$1,525 facility fee highlights medical measures at Capitol to limit facility costs

Aurora, Colorado (KDVR) — Colorado hospitals say they can’t survive without facility costs, but some patients may avoid medical care because they can’t afford rising facility costs said.

Controversial House Bill 23-1215, which limits facility fees, will have its first hearing on Friday at the State Capitol.

Aurora mom Natalie Zelinska keeps a close eye on her 4-year-old son after he receives a $1,525 facility fee after being appointed to Colorado Children’s Hospital in November 2022.

“I have to constantly monitor his heart condition. Once or twice a year, just to see where he is,” she said, formerly taking her son to Denver Health Medical Center twice a year. underwent an electrocardiogram and an ultrasound.

When her pediatric cardiologist moved to Florida, she suggested that the Zelinksas seek treatment at Colorado Children’s Hospital.

Invoices reviewed by Problem Solvers showed Denver Health had a facility fee of $55, while Xelinksa received a facility fee of $1,525 for essentially the same services at Children’s Hospital.

“If I knew it would be so expensive, I would buy a plane ticket to Florida and see my former doctor,” Zelinksa said.

She also asked investigative reporter Rob Lowe if she would request an interview.

Her experience of receiving unusually high equipment bills without warning has been highlighted in numerous articles by Problem Solvers over the past year.

Problem Solver Investigates Facility Fees

Problem Solvers’ facility fee research began with a father from Greenwood Village, Michael Kark. My son’s therapy sessions were paid for in addition to his $500 facilities fee. “It was literally just a lamp and a sofa,” recalled Kirk.

Following his talk, Aurora’s Brittany Tesso shared an $847 facilities bill for her son’s telemedicine. “It was like, ‘Facility fee?’ I didn’t go to your facility,” Tesso said.

Then there was Ben Ross, a Colorado Springs father who received a $2,518 facilities bill for his son’s brain scan. , that seems to be what hospitals are trying to do,” said Ross.

“I don’t think the bill has skyrocketed.

Lomborg said facility fees cover all costs other than doctor’s bills, so they cover costs like nurses, surgical technicians, janitors, expensive equipment, and utility bills. That’s it.

However, facility costs are not only charged in hospitals, patients are increasingly faced in clinics and outpatient clinics.

Doctors Disagree on Facility Fees, Hospital Associations Defend Them

“I think they’re terrifying,” says Dr. John McLaughlin, a family doctor who has practiced in Aurora for 30 years and never charged a patient for another facility.

“If you’re a hospital system, you can add a $200 or $300 fee if you own the business.
Because it literally breathes air. They were no different from me,” McLaughlin said, adding that medical staff and equipment were paid for by health care providers.

According to the Journal of Health Economics, 70% of physician practices have been bought by hospitals and private equity firms, adding facility fees and forcing patients to pay more for essentially the same services. I was.

When asked if he thought facility fees were a way for hospitals to make money, he didn’t hesitate to reply, “Of course they are.”

But Lomborg said it was not a fair criticism of the hospital. Again, these charges are adjusted based on the care provided. ”

enact laws to ban and cap facility fees

Under House Bill 23-1215, facility fees are prohibited in some circumstances.

This measure prohibits facility fees for telemedicine visits, primary care visits, and preventive care visits.

The measure also requires states to require independent reporting of hospital facility charges. According to the bill’s lobbyist, Kachina Weaver, independent research is needed because “reliable, third-party data will determine the true impact of these charges on patients and hospitals, and the mechanisms by which hospitals cover the costs.” Because it helps me understand.”

The newly revised measures still call for transparency. This means that future facility charges should be communicated to patients at the time of service. Zelinxa wanted to do that before taking her 4-year-old son to a cardiology appointment.

“People should know in advance. If you go to the supermarket and the bread is $2, $10, or $50, you know if you’re going to buy it or not,” she said.

“Hospitals and clinics that work with us are committed to transparency,” said Lomborg, but imposing additional limits on facility fees would cause hospitals to close clinics and reduce patient care. It added that it could reduce access to services.

“This could have catastrophic consequences for Colorado’s patient care system,” Lomborg argued.

But McLaughlin told Problem Solvers that it’s rising facility costs that are having devastating consequences for patients.

“The longer outpatient facility fees are accepted and part of the practice, the less likely we are to go back. This is another cost that the working class must bear. It just becomes,” he said.

Zelinska said she wouldn’t be taking her son back to Children’s Hospital in Colorado for his next heart follow-up.

“No. I would like a quote in advance. I regret not doing so before going to the children’s hospital. So I will do more research on where I can make my next appointment and request a quote before that.” ‘ she said.

Children’s Hospital Colorado told FOX31 in an email that Zelinska may have asked for a quote before her last appointment, but even if she had done so, Zelinska would not have been quoted an estimate for her facilities. I later found out it would be $980. As expected, she was actually charged much less than $1,525.

“All the bills were already sent to me, and I stumbled upon the quote,” says Zelinksa.

Statement from Children’s Hospital

Children’s Hospital Colorado provided the following statement to FOX31:

It is important to us that patients and families understand the costs of healthcare in the healthcare system. We take all patient concerns seriously and our team will address them and raise issues when appropriate.

As a provider of pediatric specialty hospitals, we are committed to price transparency and enhanced capabilities to better meet the needs of our patients and families. To do this, provide cost estimate information for scheduled outpatient visits in advance, review billing methods at least annually, and as necessary to continuously improve the patient and family experience. Make your changes. On-demand cost estimates are available for most services using the cost estimator.

When a child is sick or injured, parents want the highest quality care. Many families have come to expect to rely on specialized pediatric integrated care available at Children’s Colorado. Therefore, fees may vary by medical facility.

Children’s Hospital Colorado’s “facility fees” cover the costs of operating a comprehensive, integrated children’s hospital system, from nurses to social workers to pharmacists to reception teams. At every stage of the process, we strive to meet the unique needs of every child and their family.

Colorado hospitals have already won a partial victory with HB23-1215. Removed one section eliminating facility fees for hospital-owned off-campus clinics (facilities more than 250 yards away from the hospital’s main campus). It is at off-site locations that hospitals collect much of their facility fee revenue.

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