Facility fees can result in an unpleasant - and costly - surprise for consumers. As many of you know, a facility fee is charged, in addition to the full price for an office visit, when the clinician providing the service does not own the building in which care is delivered. Consumers then get two bills: one from the clinician and one from the hospital that owns the facility. This has been a source of confusion - and higher cost to employers and patients. Our analysis indicates that facility fees add, on average, 78.7 percent to the total billed charge for an office visit. 
 
Assembly Bill 207 has recently been introduced and would require that providers give fair warning to consumers regarding facility fees. The bill would require that providers notify consumers that there will be a facility fee at the time an appointment is scheduled. The bill also requires a good faith estimate to be given. The Alliance strongly supports Assembly Bill 207 and has been working with the author, Representative Chuck Benedict, to ensure that this results in consumer-friendly and actionable information.
 
Unfortunately, Assembly Bill 207 has run into some opposition from some hospitals who oppose the provisions that would require notification at the point of scheduling as well as the good faith estimate. Hospitals are concerned that schedulers are not equipped to handle questions from patients that may arise regarding facility fees (what they are, how much the charge will be).
 
The Alliance views the facility fee bill as a basic step in the right direction toward health care cost transparency. While our efforts to address facility fees through contract language have helped, they have not eliminated the problem for our members. The costs with a facility fee are greater than the costs without one - even though the care is the same (same provider, same service).
 
If you'd like to receive updates about the progress of Assembly Bill 207, please contact healthpolicy@the-alliance.org. The bill has been referred to the Assembly Public Health Committee, and we anticipate a public hearing will be scheduled on the bill sometime this summer.
 
NOTE:  Alliance members can determine which clinics charge facility fees by checking our Online Provider Directory. Look for the yellow yield signs by the facilities that charge this fee. 
 

• Up Front Cost Savings
• "Bending the Trend" for Long Term Cost Savings
• Best in Class Guarantee
• A Commitment to Transparency
• A Commitment to Excellent Service

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The Alliance encourages employers to distribute the QualityCounts for Employees information piece to their employees.

• Steps Before You Schedule an Outpatient Procedure - Save Money:  Outpatient procedures and tests are often done separate from a normal doctor's office visit. That means employees may have time to research facilities and ask the right questions before they choose. This piece tells them how.

• Net Benefits of Tobacco Cessation Interventions - The benefits of tobacco cessation interventions in adults and pregnant women remain well established. A recent issue of the Annals of Internal Medicine reviewed the 2003 recommendations by the US Preventative Task Force (USPSTF) and published research since then, which reaffirms the 2003 findings. 

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