Some cancer patients seeking treatment at a new Ballad Health facility will pay a higher out of pocket cost than current patients.
The Regional Cancer Center is located just a few miles away from the old Allendale facility, Kingsport Hematology and Oncology.
Patients at the new center will receive the same level of care from the same staff but, because the facility is located on the campus of Indian Path Community Hospital, they’ll be billed an additional fee, according to Ballad Health.
Ballad Health’s Chief Executive Officer of Kingsport Operations Lindy White said the new facility improves patient access to pharmacy, lab and imaging services, also at Indian Path.
“It’s a very consistent model that most infusion centers and chemotherapy centers are typically tied to a hospital as a hospital department,” said White.
White said this change also allows the facility to save money through a federal drug discount program called 340B.
She said those savings are reinvested back into the Ballad system to provide charity care to over 20 thousand patients who’re uninsured.
She said eligibility for 340B is based on the patient population that a hospital serves.
Kingsport Hematology and Oncology had fallen out of eligibility in recent years, according to White.
Ballad Health executives didn’t provide an estimate of how much the facility saves by qualifying for the discount program.
“We just know that the infusion center uses a lot of therapeutic drugs and that it would benefit the system as a whole greatly if the facility was tied to the hospital,” said Cathy Gott, assistant vice president for Ballad’s oncology service line.
White said the change did not require state approval because there was no discontinuation of services.
Why some patients will see higher costs?
White said that the Regional Care Center is required to bill patients for a facility fee to maintain consistent billing practices.
Indian Path Community Hospital also charges the fee.
Alan Sager, professor of health policy and management at Boston University’s School of Public Health, called facility fees “a tax on sick people.”
Sager said hospitals charge this fee across the country and the practice has increased over the last ten years.
“It’s just another example of healthcare kicking people in the face,” said Sager. “There isn’t really a counter-argument. If you have a bunch of accountants running loose in hospitals they start acting like accountants.”
White said Ballad is making accommodations for cancer patients who were already receiving treatment at the old facility.
“We’ve made the commitment to ensure that we hold our patients harmless from any increases in out of pocket for our patients that are in active cancer treatment,” said White.
She said they’re making the same commitment for six months for non-cancer patients who were getting infusion services.
But new patients will still be subject to the facility fee.
“Copays and deductibles vary across every payer so it’s very difficult, impossible for us to be able to… calculate what an average increase is going to be,” said White.
But Marni Jameson Carey, executive director of the Association of Independent Doctors, had an idea.
“The studies show that the costs will be…on average, about 60 percent more than if they got the care in a community-based or independent setting,” said Jameson Carey. “The hospital looks at these oncologists like ATM machines.”
Ballad Health Vice President of Service Line Management Clay Runnel said these costs are not prohibitively expensive.
“We’re not turning away patients across the system from getting cancer care. There are not people that are not getting cancer care for financial reason. If there were I could see that that concern would be reasonable,” said Runnel.
Jameson Carey said doing away with facility fees could play a big role in reducing wasteful spending in healthcare.
She said AID, a non-profit organization, has been fighting alongside the Centers for Medicare and Medicaid Services to do away with these fees that she said everyone pays for in one way or another.
“We pay for all of that in higher premiums every single year…our employers pay it and we pay it in taxes because Medicare goes up too,” she said. “So all this business that it only matters what you pay out of your pocket is just not true.”
Sager and Jameson Carey agreed that the fees are a way for hospitals to drive up revenue.
“It’s time to tell hospitals to stop solving their problems by squeezing more money out of patients,” said Sager. “It hits middle-income people the hardest.”