Hospitals, plagued by bad debt, ask or even require patients with high-deductible insurance plans to pay in advance

Irene Qdemat of Baptist Health enters
patient data. (C-J photo by Alton Strupp)

Kentucky hospitals are so plagued by bad debts that they are asking some patients to pay in advance, Grace Schneider reports for The Courier-Journal.

"We always encourage them to try to pay something in advance" if they have an insurance policy with a large dedictible, said Donna Ghobadi, assistant vice president of managed care and revenue cycle for Baptist Health, which includes seven hospitals. Still, "We won't turn anybody away."

Schneider notes that Americans "have been shifted to high-deductible health care plans that require the employee to spend thousands of dollars on doctors and prescriptions before insurance kicks in. Estimates are that such plans covered one in nearly five Americans this year, a sharp increase from one in 25 in 2006, according to the Kaiser Family Foundation's 2014 Employer Health Benefits Survey."

Also, "Health-care reform also is shifting the burden for patients to come up with cash for their care in many instances," Schneider reports. "Of the 7.3 million people enrolled in federal and state exchanges under the Affordable Care Act this year, roughly a fifth nationwide and in Kentucky selected bronze-tier plans, which carry deductibles exceeding $5,500 per person. Bronze plans lack subsidies that silver and other plans provide to help pay out-of-pocket costs for those who meet income-eligibility thresholds." But many patients don't seem to realize that, hospitals say.

"Meanwhile, there has been an increase in employers offering an additional benefit at annual health-care enrollment of an insurance policy paid by the employee to cover a critical illness and care after an accident, said Jeff Bringardner, vice president of Regional Market Development for Humana," Schneider reports.