The Growing Challenge of Patient Payment Delays

1. Increased Patient Financial Responsibility

• Over 55% of insured Americans are now enrolled in high-deductible health plans (HDHPs), meaning they must cover more medical expenses out-of-pocket before insurance applies. 

• The average deductible for employer-sponsored plans has risen to $1,735 per individual, delaying provider payments as patients struggle with costs. (KFF.org) 

2. Rising Medical Debt and Non-Payments

• Over 100 million Americans carry unpaid medical debt, with 15% of patients delaying or skipping payments due to financial difficulties. (Health Affairs) 

• 30% of patient balances remain unpaid after 90 days, leading to significant revenue losses for providers.

3. New Executive Orders Affecting Patient Collections

Recent executive orders have added new complications for healthcare providers trying to collect payments: 

Rescission of Drug Pricing Initiatives 

• The reversal of 2022 drug pricing reforms removes caps on copayments for generic medications and FDA-approved drugs, increasing costs for patients. 

• This could result in more patient payment delays as individuals face higher out-of-pocket expenses for necessary prescriptions. (MediaRelations.GWU.edu) 

Regulatory Freeze on Healthcare Rules 

• The temporary freeze on healthcare regulations includes medical debt reporting policies and overdraft fee limitations, creating uncertainty in billing procedures. 

Potential Medicaid and Federal Funding Cuts 

• The administration is reviewing $2.3 trillion in potential Medicaid cuts, which could reduce coverage and payment rates for providers. 

• More uninsured patients and lower Medicaid reimbursements will increase financial strain on providers. (Reuters.com) 

Given these policy shifts, providers must proactively adjust their patient collection strategies to ensure timely payments and financial stability.