Upfront collections: More hospitals set up programs for patients to pay for care in advance

They may have insurance but many patients can't afford hospital services and the unpaid bills have led healthcare organizations across the country to come up with new payment strategies, including no-interest loans and requirements that patients pay for care in advance.

Although more patients have coverage under the Affordable Care Act, the high deductibles associated with many plans means patients end up with bills they can’t pay. And even if Republicans follow through with their promise to repeal and replace ACA, they also favor high-deductible plans that offer consumers lower monthly premiums. Therefore, Reuters reports, the trend of unpaid bills will likely accelerate.

Rather than allow bad debt to pile up, many hospitals are coming up with options to help patients pay for care. Some experiment by offering patients discounts for early payment or monthly payment plans, according to the article.

Chad Eckes, CFO of Wake Forest Baptist Medical Center in North Carolina, told the publication that the conversations may be uncomfortable but staff do ask patients to pay ahead of time for non-emergency services. If they can’t afford it, the hospital also offers zero-interest, longer repayment options.

Henry County Health Center in Iowa gives patients cost estimates prior to treatment and a discount if they pay the bill ahead of time. “Most patients are appreciative that we’re telling them up front,” David Muhs, chief financial officer, told Reuters.

There is an art to collecting money so some organizations offer their financial service employees with training for point-of-service collections. The approach not only helps organizations collect money, but it creates a culture of patient-centered care by training staff to put patients first by helping them understand their financial responsibilities for the services provided.

But the impact on patients isn’t just personal finances, Reuters noted. Jessica Curtis, a senior advisor at Community Catalyst, a consumer advocacy group, said patients often choose to delay procedures and don’t follow advice on prescription drugs. When they do seek care, the procedures are often more expensive because they’ve waited too long, she said.