ATLANTA - Some metro Atlanta residents have seen their medical bills go up by as much as double, and they are having a hard time understanding why.
Channel 2's Erica Byfield investigated and found that it's a nationwide trend. Independent doctors are disappearing and are going to work for big hospitals.
Cancer patient Mike Rosenberg, who gets chemotherapy every month, used to go to the Atlanta Cancer Care. Rosenberg stopped going in early 2013 after his last bill shocked him. He said the bill was the only thing that had changed.
"The same doctors, the same chair, the same material, everything is exactly the same," Rosenberg said.
It took him months of fighting to learn that Northside Hospital had bought the practice, and the hospital charged his insurance a $3,000 facility fee. (Click here to read Northside's statement)
Rosenberg isn't the only one dealing with sticker shock.
In Woodstock, an annual heart test cost a woman hundreds of dollars instead of her normal $40 co-pay. When she complained, Wellstar sent her a letter that read: "While the physical location is actually the physician's office, testing is performed through the outpatient diagnostic center."
A Gwinnett woman went to Strickland Family Medicine not knowing that it was owned by Gwinnett Medical Center, and got a bill for $1,600. She even had to pay a fee for a "treatment room." (Click here to read Gwinnett Medical Center's statement)
Our research shows that Gwinnett Medical Center, WellStar, Northside, Emory and Piedmont hospitals all have offices where doctors once worked independently.
Here is a map of facilities owned by, operated by, or affiliated with hospitals:
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(Yellow: Emory, Red: WellStar, Purple: Piedmont, Blue: Gwinnett Medical, Green: Northside)
Last fall, researchers from University of California-Berkeley reported that patients generally pay 10 percent more at hospital-owned practices.
Medicare will usually reimburse a hospital facility more than private practices for certain services, and other insurance companies follow Medicare's lead.
But even in cases where hospitals cannot charge more, they're still buying up practices. A bill to see a primary care physician is often the same whether the office is owned by a doctor or a hospital.
Why it's happening
It’s happening because of a term that the industry calls "vertical integration."
The idea is, if you see a doctor who has privileges at only one hospital system, the patient will follow the doctor.
"You can't have a hospital if you don't have doctors," said Max Reiboldt, a national health care expert and CEO of The Coker Group.
He told Byfield that while all of the consolidation might cost patients more at first, there is an upside. "The delivery of care can be much better coordinated," Reiboldt said. He said that in the long run, the efficiencies could contain costs.
A doctor who didn't want to be identified told Byfield that he disagrees that consolidation can be a good thing.
"Patients, when they walked in the office, they had no idea this was a corporate-owned facility," he said.
After his practice was sold to a hospital, he left and now works in private practice again. He said he got into the business to care for patients, not to explain why they have to pay more.
Some people surprised by higher bills seek out state Rep. Sharon Cooper of Cobb County.
"I certainly don't think that these CEOs of these big hospitals would be buying up these practices if it wasn't very advantageous to them," Cooper said.
"What we are losing is patient choice," said Cooper, who chairs the House Health and Human Services Committee.
With patient bills piling up, there is one way to save money: Ask your doctor's office ahead of time who owns the practice and how will you be billed for the service.
Patient takes matters into his own hands
Mike Rosenberg went about saving money his own way.
"I kept calling billing ‘till one day I got a supervisor, and the supervisor said 'Well, there is nothing we can do’. OK, so I said ‘Here's what I’m going to do. I'm going to picket your hospital.’”
Rosenberg picketed, and the hospital dropped its fight to collect the extra charges. He now gets chemotherapy through a different provider.
We found that some hospitals are fairly transparent about the change in ownership, even changing the name of the practice.
But at other places, you'd never know it was owned or operated by a hospital.
We asked Wellstar Health System, Gwinnett Medical, Northside, Emory and Piedmont to give us the names of the facilities that they own. Only Wellstar and Gwinnett Medical provided lists.