The Farce Everyone Pays For

Imagine going to a restaurant and having a nice dinner. You get the bill. Everything looks good except there is a facility fee added at the bottom. A facility fee? What’s that you ask. “Its what we charge for you to use our facility” says the waiter………………”Our new owner says it’s necessary.”

Facility fees: the farce everyone pays for

Marni Jameson Carey – August 16, 2018

Editor’s Note: Welcome to Medical Economics’ blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions expressed here are that of the authors and not UBM / Medical Economics.

Imagine that you and your family love going to a local chef-owned restaurant. The service is good. The price is reasonable. The staff is friendly and knows your order. You know the chef-owner personally, and have heard that he often donates surplus food to the local food bank.

Then a large restaurant chain buys up the restaurant. The menu looks exactly the same, but it doesn’t have prices. You go ahead and order the Caesar salad and hamburger that you always get for $12. After you’ve eaten, you get your bill. The meal is now $48. When you ask why, you don’t get a straight answer.

Finally, after some persistence, you discover that the chain-owned restaurant has layered in a facility fee: a charge that adds no value to your dining experience whatsoever, but that allegedly helps the corporate entity maintain its overhead and give an occasional free meal to the poor—so the owners claim.

Facility fee? The facility looks the same. You find the former owner, who looks a little sheepish, and demoralized. He tells you he wishes he never sold out, but the corporation pressured him and paid him a lot of money. And now the corporate honchos are making him prepare twice as many meals a day as an employed chef. He’s burning out. Quality has suffered. He can’t buy the fresh market ingredients he wants, but must make do with what the company supplies. What’s more, he is contractually forbidden from opening another restaurant within 100 miles. He’s stuck.

You start trying out other nearby restaurants to find a new favorite and learn they’ve all been bought by the same company.

You know where this is going.