By NextBestFitFacility fees: the same service costs more in a hospital-owned building
When a hospital owns a clinic, it can charge a facility fee on top of the physician fee for the same visit, which encourages hospitals to buy practices.
Who's affected
Who is hurt
- People with unaffordable deductibles or coinsurance: Hospital ownership adds a facility fee to the cost of the same clinic visit.
- Health insurers, brokers, and their shareholders: Hospital ownership adds a facility fee to the cost of the same clinic visit.
- Taxpayers and public budgets: Hospital ownership adds a facility fee to the cost of the same clinic visit.
Who gains while it lasts
- Hospitals, clinics, and care organizations: Hospital systems collect facility fees on top of physician fees.
Under your mix of paths
Paths that fix or soften it
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Root causes
- Payment rules that pay more by site rather than by service
Related costs
Open questions
- Should payment be the same regardless of site?
Solution paths (2)
Open a path for what it fixes, what it creates or worsens, who gains and who loses, precedents, and how it connects to other paths. See all paths as a decision tree.
Site-neutral paymentChosen
Pay the same for the same service, whether in a hospital outpatient department or an independent office.
- +Facility fees: the same service costs more in a hospital-owned building
- +Hospital and physician consolidation raises prices
- −Reduces income or business for affected groups
- −Adds paperwork, coordination, or complexity
No facility fees for office-type care outside a hospital campus.
- +Facility fees: the same service costs more in a hospital-owned building
- −Solves only part of the problem
- −U.S. prices are far higher than in other countries