Health care providers see patients in our exam rooms these days who are struggling with more than just illnesses and injuries. Far too many are also struggling with huge medical bills. To the many factors, including astronomical prescription drug prices and insurance premiums, we now add another driver of rising health care costs: mysterious charges for routine procedures done at a so-called hospital-based setting, even when the location is just an office.
The Minnesota Legislature has taken meaningful steps this year to help lower health care costs by expanding MinnesotaCare to add a public option for residents to buy into and creating a Prescription Drug Affordability Board. But as more hospital mergers and acquisitions loom on the horizon in Minnesota, our elected officials must do more to reduce unfair charges and fees from hospitals.
Thankfully, Congress has an opportunity to come together to rein in these out-of-control costs. By passing the “Lower Costs, More Transparency Act,” Congress can help patients see what a procedure will cost and determine whether they’re being unfairly charged. This bipartisan legislation is an important first step toward making health care more affordable and promoting site-neutral payment reforms, so that patients pay the same price for the same service, regardless of the location.
A kind of modern-day gold rush is driving wild price swings of medical procedures depending on locations. Large health systems and private equity firms are buying up independent doctors’ practices. With consolidation, competition goes down, and patient care is shifted from regular doctors’ offices to “outpatient” settings, which allows them to drive up the cost. As a result, patients pay additional fees for the same service they used to get at an independent physicians’ office. Meanwhile, hospitals are making more profits despite being non-profits or not for profit facilities.. Even “nonprofit” health systems are enjoying healthier margins than they’ve seen in years.
As practitioners, we struggle to justify these discrepancies when our patients ask why their bills include huge hospital fees.
In my own experience as a nurse, when ordering blood work drawn, I found that the costs for the bloodwork varied significantly among different locations — even though it was the same service.
As a nurse in a hospital which rejected attempts to improve nurse-to-patient staffing ratios, it’s particularly frustrating that these same hospitals are charging exorbitant fees for hospital care, including in settings outside the hospital.
Minnesota patients and their families should not be forced to skip important potentially life-saving procedures because they’re afraid of getting stuck with exorbitant fees for the same routine procedures that cost less in an office setting. Too many people — 4 in 10 — are already skipping care because of medical costs. Patients should also know that these extra hospital-based fees do not indicate improved safety or better health outcomes.
These fees are, simply put, a money grab by large hospitals.
The “Lower Costs, More Transparency Act” requires all hospitals to publicly disclose the underlying price of procedures, services and medications. This step can help consumers understand what they’ll pay for health procedures and services before they happen. The proposal also tackles site-specific payment discrepancies so patients get some relief.
By passing the “Lower Costs, More Transparency Act,” Congress can help Minnesota — and all American — patients and their families afford health care at a time when costs are squeezing them from every direction. Providers are calling on our leaders to act, and Minnesotans should too.
Sue Schroeder is a hospital RN of 44 years who retired in July 2023. She lives in Minneapolis.
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