My new rheumatologist is across the street from the hospital. Medicare reimbursed him $164 for an hour long office visit when he went over a 40-year plus medical history in detail. I appreciate the thoroughness. A few weeks later I got a bill from the hospital for an extra $75 (i.e., the hospital “facility fee” they get to charge just because) along with a letter asking if I’d like to make a charitable donation. Since the CEO of Providence Health Care makes $14 million/year, it sounds like they’re flush enough to not need my money.
Yes, this is the reality of third party reimbursement…regular group health plans as well as Medicare…there’s absolutely no way to provide a sustainable service at this fee alone for the time spent. Possibly if your rheumatologist gave you the “once over” working alone from the trunk of his car parked on the public highway.
It’s why I signed up for the Chronic Care Management programme at my PCP’s office…even though it’s primarily designed to reimburse the practice for managing folk with multiple comorbidities. No way could it continue to provide for quality patient care and cover the facility costs and provide for a meaningful compensation package for the folk whose services can’t be billed for (receptionists, MAs, cleaning crew etc) on Medicare reimbursement alone.
In a nutshell, it’s the ability to bill Medicare for some of the non clinical nuts and bolts of taking care of patients who place a greater demand on a practice than a straightforward fee for clinical service provides for. From what I can tell…via the questions I am supposed to answer on the emails I get…it’s the cost burden that folk with metabolic syndrome, T2D etc impose on a practice what with calling in repeat prescriptions, coordinating specialist appointments, poring over lab results etc. Probably unheard of a few decades back when the proportion of overweight folk and their issues was less and rebursement higher…you could kick the deficit created around and lose it. Not so nowadays. Don’t know what gives with MA plans as this is trad Medicare
That’s true, but they did disclose the “facility fee” in the paperwork you sign when you become a patient. It’s OK if you’re on Medicare, but I wouldn’t be using these guys if I was still on Obamacare because I’d be eating the “facility fee”.