In the month since American Samoa's LBJ Hospital raised its outpatient fees, it has seen an increase in inpatient numbers while outpatient traffic has dropped.
Local residents now pay 20 US dollars to see the doctor while non residents pay $105.
The hospital's CEO Michael Gerstenberger told a hearing of the House health committee that patient revenues have also increased.
"It looks like the inpatient volume actually went up this July, relative to the previous July, about 7 percent, and about 5 percent from all Julys in the past 5 years. So that's good news. That suggests to us that really sick people who absolutely need care are still getting it."
Michael Gerstenberger says 4,000 people or 400 families are included in the LBJ's sliding scale program, which offers discounts based on household income and size.