As hospitals and health systems expand their ownership and control of ambulatory care practices, they are frequently charging new facility fees for routine medical services delivered in outpatient settings. These bills are driving up premiums and health expenditures for consumers, employers, and, ultimately, tax payers. Consumers also directly face growing financial exposure to these facility charges as insurance deductibles increase and payers apply benefit designs that increase patients’ exposure to out-of-pocket costs, particularly in hospital outpatient settings. With support from and working in partnership with West Health, CHIR experts are studying outpatient facility fee billing reforms and share their findings here.
