For every independent urgent care operator who claims facility fees give them a competitive edge over their health system counterparts, there’s a hospital-based numbers cruncher licking his lips over the revenue those fees provide. Either way, with more and more hospitals bringing single-location or small-group operations into the fold, patients may start to wonder why the same care provided by the same providers in the same location no longer costs the same. If you’re a provider or an office manager at one of the centers taken over by a hospital—and therefore now charging a facility fee for the first time—you may want to prepare yourself for puzzled or even angry questions from long-time patients. As noted in an article posted recently on the Medical Economics website, “these fees add zero value” as far as the patient is concerned. Nevertheless, it may be best to answer any questions about new, higher rates directly, honestly, and without judgment. Explain to patients that the price for the care they’re receiving hasn’t changed, but that all hospital facilities—which would include the formerly independent urgent care center they’re sitting in—charge a fee designed to keep overhead down so the hospital can provide the most cost-effective care possible. Further, the fee structure follows guidelines established by the Centers for Medicare and Medicaid Services. In the example sited in the Med Ec article, “Medicare pays $116 for a visit to a doctor in an outpatient hospital clinic and only $46 for the same level of care to an independent doctor.” You should also be aware, for your own edification, that CMS proposed a change in policy a few weeks ago that would push the agency toward a site-neutral system sometime next year. Estimates are that such a move could save the healthcare system $760 million in 2019 alone.