ORLANDO, Fla — As healthcare costs continue to rise, patients are feeling the stress.
“You just have to be healthy forever. And God forbid you do get sick,” said Orlando resident Evan Burgos.
Some believe part of the rising costs can be contributed to costly hospital fees that patients could be paying even if they are nowhere near a hospital.
Patients used to pay these fees when they visited the emergency room or a specialty unit in the hospital, but now hospital facility fees are often tacked on for routine care at regular doctor’s offices.
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Central Florida has become a healthcare hotspot. Healthcare is a booming industry fueled by demand for quality care from the flood of people moving to the Orlando area each week. But like many places, demand on resources has patients facing increasing costs.
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Evan Burgos said, “It’s really expensive. I mean, I personally don’t have health care right now, just because it’s very expensive.”
Burgos just started a new job, and is waiting for his new health insurance to kick in.
Across the country, one of the driving forces believed to be behind increasing health care costs is the use of facility fees.
“Facility fees were allowed to be charged by hospitals, purportedly to support the extra costs that a hospital has,” said Patricia Kelmar with U.S. Public Interest Research Group, often referred to as PIRG.
Kelmar explained that means things like 24-hour emergency rooms and intensive care units. But in recent years, she said with hospital consolidation and chains buying up smaller practices the use of facility fees has increased.
Even patients going to their regular doctor’s office or those needing routine outpatient services, not at a hospital, could get hit with a new fee.
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“They’re going to the same doctor in the same building, same boring waiting room, but now unbeknownst to them, that physician practice is owned by a hospital system,” Kelmar explained.
She noted fees could be around $50 for some, but PIRG has seen patients get surprised with fees topping $1000.
Evan Burgos said even when he had insurance, some of charges caught him off guard.
“Oh 100%. Like, I get surprise bills all the time,” Burgos said.
Patricia Kelmar said, “I think it’s most outrageous when patients are being charged a facility fee for a telehealth appointment.” Those are doctor’s appointments done over a computer often from the patient’s own home.
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In a new study PIRG just released called “Outpatient Outrage 2026”, it found the higher hospital-level charges increase the cost for patients without adding any benefit and outpatient facility fees bring in hundreds of millions of dollars for hospitals.
But hospitals contend the fees do provide a benefit.
“Our hospitals are really not just hospitals anymore. They are health systems, and these health systems are trying to preserve access to an array of community-based services,” said Mary Mayhew, the President and CEO of the Florida Hospital Association.
Mayhew explained the fees help maintain services often in areas that wouldn’t otherwise have the quality care they have now.
“Proximity to care matters,” she said. “When people need treatment, they want it close by, and we should be very proud in Florida of the healthcare systems that we have.”
And she said healthcare affordability is an issue that’s a lot more complicated than just facility fees.
Still, U.S. Public Interest Research Group is calling for state lawmakers to take action to prohibit facility fees for routine outpatient care, require public reporting of facility fees, and require site-neutral payment policies--meaning a same service, same price standard to keep patients from being overburdened.
Evan Burgos said, “I mean at this point you just can’t get sick anymore, right?”
21-states have passed some legislation targeting these fees. In Florida, for non-emergency services, if you ask they have to provide a good faith estimate for anticipated charges that clearly shows the facility fees.