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.

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