Hospitals demand upfront payments from ER patients

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In an effort to process collections and reduce overcrowding, many hospitals are now requiring upfront payments from patients visiting emergency room visits without serious medical needs, reports Kaiser Health News.

The effort has borne some success: HCA, one of the nation's largest hospital chains, reported that 80,000 patients who didn't need ER treatment left after being asked for a $150 upfront payment.

According to the Healthcare Financial Management Association, half of the nation's hospitals now charge upfront fees for ER visits, with the percentage likely more than that.

The initiative is a response by some hospitals to cut down bad debt from uninsured patients seeking care at ERs, and by reductions in Medicaid and private insurer reimbursements for patients who seek routine care in inappropriate venues.

However, the effort has raised concerns from patient advocates. "It seems the point of the policy is to put a financial barrier between the patient and care," said Anthony Wright, executive director of Health Access California, a group that focuses on expanding access. Officials with the American College of Emergency Physicians has also raised concerns, noting that up to 7 percent of patients who present at ERs without serious problems are admitted to hospitals within 24 hours.

To learn more:
- Read the Kaiser Health News story
- here's ACEP's statement regarding ER reduction efforts
- get the Washington State Hospital Association's bulletin on ER usage reduction

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