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(35,020 posts)
Sat Dec 3, 2022, 04:47 AM Dec 2022

Hospitals' Dishonest Billing Practices Add More Pain to CA Small Businesses

Over the last five years alone, America’s top ten largest health systems have amassed control over a quarter of the hospital market share. Unsurprisingly, during the same five-year period, hospital prices spiked 31% nationally, a growth rate that is four times that of workers’ paychecks. Hospitals without any competitors within a fifteen-mile radius have prices 12% higher than hospitals in markets with four or more competitors – the data is clear: without meaningful competition, hospitals are able to extract higher prices from patients.

Another way hospital systems exploit their growing monopoly power to maximize their profits is a shady practice known as “dishonest billing.” This occurs when big hospital systems buy up small, independent doctor’s offices and take over their billing operations, tacking on additional hospital facility fees, despite the patient never stepping foot inside a hospital and receiving the same service from the same physician.

Usually, hospitals justify the high cost of visiting a doctor who works out of their main campus by associating the higher cost with the overhead of the facility, such as building costs and amenities. The same treatment at a hospital is nearly 300% more expensive as compared to a traditional office setting. Most accept this reality and just avoid unnecessary visits to large hospitals, only choosing to go when it is absolutely necessary. Otherwise, customers tend to prioritize receiving medical care at smaller, private practices because it is known there is less cost associated with this kind of setting.

But what happens when a consumer tries to save money, goes to an off-campus location, and then still gets charged the higher cost as if they had been treated directly at the hospital?


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