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KANSAS CITY, Mo. — When a scab on Laura Wheaton-Werle’s son’s wrist wouldn’t heal, she suggested he visit his doctor. The doctor said it was nothing serious, but removed the lesion in his exam room.

Wheaton-Werle said she thought nothing more about it, until the bill arrived.

“That was $202,” she said. “That’s what I would expect from a physician,” she said.

What she didn’t expect was a second bill for $746 from Truman Medical Center, a hospital her son had never visited.

“When I called Truman Medical Center to ask them about this they said, `Well he came to our hospital,'”recalled Wheaton-Werle. “No he didn’t. He was at the doctor’s office.”

That’s when she learned Truman Medical Center owned the doctor’s office and considered it part of the hospital. The $746 bill was for something called a “facility fee” that goes directly to the hospital.

What happened to Wheaton-Werle is happening all over the country as more and more doctors abandon their private practices to join the staff of a hospital, said Elizabeth Rowe, a biochemistry researcher whose husband is a private practice neurologist in Kansas.

“It’s driven by the higher payments that are given to hospitals because hospitals can pay a doctor more than he makes in private practice,” said Rowe, who finds the shift from private practice to a hospital-owned practice troubling because it is driving up healthcare costs.

“Anything that happens at a hospital setting is billed at a hospital rate,” Rowe said.

In fact, the higher fees are so alarming that Connecticut enacted a law requiring patients be informed that they will pay additional fees if they use hospital-employed physicians. Kansas is considering a similar measure, which is now in committee.

“You are paying for those million-dollar administrators and that beautiful marble new building,” Rowe said. “That’s what you’re paying for.”

Federal officials are also concerned by the increasing costs, and are considering a change in the formula on how doctors are reimbursed so that every procedure costs the same, no matter whether the doctor is in private practice or employed by a hospital.

Wheaton-Werle said she doesn’t plan to wait for the feds to act and has already taken matters into her own hands.

“I was supposed to go in for blood tests,” she said and asked the nurse whether she would be charged a facility fee. When she learned she would, she cancelled her appointment.

She’s now in the market for a new doctor not employed by a hospital.

By the way, after Wheaton-Werle complained about the facility fee for her son’s visit, Truman Medical Center agreed to cut the fee in half. TMC said it collects the fee to cover the cost of the additional services it able to provide to its physicians. Plus, TMC said it prides itself on having some of the lowest fees in the country.