You shouldn’t pay more just because your doctor’s office was bought out
If you’ve had to have a medical test or procedure done recently, or if you’ve just been keeping up with the news, you may have noticed a concerning trend — the consolidation of hospitals and doctors’ practices. Large hospital systems aren’t just merging with each other, but also buying up small physician practices. Then they’re charging patients at these practices more — even though the services provided are exactly the same. It’s time to stop this.
Mona V. Mangat
As a physician, it’s been troubling to see so many health care mergers and acquisitions as of late. These have been so prevalent that over half of physicians are now employed by health systems or hospitals. What’s most worrisome is that, when small physician practices are purchased by large health systems, the cost for the same services goes up. Countless numbers of my patients have refused a simple CT scan of the sinuses because they are quoted excessively high rates when trying to schedule at a hospital radiology department rather than an outpatient imaging center. Patients are unaware of this pricing tactic and their care suffers.
This is happening across the state and country, as patient care is being shifted from regular physician offices to hospital “outpatient departments.” When the logo on the doctor’s office door changes, the prices go up. Unfortunately, our health care system incentivizes this.
And it’s costing patients billions.
Take some examples. In 2023, for an epidural injection in a lumbar or sacral region, Medicare paid $255.89 if the service was provided in a physician’s office, but paid $740.88 when provided in a hospital outpatient department. For privately insured patients, hospitals acquiring physician offices can charge an additional “facility fee.” In this case, the average price for an ultrasound can increase from $164 to $339. The price for an office visit can jump from $118 to $186.
This simply isn’t fair. Patients receiving the exact same health care services should be charged the same prices.
When health care costs become too burdensome or unpredictable, many patients stop seeking care. A patient who goes to his longtime local physician’s office, newly owned by a large hospital, and gets a new “facility fee” tacked on his bill, may decide to skip his next visit. Someone who is afraid of an unaffordable bill may forgo the biopsy that was recommended to her. For these patients, health conditions that would have been manageable if treated earlier can worsen, becoming more uncomfortable and painful, as well as more difficult and expensive to treat. These stories are all too familiar to physicians.
And high health care premiums are all too familiar to us all. As health care spending continues to skyrocket, with billions of dollars going toward the bank accounts of health care executives, premiums for all of us increase.
It’s time for Congress to act. Our lawmakers have an opportunity to pass common sense, bipartisan solutions that ensure that patients receive the same health care services for the same prices. This is a rare issue that leaders from both sides can and should agree on. Fair is fair.
Doctors are looking out for our patients, and patients across America, when we call on Congress to work together to ensure the same service at the same price.
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Dr. Mona Mangat is an allergist and immunologist in Tampa Bay, and the chairperson of the board of the Committee to Protect Health Care.
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