Why Hospitals Want Patients to Pay Upfront

Melody Rempe spends much of her day telling people who are about to go into the hospital how much they’ll have to pay. As a patient financial counselor at Nebraska Methodist Health System, she calls patients about a week before they go in for procedures with estimates of their bills and what portion insurance will cover. Although many are grateful, some cry or yell. “Sometimes you’re talking to them about the biggest thing in their life,” she says. Rempe says most calls end well when she walks patients through the hospital’s payment-plan options or other financial assistance.

Hospitals have good reason to be concerned about their patients’ finances: Even people with insurance are increasingly responsible for a big portion of their medical bills. Among Americans who get health coverage at work, 41 percent have deductibles of at least $1,000 they must meet before insurance starts paying. That’s up from 10 percent in 2006, according to the Kaiser Family Foundation. Those with employer coverage are joined by 7 million new enrollees in Obamacare plans, which typically make patients share a large chunk of costs. The average deductible in the most popular “silver” tier of coverage is $2,267, according to an analysis by the Robert Wood Johnson Foundation.