The Wall Street Journal recently highlighted a trend at hospitals to collect payment for care in advance to ensure costs are recouped. As the CFPB pursues a regulation on credit reporting and medical debt, this trend could further grow as an unintended consequence of the bureau’s actions.
06/06/2024 2:45 P.M.
2 minute read
A recent report from The Wall Street Journal highlights how some health care providers are shifting to advance billing for medical procedures, outside of emergencies.
The report, “Hospitals Are Refusing to Do Surgeries Unless You Pay in Full First” (a subscription may be required), reviews whether the shift will allow patients to comparison shop and plan for the expense, cause them to delay treatment until they have the money, or borrow money.
It says the advance billing is a way to help providers avoid pursuit of patients to settle their accounts, but the other side is patients needing to come up with payment in advance when they are struggling with a health issue. Some patients are delaying procedures.
The article cites an analysis of first-quarter reports from 1,850 hospitals by Kodiak Solutions, a health care consulting company, that approximately 23%, or 425 hospitals, collect the patient’s portion of the procedure before care is provided.
Will this be an option for providers to ensure their viability and help patients in some cases, or a struggle to closely determine how much patients will owe depending on their health plan and impact access to care?
As soon as delays in the No Surprises Act are resolved, providers will be required to provide an Advanced Explanation of Benefits.
ACA International has noted that the need for upfront payments could be a negative, unintended consequence of the Consumer Financial Protection Bureau’s pending Notice of Proposed Rulemaking on the Fair Credit Reporting Act—ultimately reducing access to care.
In comments on the bureau’s proposed changes to the FCRA and credit reporting medical accounts, ACA focused on the impact for low-income consumers and health care providers, especially in rural areas.
“Arbitrary changes hurt patients,” said ACA CEO Scott Purcell in the comments (PDF). “Delaying reporting to one year enables insurance companies to deny claims for untimely filing. This, and not reporting debts under $500, negatively affects health care providers’ revenue, resulting in reduced access to care for low-income [consumers] as providers move to more upfront payments. Congress didn’t provide for unelected CFPB staff to make health care policy decisions; it’s a slippery slope. Americans deserve greater access to affordable health care, not less.”
ACA also extensively outlined other negative impacts the CFPB’s actions would have on patients, including increased costs, a temptation to forego health insurance, and a likely increase in litigation from hospitals and collection agencies.
The CFPB’s NPRM on the FCRA is expected to be released this summer. ACA will have resources on how to file comments and navigating the proposals.
Attend the ACA Huddle at 11 a.m. CT Wednesdays for the latest on federal and state regulatory matters and compliance updates.
Remember, subscribe to ACA Daily and Member Alerts under your My ACA profile when logged in to acainternational.org.