Health care mergers bad medicine for patients

Dr. Roger Kinnard
 |  Worcester Telegram & Gazette

As a neurologist in Melrose who is in private practice, I have noted an alarming trend that is raising health care costs, further burdening our public and private health care systems.

In recent years, we’ve seen a surge in health care mergers, with big hospital systems buying up smaller physician practices. Over half of all physicians are now employed by hospitals and health systems. When a hospital system acquires a small physician’s office, the cost of care increases on average by 14.1%.

That’s because, when the hospital owns the facility, it is claimed as a “hospital outpatient department” that can charge more for the same service. On top of those higher charges, it can also add a “facility fee,” an extra cost for hospital overhead costs — even though in many cases the care is being provided outside the physical hospital. 

For example, when a hospital purchases a physician’s practice, the price for an ultrasound can increase from $164 to $339, and the cost of a simple office visit can increase from $118 to $186. These inflated prices don’t reflect improvements in the quality of care patients receive. Instead, they create financial barriers that prevent patients from accessing the care, and cost insurance companies more for the same service.

Patients and taxpayers alike are paying more. In 2023, Medicare paid 194% more for an echocardiogram in a hospital outpatient department than in a freestanding physician’s office. Similarly, an epidural injection that costs $255.89 in a physician’s office costs $740.88 when administered in a hospital outpatient department.

This trend is not only bad for patients but bad for our health care system as a whole. As the costs of care continue to rise, insurance premiums increase for everyone, as well as costing Medicare and Medicaid more. The billions of dollars that are being funneled into the pockets of large hospital systems come directly from patients and taxpayers. This is money that could be better spent on improving care and expanding access.

Congress has an opportunity to pass common-sense, bipartisan legislation on site-neutral payments that would protect patients from being overcharged for the same service. By ensuring that prices are more consistent across different settings, Congress can help save patients billions of dollars and prevent large hospital systems from gaming the system at the expense of patients. Those doctors who are in private practice should be paid equally to those in practices owned by hospitals. 

This is an issue that transcends political boundaries. It’s about fairness, affordability and access, as well as protecting small businesses. As a physician, I’m calling on Congress to take action. My patients, and patients across Massachusetts and the country, deserve better. It’s time to ensure that health care costs are driven by the quality of care, not by the logo on the door.

Dr. Roger Kinnard is a neurologist in Melrose. He has 43 years of experience in the medical field. 

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