Opinion: Congress Should Pass Fair Billing Legislation to Make Healthcare More Affordable

Rising healthcare costs are making it harder for patients to get the care they need without breaking the bank. Sadly, rampant consolidation by major corporate health systems and hospitals are only exacerbating the issue, often inflating costs for patients without expanding any tangible benefits or delivering a meaningful difference in the quality of care or services provided.

Here in Missouri as well as nationwide, the growing trend of large, corporate hospitals purchasing smaller, independent physician practices has led to inflated costs for patients. This is no small problem, either. According to a recent report, hospitals and corporate entities employed nearly 78 percent of physicians in 2024.

What’s behind this trend? As with most things, just follow the money. When these corporate hospital systems acquire a private physician’s practice, these practices become a “hospital outpatient department” (HOPD) and can begin charging Medicare and insurers higher reimbursement rates as a result. This means patients end up paying more for the exact same services and quality of care—up to 14 percent more, to be specific.

This is a powerful incentive for larger hospitals and health systems to continue acquiring and absorbing physician practices, essentially allowing these corporate entities to become de facto healthcare monopolies in some communities. This can have an acute impact in rural parts of states, as patients may have no other options available to them once their physician’s practice has been taken over by a major hospital system.

This is an issue that concerns me not just as an O’Fallon City Councilwoman, but as the daughter of an elderly father who has medical needs, and as someone who lives with health issues of my own. Patients and their families shouldn’t be stuck with higher healthcare costs—and nothing to show for it—just because of the greed of corporate hospital systems.

This is why lawmakers in Washington, D.C. must pass legislation to ensure fair hospital billing as soon as possible. Fortunately, both chambers of Congress are considering bills—the Facilitating Accountability in Reimbursements (FAIR) Act in the House and the Site-based Invoicing and Transparency Enhancement (SITE) Act in the Senate—that would do just that.

Both pieces of legislation would ensure patients are billed based on the services and care they receive, not the setting in which that care is provided. This is critical given how easily larger hospital systems can quickly gobble up and “rebrand” a regular doctor’s office into one of their HOPDs so they can inflate health care costs for their financial advantage.

Passing fair billing legislation is in the best interest of patients, independent physician practices and the communities they serve, our overall healthcare system, and the entire economy. Given the broad bipartisan support for fair billing and the need to lower burdensome healthcare costs that threaten patients, lawmakers should work swiftly to pass both the FAIR and SITE Acts. I urge Representative Jason Smith and Missouri’s entire congressional delegation to help make that happen this year.