Two bills in Congress can help to reflect services and care provided, not the site in which they were delivered.

By Rick Snyder | Dec. 16, 2024

In Texas, and across the country, patients are struggling with a difficult mix of health care challenges: high medical costs, vague and unclear hospital billing policies, and a lack of access to care.

These challenges are particularly harmful for our rural and underserved communities, and they are being exacerbated by unfair hospital billing practices that are rooted in corporate greed.

In a broken system, larger hospitals and health systems are incentivized to acquire private physician practices because Medicare reimburses hospitals at higher rates than independent physician practices. The new owners can then rebrand these facilities as “hospital outpatient departments” (HOPDs), and charge Medicare higher rates for delivery of the exact same care. Often, patients have no idea there has even been a change of ownership over these practices — that’s how little of a difference there is in the kind or quality of care being delivered.

Without fair billing reform to fix this problem, hospitals will continue to acquire and absorb independent physician practices for no other reason but to charge higher rates. As this continues to happen on an increasingly large scale, vulnerable patients will be forced to pay higher prices and out-of-pocket expenses despite seeing no real difference in the care they receive. Also, independent physician practices could soon be a thing of the past.