Ethics of Point-of-Service Collections in Dermatology.

Abstract

In recent decades, rising healthcare prices and high out-of-pocket expenses have left patients with outstanding medical debt and increasing concerns about the costs associated with accessing medical care.¹ The repercussions of patients failing to pay for medical services and incurring medical debt are encountered by patients, hospitals, clinics, and private practices. To combat delinquent payments, some healthcare entities have adopted point-of-service collections (POSc), requiring partial (co-pays) or full payment for services not covered by insurance before medical services are rendered.² POSc are associated with significant financial and ethical implications. POSc can ensure timely payments for hospitals, clinics and offices as well as provide price transparency for patients; however, POSc can also result in challenging access to medical care for patients who cannot afford steep, upfront out-of-pocket payments. A practical application of POSc should ideally consider patients' needs, streamlining a mixed-payment model and sliding scale fees.³ We discuss the financial and ethical implications of POSc and recommend a pragmatic approach to POSc in healthcare.