Hospital services pre-payment may loom large in future

Recently, we've covered a variety of news that touched on the issue of whether hospitals should get tough about collecting from patients prior to delivering care for elective procedures. Most of it suggests that this is a risky strategy, at least politically:

*  The Wall Street Journal ran a very unflattering piece on the M.D. Anderson Cancer Center's decision not to treat a leukemia patient until she coughed up $100,000 in cash.

* Perhaps in response to the WSJ story--or others like it--the Minnesota legislature just passed a measure forbidding the state's hospitals from investigating a patient's medical debt prior to treating them.

* According to one blog, an ED surgeon recently was sued under EMTALA because he gave a patient a realistic estimate of costs during treatment and the patient went elsewhere.

This is a difficult situation, and it's going to get nastier, particularly if reform-minded types take over the White House this year. Why? Because historically, hospitals have been asked to carry many of the costs of system, and policy-makers don't always bear in mind that they don't have the resources.

On the other hand, hospitals aren't completely helpless. As our sister publication, FierceHealthFinance, points out, hospitals often can do much more to qualify patients for various forms of charity care and public assistance, as well as collect from self-pay patients after the fact. That, at least, is a start.

Other than that, I suspect it's time for even the least politically minded hospital executives among us to become active. Make your case on the local, state and even federal level. Otherwise, our political leaders may continue to assume--as some seem to now--that you're the bad guys. - Anne

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