PUERTO ST. Lucie, Florida-When the Cleveland clinic began acquiring hospitals and medical offices in this region lined with palm trees six years ago, many Floridans were excited. Ohio’s non -profit organization, classified among the best hospitals in the world, promised to provide expert care and an infusion of cash to the state’s treasure coast, an area north of Boca mouse full of closed communities of 55 years.
But in the years after the blue and green signs of the Cleveland clinic were appeared outside dozens of medical offices, patients began receiving unexpected invoices: $ 95 additional for a consultation with a neurosurgeon. Additional $ 112 to see a family medicine doctor. And $ 174 more for a neurologist appointment that previously cost only a $ 50 cup.
Challenged, patients contacted their offices and insurers of their doctors and learned that the new costs were “facilities rates”, charges that hospitals have traditionally announced by stays for hospitalized patients and visits to the emergency room, but now they become increasingly charged for routine appointments in their ambulatory clinics. According to hospitals, rates, which are often not completely covered by insurance, are destined to support the highest level of care that these doctors provide, according to hospitals.
For patients with blind, that can mean paying a hospital rate, even if you never set foot in a hospital.
“My heart fell,” said Brandy Macaluso-Owens, 43, a social worker who lives in Port St. Lucie. He received an installation rate of $ 174 after a visit in March with a Cleveland clinical gastroenterologist. “I probably met with the doctor maybe just 15 minutes.”
The Cleveland Clinic defended the rates of the facilities in an email, saying that they are an “appropriate practice” that aligns “with government regulations and industry guidelines.”
“These rates help support only some of the costs of maintaining outpatient facilities so that we can continue to provide compassionate and high quality care to all patients,” said the Cleveland clinic.
The Cleveland clinic is far from the only rates of the hospital collection center, equivalent to billions of dollars annually for patients throughout the country. Rates have been generalized in recent years, since the main health systems have taken advantage of doctors’ offices, which makes patients find independent practices: more than half of all doctors nationwide are now used by hospitals or health systems, compared to only a quarter in 2012.
For more information about facilities rates, see the “Night Night Flames” of NBC at 6:30 pm ET/5: 30 PM CT and “Top Story” in News News now at 7 pm et.
At the same time, the rates of the facilities have become more notable due to an increase in high deductible health insurance plans, which leave patients who pay for most of their medical invoices before their insurance is activated. A study last year found that the average deductible coverage sponsored by the employer had increased around 47% in a decade.
These factors are affecting many patients who are already staggering financially. Around half of adults in the US.
Facilities rates can reach hundreds of dollars, and even small amounts can quickly add.
Did your doctor’s office charge an installation rate? This is what you should know
“People are receiving really high bills for simple and routine care,” said Christine Monahan, a research assistant professor at the Health Insurance Reforms Center at the University of Georgetown who has studied the subject. “They do not expect to pay high bills for this. And it is not realistic to expect people to pay this.”
The opposition to the rates of the outpatient facilities is a rare area of agreement between the defenders of the patients and the insurance companies, which argue that the hospitals are unnecessarily inflate the cost of care. While efforts to restrict facilities rates have attracted bipartisan support at the state and federal level, the hospital industry has delayed, arguing that rates are necessary to help finance central services such as emergency departments 24 hours a day, 7 days a week, and that insurers should cover them.
All these national forces are colliding in southeast Florida, where 11 patients told NBC News that the Cleveland clinic had charged unexpected rates of the facilities in recent years. For some, rates were a mere discomfort, a sign of the growing cost of medical care. For others, the bills were a financial burden too large for the shoulder. And some refuse to pay them.
Billie Paukune Boorman, a waitress, recently charged a $ 174 installation rate for her daughter, nose and throat of her 13 -year -old daughter, along with more than $ 200 in other unexpected positions.
“I don’t have that kind of money that is placed,” he said.
The Cleveland Clinic rejected an NBC News interview application and declined to comment on individual cases, but said in their email that patients are charged rates of the facilities in the offices of doctors who are classified as hospital outpatient departments, which must comply with the most strict safety and safety standards than non -accredited medical practices. The facilities rates reflect “the significant additional costs for hospitals to meet these standards,” added the Cleveland clinic.
The Cleveland clinic told NBC News that it has sent more than 250,000 cards to its Florida patients who informed them about the rates before their appointments, and said that he publishes signals in his offices saying that they are outpatient departments of the hospital. Patients with Medicare receive additional warning in check-in. The letters sent by the Cleveland clinic say that patients can see “a change of how it was billed in the past” but do not explicitly observe that patients can be charged more from their pocket. Many of the patients who talked to NBC News did not remember receiving the cards.
The health system did not answer questions about how it determines the price of a rate of the installation, but said that the costs “vary according to the installation and the type of medical services provided.”
Several patients said they noticed any difference in their care after implementing rates.
Last year, Irene Rauch, 66, a semi -themed human resources executive, a $ 95 installation rate was charged for an appointment with a neurosurgeon who said she had seen for the same type of appointment three months before for only a co -payment of $ 15. The additional position was not something for which she had budgeted.
