Dive Brief:
- Hospitals are increasingly asking patients to prepay for medical procedures or shell out before they're discharged, fearful of being left on the hook for large deductibles.
- Hospitals have good reason to be concerned about unpaid bills. Silver and bronze plans available on the state health insurance exchanges may come with deductibles as high as $5,000. And 41% of employer-based plans have deductibles of $1,000 or more.
- Attempting to help hospitals cope with this dilemma, the Healthcare Financial Management Association released guidelines last year. These best practices call for open and early communication, sharing clear information and finding resolutions fair to both patients and healthcare organizations.
Dive Insight:
Given the growing level of financial responsibility patients must bear for hospital care, it's not surprising that hospitals are working to get ahead of the problem. Methods used by hospitals vary, though the goal—collecting as much as possible—is the same. The most aggressive hospitals are asking for as much as 70% of the amount due ahead of time. Others are merely calling ahead to patients and letting them know what kind of bill they can expect, while walking them through options that might help pay the bill. Regardless, the goal is to chase money ahead of time rather than after-the-fact.
That being said, it's hard to tell how effective such practices will be. After all, while a hospital financial counselor may be able to get an indigent patient into Medicaid or help them qualify for charity programs, they can't produce money patient simply don't have. Some argue that this is the reality of high deductible plans and that those plans were always about shifting the cost to the providers.
Payers talked a good game about high-deductible plans, which they claimed would put financial power in consumer's hands and encourage quality care. But research by RAND Corp. has demonstrated that high deductible plans can encourage patients to put off needed care. Hospitals dealing with patients facing such burdens may end up eating a lot of the cost regardless of what strategy they use. Is it time to kill the high-deductible plan and find other ways to cut premium costs?