Should patient deductibles be a profit center?

Right now, if a patient has a large deductible plan--particularly those tipping the scales at $5,000 or more--your odds of collecting that money aren't great. Realistically, those who buy high-deductible plans are largely those who don't have much money in the first place, and they're not likely to have thousands to give you on the spot.

What's worse, as any revenue cycle manager reading this knows, once they walk out the door the odds of collecting get smaller by the day. At that point you're lucky to get a portion of what you charged.

If you're in luck, they may have a credit care or consumer medical credit to access, but in these days of tapped-out credit, even that may not be an option.

Well, tell me this: Does it make sense for you to become a lender? Hell, you're already being treated like one by the FTC's Red Flag Rules, and heaven knows you extend credit on very unfavorable terms (i.e. rarely getting paid) to many who walk into your ED.

(By the way, I know I've come out against this idea before; let's just say the times have changed me. I want my community healthcare provider to survive, and the way things are going I'm beginning to doubt that will happen.)

By extending credit agreements to patients on reasonable terms, you may be making money even if you pay more to borrow it than they do. After all, you could conceivably recoup millions by simply collecting the full amount you owe.

Yes, I realize that managing a line of credit dedicated to this purpose calls on talents you might not have in house. And if you outsource the lending, that's another management issue. But in these days of defaulted bills, that relationship may be more profitable than the one you have with collectors.

Folks--am I going out on a limb here? Is it time for hospitals and other caregivers issuing large bills to get more involved in financing their patient's debts? What do you think? Write to me and let me know. - Anne