Letters to the Editor Published on August 12, 2025

The compensation of chief executive officers at nonprofit health systems has sparked significant controversy, particularly in Pennsylvania, where many citizens remain burdened by unexpected fees hidden within medical bills. A recent report revealed that executives at these health systems are receiving substantial salaries while patients are grappling with additional charges labeled as “facility fees.” These fees are often attached to medical services to cover various operational costs such as utility expenses, facility maintenance, and even landscaping. Strikingly, these fees have the potential to add hundreds of dollars onto bills for routine outpatient care—even for services rendered outside of hospital premises.

For instance, a patient incurred a facility fee of 6 after attending a consultation at a physician’s private office, simply because the doctor was affiliated with a nonprofit health system. Such practices have raised alarm bells, prompting lawmakers in numerous states to take action. Several states have enacted regulations to limit or outright ban these charges or imposed requirements for healthcare providers to give advance notice to patients regarding potential fees. However, in Pennsylvania, legislative efforts to tackle this issue appear stagnant, with pending bills aimed at mandating notification for patients failing to gain traction in committee.

The implications of prioritizing CEO compensation over patient affordability and transparency have been considerable. Nonprofit hospitals, by nature, are expected to serve their communities, yet the prioritization of high executive pay raises questions about their commitment to community health and financial accessibility. If these institutions are to uphold their nonprofit status, it is essential that they align their operations with their foundational mission and serve the patients who rely on their care.

In summary, while the salaries of nonprofit health system CEOs continue to rise, the burden of additional fees on patients demands scrutiny. It is imperative for state authorities in Pennsylvania to take decisive action to ensure that healthcare remains accessible and that institutions uphold their responsibilities to the communities they are meant to serve.

Media News Source emphasizes that with greater legislative accountability, the balance between executive compensation and patient care can be better managed, fostering a healthcare environment that prioritizes the well-being of the community over inflated salaries.