You've been seeing the same doctor for 10 years. Same office, same staff, same care.
Your $15 copay just became a $563 bill.
Welcome to "facility fees" – healthcare's most insidious surprise billing scheme.
blog.rockettools.io/p/31afbb19-2bba-43ee-a190-94f87d343587/
2/8
Here's what happened: A hospital bought your doctor's practice.
Everything looks identical – same building, same receptionist, same exam room.
But now they can charge you "facility fees" on top of your regular visit cost.
Pure regulatory arbitrage.
3/8
The numbers are staggering:
• Hospital employment of doctors doubled from 2012-2024 (now 55%)
• Facility fees rose 53% from 2011-2017
• Real patient charges: $503 for pediatric visits, $488 for ADHD meds
Each hospital acquisition creates new billing opportunities.
4/8
The four-step scheme:
1. Hospital buys independent practice
2. Converts to "hospital outpatient department" on paper
3. Keeps everything else identical
4. Starts billing facility fees + professional fees
Result: You pay hospital prices for clinic visits.
5/8
The most absurd example? Facility fees for telehealth visits.
You're literally at home, but hospitals claim you're using "hospital facilities."
Charging hospital-level fees for a video call from your couch is pure exploitation.
6/8
In Texas, 64% of residents skipped care in 2023 due to costs.
Recent bills to ban facility fees for preventive care and telehealth? Both died after hospital lobbying.
When preventive care becomes financially punitive, we've broken healthcare.
7/8
Hospital industry defense: "We need the revenue to survive. It's an insurance problem."
Translation: "We have the right to surprise patients with hidden fees because we want more money."
That's economic hostage-taking, not patient care.
8/8
74% of voters want facility fees banned for outpatient services.
The patients have spoken. Time for policymakers to act.
What's your worst surprise medical bill story?
blog.rockettools.io/p/31afbb19-2bba-43ee-a190-94f87d343587/
#HealthcareReform #SurpriseBilling #FacilityFees
Dan McCoy, MD
@docdano
Storyteller + Artificial Intelligence + Healthcare https://danmccoymd.substack.com/