Opinion: Oregon can reduce health care costs by stopping hidden facility fees

Published 4:45 am Tuesday, March 18, 2025

As a physician, I see firsthand how rising health care costs are forcing my patients to make impossible choices. Families are struggling to afford their medications, delaying necessary treatments, and in some cases, skipping care altogether.

One of the most frustrating and harmful contributors to these costs is the rise of hidden facility fees — unexpected charges that patients are often blindsided by, sometimes just for walking through the door of a hospital-owned clinic. It’s time for Oregon to put an end to this deceptive practice by passing legislation to restrict these fees.

Oregonians are already grappling with some of the highest health care costs in the country. Families now spend nearly a quarter of their household budgets on medical expenses, with costs having risen by over 30% in the last decade. As a result, three out of four Oregonians have reported delaying or forgoing care due to financial concerns. Meanwhile, large hospital systems continue to tack on facility fees, adding even more financial strain. These charges can range from tens to hundreds — or even thousands — of dollars, and they often aren’t covered by insurance. Patients frequently don’t know they’ll be billed until they receive a statement in the mail.

Imagine making an appointment at what you think is a standard clinic visit, only to receive an additional bill for a “facility fee” weeks later. This sort of thing happens every day to patients like mine. A routine check-up, a quick follow-up with a specialist, or even a basic diagnostic test can come with these unexpected fees. And because patients don’t receive clear explanations or advance warnings, they can’t prepare for the financial burden and often fall into medical debt.

As a patient, I have also experienced receiving unexpected bills. After paying my co-pay to see my doctor for an outpatient visit, I received an additional bill for approximately $100 labeled as a “facility fee.” Because of my line of work, I noticed the extra charge and contacted the billing office, as I had no idea what it meant. I was told that the facility fee was an additional charge to offset the cost of paying for the upkeep of the building, i.e. electricity, water, repairs, etc. I was also told that I was notified of this charge in my “new patient paperwork,” except that I have been a patient for several years. Meanwhile, these same health systems pay their chief executive officers annual salaries in the millions.

Oregonians are penalized for seeking care in hospital-owned clinics, facing higher fees even when the level of care is no different from what they would receive in an independent office. This is an unfair and unnecessary cost burden that must be addressed.

Fortunately, Oregon lawmakers have the opportunity to take action. A bill currently in the legislature, Senate Bill 539, would eliminate facility fees for routine services, require upfront cost estimates and collect data on how these fees are being applied. This is a common-sense solution that would increase transparency, lower costs and empower patients like my own to make informed health care decisions. By passing this legislation, Oregon would join 18 other states that have already taken steps to curb hidden medical fees and protect patients.

Support for this change is overwhelming. A staggering 92% of Oregon voters — including 93% of Democrats and 90% of Republicans — believe hospitals should be required to disclose costs in advance. It is clear this is not a partisan issue; it is a matter of fairness and financial security for Oregon families.

The time to act is now. Hidden facility fees are driving up costs and making it harder for people to access care. As a physician, I believe in putting patients first, and that means advocating for a health care system that is transparent, fair, and affordable. Oregon lawmakers must pass this bill and put an end to these unfair medical fees once and for all.

One of the most frustrating and harmful contributors to these costs is the rise of hidden facility fees — unexpected charges that patients are often blindsided by, sometimes just for walking through the door of a hospital-owned clinic.