There’s a troubling trend creeping through our health care system that’s hitting patients’ wallets and making it difficult for people to get the care they need. You don’t hear much about it on the news, but hospital systems are quietly buying up local, independent doctor’s offices. When they do, they reclassify them as “hospital outpatient departments” (HOPDs), which allows them to charge patients more for the same services.
As an obstetrician/gynecologist (OB-GYN) in Minnesota, I’ve seen how hospital consolidation hurts patients by landing them with higher, surprising bills. Imagine you’ve been going to the same OB-GYN for years — a trusted doctor who knows your health history and whom you’ve relied on for annual check-ups. Then one day, you get a bill that’s much higher than any previous visits, even though nothing about your visit changed.
You call the office to ask why and are told that, while you saw the same doctor, the practice was recently bought by a hospital system. This means that now any care you receive at that office is billed at a higher “hospital” rate. This is happening across the country and right here in Minnesota, driving up health care costs without improving the quality of care.
The data show just how much patients are paying once the logo on the door changes. For example, Medicare pays 51% more for a preventive exam in a hospital outpatient department than in an independent physician’s office. For drug administration services like chemotherapy, the cost can be as much as 211% higher in hospital-owned settings. These higher prices aren’t improving patient care — they’re simply increasing health care costs for patients and boosting hospital profits.
This isn’t just a financial burden on my patients; it has serious health consequences. When routine care becomes too expensive, patients are more likely to delay or skip important visits. This can lead to worse health outcomes, as conditions that could have been caught early end up becoming more serious and harder to treat.
We know that many people who are struggling to make ends meet often put off preventive care, which can mean they don’t get help until their health problems become severe, more complicated and, ultimately, more expensive to treat.
Congress needs to act now to close this gap and expand site-neutral payment policies. By ensuring patients pay the same price for the same service, whether it’s a doctor’s office or a hospital-owned clinic, we can help make healthcare more affordable. This would also reduce the incentive for hospitals to buy up independent practices just to charge higher prices, keeping costs down and giving patients more options for where to get care.
Site-neutral payment reform is a common-sense, bipartisan solution that would save patients billions of dollars each year without sacrificing the quality of care they receive. It would also reduce the incentive for hospitals to acquire independent practices, which is making health care more expensive and less accessible.
As an OB-GYN, I know how important it is for patients to have access to affordable health care — whether it’s routine visits, prenatal care or life-saving procedures. It’s time to stop big hospitals from gaming the system at the expense of Minnesotans’ wallets and health. No one should have to pay more for the same care just because the logo on the door changed. Congress must act to pass site-neutral payment reforms and put patients over profits.
Dr. Siri Fiebiger is an OB-GYN in Minneapolis.