff and nearly everything else remains outwardly the same and unchanged. But the logo on the door is different and the once independent location is now a “hospital outpatient department.” The result: Prices increase by 14.1% at a doctor’s office when it becomes part of a large hospital system.
As doctors, we know that the higher costs don’t mean increased quality of care. An MRI or a checkup at a location owned by a hospital isn’t necessarily better than one that belongs to an independent physician.
Hospitals may be applauding themselves for recording big profit margins as a result of mergers and consolidations. But their profits come at a cost to the very people hospitals are supposed to serve. When they drive up out-of-pocket costs and raise premium prices for everyone, they put up more obstacles and barriers to care. They are effectively contributing to worse health outcomes.
The Lower Costs, More Transparency Act is a good start because it requires all hospitals to publicly disclose the underlying price of procedures, services, and medications. This legislation also tackles site-specific payment discrepancies, where costs can vary wildly, with seemingly no logic to these variations.
Holding down hospital fees will help check anti-competitive and predatory behavior of hospital monopolies. Addressing the issue of high hospital bills can further help reduce government spending and save taxpayers billions of dollars.
My patients deserve relief from huge hospital bills that are sending families into financial ruin and forcing people to avoid potentially life-saving care. This Congress can make its mark in the fight to help more people get affordable health care, by increasing hospital transparency and holding them accountable for their irresponsible pricing practices.
Cindy Finkelman lives in Bucks County and is a general practice physician.
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