Colorado
Opinion: New Colorado report shows the urgent need to rein in hospital facility fees for patients like mine
As a physician in Colorado, I see firsthand how high health care costs are burdening families. Insurance premiums and deductibles are already stretching budgets, but unregulated facility fees are making things worse. These hidden fees add unexpected costs to routine care, further burdening patients who are trying to access the medical services they need in the future. A new report illustrates even more clearly the need to rein these fees in.
Facility fees, which can range from a hundred dollars to over $800, are additional charges that hospitals tack onto your bill when you receive care at a hospital-owned clinic or provider. These fees are often separate from the cost of the actual medical service and can drastically increase the price of a doctor’s visit or procedure. Patients often don’t realize they’re being charged until they get the bill, leaving them with financial stress and uncertainty about getting further treatment.
Colorado recently released the Hospital Facility Fee Report, providing crucial insight into the growing problem of these fees. The 200-page report stems from House Bill 1215, passed by Colorado lawmakers in 2023. The bill created a steering committee composed of health care consumers, payers and providers, to examine the prevalence of facility fees and their impact on consumers.
The steering committee had limited data to work with, given that differing billing practices and that the fees are generally poorly disclosed, has made researching the fees a difficult task. Still, the findings were alarming and confirmed what patients and providers alike have been experiencing for years: Facility fees are driving up health care costs without improving care.
One of the most concerning findings in the report is that patients who see a doctor or provider affiliated with a hospital in Colorado are paying nearly double the amount in added fees compared to those who visit independent providers. Between 2017 and 2022, Coloradans paid over $13.4 billion in facility fees. Even worse, the amount of these fees has been increasing by 10% every year. These costs are unsustainable for patients and create yet another barrier to health care access.
It’s no coincidence that facility fees have risen at the same time that large hospital systems are buying up independent providers at an unprecedented rate. This consolidation of health care providers allows hospitals to charge more unregulated fees, boosting their profits while limiting affordable options for patients. As competition dwindles, Coloradans are left with fewer choices for health care, and they’re paying the price — literally.
The Hospital Facility Fee Report underscores the need for swift and comprehensive action from state leaders. Without additional protections, these fees will continue to increase, making health care more expensive for everyone.
As a physician, I see how this directly harms patients. Many are delaying necessary care because they simply cannot afford the fees that come with a hospital-affiliated provider.
The key takeaways from the report are clear: Facility fees do not result in better patient outcomes, and they create uncertainty around health care costs, often preventing patients from getting the care they need.
Colorado has already taken the first step by commissioning this report, but it’s not enough. We must act now to regulate facility fees and protect patients from skyrocketing health care costs.
Our leaders need to do more to protect patients from rising hospital costs, and consumers deserve to know what their costs are so they can anticipate their family budgets. Eighty-three percent of Coloradans report being worried about affording health care costs now and in the future.
Our legislators need to take the concerns of their constituents seriously. Coloradans support legislation that would require hospitals to provide up-front cost estimates, set standard payments to hospitals for specific procedures, impose price controls between insurers and hospitals, and create policies that drive competition. By doing so we can take yet another step toward ensuring health care is truly affordable and accessible for all Coloradans.
Dr. David Silver, MD, MPH, of Boulder, is a medical advocate whose 46-year career in emergency medicine, occupational health and primary health care was based in Colorado. The views expressed are their own and do not represent the opinions of any entity with which they are affiliated.
The Colorado Sun is a nonpartisan news organization, and the opinions of columnists and editorial writers do not reflect the opinions of the newsroom. Read our ethics policy for more on The Sun’s opinion policy. Learn how to submit a column. Reach the opinion editor at opinion@coloradosun.com.
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- Possible fire danger ahead
- Warm for the week ahead
- Still a bit breezy
MONDAY: Monday will be warmer with 60s returning for many in southern Colorado. Plenty of sunshine is expected with a bit of a breeze too. Spotty fire weather conditions are possible for some too.
MID-WEEK: Humidity levels will likely improve throughout the week with less fire danger expected. However, sunshine and temperatures about 20 degrees above averages continue.
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CHRISTMAS: Christmas will be warm and dry with highs in the 60s for many with sunshine. The high country through the divide and Wolf Creek Pass may see some snow, but we will be dry in southern Colorado.
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Colorado
President Trump denies Colorado’s disaster declaration request for wildfire, flood recovery efforts, Polis says
Colorado Gov. Jared Polis and Sens. Michael Bennet and John Hickenlooper are asking President Trump to reverse a decision, saying the president denied disaster declaration requests for major wildfires and flooding across the state earlier this year.
In August, lightning strikes near the town of Meeker sparked two massive wildfires that burned over 150,000 acres in Rio Blanco County. The Lee fire became the fifth-largest wildfire in the state’s history. Polis declared a disaster emergency for the Elk Fire on Aug. 3, which was updated on Aug. 6 to include the Lee Fire. That declaration unlocked over $18.5 million in state funding to help with suppression and recovery efforts.
The Elk and Lee Fires and subsequent mudslides caused approximately $27.5 million in damage, according to state estimates validated by FEMA. State officials expect that estimate to grow as recovery efforts continue.
Polis said the region’s Piceance Basin produces between 2 and 5% of the United States’ daily consumption of natural gas and that the two local utility providers in the area suffered almost $24 million in damage to their infrastructure. He warned that a lack of support could stall production, damaging the local economy and causing rate increases that reach far beyond the region.
Polis declared another disaster emergency in October when areas of southwest Colorado along Vallecito Creek, the Piedra River, and the San Juan River basin were struck by intense flooding.
According to a statement from the governor’s office, “The Western Colorado Flooding destroyed or damaged essential drinking water and wastewater infrastructure, including near-total sewer system failures in the Pagosa Springs area. Floodwaters breached levees, triggered evacuations for nearly 400 homes, prompted multiple boil-water advisories, and caused at least 11 high-water rescues by local first responders. Rivers reached historic levels — including the San Juan River’s third-highest crest since 1911 — and debris flows, sediment deposits, and rechanneling of waterways have created long-term risks for residents living along Vallecito Creek, the Piedra River, and the San Juan River basin.”
Polis made a formal request for support in September. Colorado’s entire congressional delegation — four Democrats and four Republicans — along with both Democratic senators, asked the president to support the request and to issue a major disaster declaration to help the people affected by the fires and floods.
According to the governor’s office, that request was denied Saturday night. In a joint statement, Colorado’s governor and senators called on the president to reconsider.
“Coloradans impacted by the Elk and Lee fires and the flooding in Southwestern Colorado deserve better than the political games President Trump is playing. One of the most amazing things to witness as Governor has been the resilience of Coloradans following a natural disaster. Their courage, strength, and willingness to help one another is unmatched – values that President Trump seems to have forgotten. I call on the President’s better angels and urge him to reconsider these requests. This is about the Coloradans who need this support, and we won’t stop fighting for them to get what they deserve. Colorado will be appealing this decision,” Polis said.
Bennet condemned the denial, claiming that the president is using Coloradans for “political games” and calling the move “malicious and obscene.
“A disaster is a disaster, regardless of what state in the country it took place. Together with Governor Polis and the Colorado delegation, I will take every available step to appeal this decision,” he asserted.
“Coloradans are trying to rebuild their lives after fires and floods destroyed homes and communities across our state. Trump’s decision to reject our disaster requests, and therefore, withhold resources as our communities continue to recover, is unacceptable. This isn’t a game. These are people’s lives,” Hickenlooper said.
In response to CBS News Colorado’s request, White House Spokeswoman Abigail Jackson provided the following statement regarding the denial:
“During the fires, the Administration prioritized and mobilized two Modular Aerial Fire Fighting Systems, which are jointly managed by the U.S. Forest Service and Department of War, and retrofitted to C-130s operated by the Air National Guard. These systems enhanced aviation support to Colorado as they battled the Lee and Elk fires.
The President responds to each request for Federal assistance under the Stafford Act with great care and consideration, ensuring American tax dollars are used appropriately and efficiently by the states to supplement-not substitute, their obligation to respond to and recover from disasters.
There is no politicization to the President’s decisions on disaster relief, unlike under the Biden Administration where FEMA officials refused aid to disaster survivors who displayed political signs and flags they disagreed with. The Trump administration remains committed to empowering and working with State and local governments to invest in their own resilience before disaster strikes, making response less urgent and recovery less prolonged.”
CBS News Colorado reached out to FEMA for comment on Sunday. Its Denver regional office referred questions to its national office in Washington, D.C., but as of the time of this story’s publishing, it has not yet responded.
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