Guest Opinion: Idaho patients should not have to decipher confusing bills


May 28, 2014 

After you visit a hospital or see a doctor who is contracted or employed by a hospital system, there may be an unpleasant surprise when you get the bill.

Hospitals and larger health care systems are able to charge an extra "facility fee" just for the use of the exam room and other "facilities." These fees can be anything from room and board for a patient who never sets foot in a hospital to more confusing labels such as "hospital services."

Understanding modern health care is challenging enough for the average person, but these extra fees are unexpected.

And it gets worse. Some insurance companies don't cover facility fees, leaving the patient responsible for the balance. As hospitals and their parent companies grow and expand into new markets in Idaho and elsewhere, these add-ons are likely to grow as well.

Most doctors who work for these systems don't make more from these extra charges. As employees, they may be unaware of the extent of added fees.

Comparing a visit to an employed doctor or hospital facility is like buying a modern airline ticket: Your ticket covers the ride, but not your luggage. If you bring a suitcase, want something to eat or see the movie, you'll pay more. Such practices reduce overall customer satisfaction, trust and loyalty for both airlines and hospitals. As health care grows with the aging population, and as the previously uninsured enter the system, patients need alternatives to reduce costs and confusion.

There is a different way. A growing number of patients in Idaho and beyond are looking to independent doctors who are free from cumbersome, bureaucratic, expensive health care "systems" that are rapidly dominating the medical landscape. When a patient chooses an independent physician, they get a provider willing to personalize care which can be 20 to 60 percent less for an equivalent service. Unexpected fees aren't part of the deal.

A little over a year ago, 180 self-employed doctors in the Treasure Valley came together to form the Independent Doctors of Idaho. IDID is a nonprofit association determined to provide alternatives for patients. These doctors are committed to quality, personalized, cost-effective care. Independent doctors want people to know they have another choice when it comes to selecting their doctor. During our annual meeting this month we recommitted to the "Declaration of Independents," IDID's basic philosophy.

Self-employed physicians have options employed doctors may not. They own their practices, control overhead, and may be less rushed when explaining treatment options. Informed patients make better decisions about their health care.

Now hospitals have an opportunity to help solve the facility fee issue. We invite Idaho's large hospital systems and others in our region to get rid of unnecessary fees and help us return to the critical work of caring for patients in a transparent, understandable, and affordable manner. As expensive new treatments and medications proliferate, the costs to support these treatments will likely rise. Indeed, hospitals can help offset this trend by asking patients to pay for services actually rendered, and not for charges cloaked in indecipherable language.

Patients shouldn't have to struggle to pay a bill they don't understand. Idaho's independent doctors believe we can deliver patient-centric care. Idaho's large hospital systems can help all of Idaho's sick by taking the lead in reducing unnecessary fees.

Dr. Richard DuBose is a board-certified interventional pain specialist and partner with Idaho Physical Medicine and Rehabilitation, Boise. He is a member of Independent Doctors of Idaho.

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