Imagine one day you wake up with a cough. After several hours, you develop a fever and get the chills. You think to yourself, “this is probably strep throat, nothing too serious.” So you head to the closest urgent care facility, describe your symptoms and get a strep test.
Whether the test is positive or not, you are charged an astounding $300. You are angered, since you only expected to pay $50 — your standard co-payment. But there is a $250 off-site hospital fee. In Massachusetts, this is not an uncommon occurrence.
As detailed by The Boston Globe, there have been several complaints submitted to Massachusetts Attorney General Maura Healey’s office relating to multi-hundred dollar bills faced by some patients after they visited a physician’s office or urgent care facility.
These health care centers are able to charge such enormous costs by listing, for example, a “hospital” fee on a patient’s bill. In Boston, many physician offices and urgent care facilities are owned by large hospitals such as Brigham and Women’s Hospital or Massachusetts General Hospital.
It is rarely discussed, but according to the Globe, outpatient and similar fees have increased over the last 10 years. Medicare and some insurers have scrutinized these charges, yet more needs to be done on the state level to prevent this pricing malpractice.
Healthcare is not a transparent sector of our economy. In a July survey by the New England Journal of Medicine Catalyst Insights Council, only 17 percent of healthcare facilitators described their organization as “very mature” or “mature” in addressing transparency.
However, there have been a plethora of laws passed by states across the country to push for greater transparency in the healthcare sector. Last year, the Massachusetts Senate passed Bill S.2202, which includes a provision that would prevent hospitals from charging outpatient costs for many services.
However, the bill is currently in a legislative abyss, with little motivation shown from the House to consider it.
A rise in the number of urgent care facilities is relatively new to Massachusetts. For example, in 2012, CareWell Urgent Care owned only one clinic in the state. Now, six years later, they’ve established 16 centers in Massachusetts — five of which are under the UMass Memorial Health Care umbrella.
Urgent care facilities have many benefits: they allow for more accessibility and offer the potential for cheaper care, and they ease congestion of already overcrowded hospitals. But going to an urgent care facility is not equivalent to going to the hospital. Urgent cares facilities can sometimes be more concerned with the “urgent” aspect of their business than they are with the “care.”
While quality of care is of paramount importance, price transparency is important, too. Anyone would be outraged if they were charged $400 for treatment for an eye injury. Anyone would be furious if they were charged $800 for the removal of several warts. These aren’t simply hypotheticals. This happened in our state.
If an urgent care facility is owned by a private hospital, then that hospital has the right to charge additional fees. But is the quality of care better at a facility owned by a large hospital than at one that is not? It’s tough to say. Regardless, responsibility lies with the hospitals to prove that it is beforehand.
The largest concern with hospital ownership of these facilities is their ability to hide additional fees. These organizations must be transparent about their pricing prior to when a patient is seen.
The ownership of urgent cares themselves by hospitals is not the issue. Greater integration of healthcare to provide better treatment is beneficial, but ownership should not lead to exploitation. Healthcare costs are exorbitant as is.
CLARIFICATION: The House has already passed a healthcare bill, H. 4639, that has addressed facility fees — requiring transparency standards on facility fees so patients are informed on their expected healthcare costs before seeking care.
