Expensive “facility fees” target of state Comptroller hearing

kevinConnecticut Comptroller Kevin Lembo, who reviews state finances and benefits, this morning announced a public hearing as part of his active probe into hospital consolidations and the rising use of so-called facility fees that are hitting patients in their pocketbooks.

“Hospital systems in Connecticut are rapidly acquiring private physician practices and medical facilities,” Lembo said in a statement. “We are investigating the potential ramifications — including additional costs to patients and state taxpayers in the form of new hospital system fees or so-called facility fees.”

The fees, also called “provider-based billing,” claim overhead costs in hospitals in addition to traditional “professional fees” to which independent doctors are limited. Lembo is hosting a public hearing on December 3 from 2:30 until 5:30 in Room 2-D of the Legislative Office Building in the state Capitol complex to explore the issue with doctors, patients, hospitals, insurers and members of the general public.

From Lembo’s news release:

“Public Act 14-217 charges the Office of the State Comptroller with evaluating the impact of provider consolidation with hospital systems on the state employee plan, including the impact of facility fees. It also requires the state comptroller to determine the appropriateness or reasonableness of any higher costs or newly instituted facility fees; and finally, to determine the feasibility of limiting such fees. Lembo will report his findings to the governor and legislature by Oct. 1, 2015. An evaluation by the Robert Wood Johnson Foundation found that consolidations “generally results in higher prices,” with as much as a 20-percent increase in already concentrated markets. The Journal of the American Medical Association also published a study that said, “From the perspective of the insurers and patients, between 2009 and 2012, hospital-owned physician organizations in California incurred higher expenditures for commercial HMO enrollees for professional, hospital, laboratory, pharmaceutical, and ancillary services than physician-owned organizations. Although organizational consolidation may increase some forms of care coordination, it may be associated with higher total expenditures.”