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How Much Patient Cost Sharing Is Paid Upfront for Care?
A large portion of cost sharing goes unpaid, providing an incentive for upfront collections when possible. Using data from 2018？23, we document the share of patient payments that occur on or before the day of service for hospital care. We find that 11.2 percent and 17.9 percent of patient payments are collected upfront for those with private insurance and Medicare Advantage, respectively. For elective services, this share rises to 14.5 percent for the privately insured and 24.1 percent for those with Medicare Advantage. Upfront payments make up a slightly increasing share of patient payments over time primarily because payment of post-service cost sharing has declined.
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