Hospital CEOs came under fire at a House hearing Tuesday, with Republicans accusing them of overcharging patients and exploiting the system.<\/p>\n\n\n\n
Executives from HCA Healthcare, CommonSpirit Health, New York-Presbyterian and ECU Health testified before the House Ways and Means Committee, defending their pricing practices \u2014 including that they should be able to charge higher prices for the same services compared with what patients might pay at independent practices.<\/p>\n\n\n\n
Hospitals accounted for nearly one-third of U.S. healthcare spending in 2024 or about $1.6 trillion, according to a report in the journal Health Affairs. Another study, published in JAMA Health Forum, found that patients tend to pay more for the same doctor\u2019s visits when their doctor is part of a hospital or private equity firm.<\/p>\n\n\n\n
\u201cThe American people are fed up with outrageous prices that seem artificially high,\u201d said Rep. Jason Smith, R-Mo., the committee\u2019s chair.<\/p>\n\n\n\n
Throughout the hearing, Republicans cited instances of hospitals in their states charging high prices at outpatient facilities affiliated with the hospital. These prices are often inflated by so-called facility fees, which are not related to the care provided but instead help cover expenses like staff and equipment.<\/p>\n\n\n\n
Rep. David Kustoff, R-Tenn., pointed to an example of an independent ambulatory surgical center in his state that charged a facility fee of $656 for a colonoscopy, while an unnamed hospital outpatient facility charged a $1,222 facility fee.<\/p>\n\n\n\n
\u201cIs an 100% increase in the fee that you charge versus the surgical center, does that seem reasonable to you?\u201d Kustoff asked the executives.<\/p>\n\n\n\n
Rep. Greg Steube, R-Fla., said patients in his state are charged significantly more at hospital-owned outpatient clinics than at clinics owned and operated by physicians.<\/p>\n\n\n\n
\u201cHow can you justify facility fees on outpatient facilities when there is no meaningful difference in the care delivered or the quality of the care?\u201d Steube said.<\/p>\n\n\n\n
The hospital CEOs pushed back, saying the higher fees are because hospitals are often reimbursed below the cost of providing the care, particularly by government programs like Medicare and Medicaid.<\/p>\n\n\n\n
They also said the higher prices reflect the higher quality of their care, the cost of treating sicker patients and a federal requirement for hospitals to care for all patients, regardless of their ability to pay. Privately owned clinics and facilities can generally have the right to choose what patients they see and can demand payment up front.<\/p>\n\n\n\n
\u201cWe\u2019re the only participants in the healthcare value chain that have that obligation,\u201d said Michael Waldrum, the CEO of North Carolina-based hospital system ECU Health. \u201cDoctors, nurses, insurance companies, drug companies do not.\u201d<\/p>\n\n\n\n
Democrats were far more muted in their criticism of the pricing practices of the CEOs who appeared before the committee, accusing Republicans of using the hearing as a distraction from the impact of Medicaid cuts, which Republicans passed as part of President Donald Trump\u2019s sweeping domestic policy bill last year.<\/p>\n\n\n\n
\u201cThis is more a deflection hearing than a hospital hearing,\u201d Rep. Lloyd Doggett, D-Texas, said.<\/p>\n\n\n\n
Rep. Richard Neal, D-Mass., the committee\u2019s ranking member, said Republicans \u201ckeep trying to convince people that it\u2019s about just the providers,\u201d adding that \u201cit\u2019s about many of their policies as well.\u201d<\/p>\n\n\n\n