As the struggling economy puts the squeeze on patient pocketbooks, some healthcare facilities are seeking financial security by requesting that patients pay a portion of their out-of-pocket expenses up front for non-emergency procedures. It may seem odd, but the Medical Group Management Association says physician groups are increasingly adopting pre-payment policies in these tough economic times.

"With the economic downturn and the increased difficulty in collecting outstanding balances from patients, more practices are adopting this policy," Ken Hertz of the MGMA Health Care Consulting Group tells the Urbana/Champaign (Ill.) News-Gazette.

The paper reports that the Carle Clinic physician group in central Illinois adopted a down-payment policy for non-emergency surgical procedures earlier this month. The amount that patients are required to pay before going under the knife varies depending on their insurance coverage. According to Carla Kurtz, director of surgery services for the clinic, those with private health insurance must pay $500 of their out-of-pocket fees, Medicare patients pay $250 and uninsured patients must pay half the clinic???s total charges.

Ms. Kurtz explains that patients are notified of the policy when they call to schedule a surgical consultation. The policy actually helps patients, she says, because it gives them a chance to work out the details of their payment ahead of time and avoid confusion down the road. "It???s a much easier discussion to have on the front end sometimes, than on the back end sometimes when you get your clinic statement and are shocked at what your financial responsibilities are going to be," Ms. Kurtz tells the News-Gazette.

However, some healthcare consumer advocates worry that pre-payment policies could prompt patients to hold off on treatment until their conditions are at the emergency level.

—Irene Tsikitas