UnitedHealth Group in April will launch a pilot program that will deduct medical payments from patients' paychecks, plus interest, if medical bills are not paid in full within 20 days, the Wall Street Journal reports. As "health plans impose higher deductibles, copays and premiums, many patients are becoming slower to pay their portion of hospital and doctor bills, driving up providers' collection costs and bad-debt accounts," according to the Journal. UnitedHealth's pilot program, known as OnePay, "is set to offer an automatic-payment program that would give providers a strong measure of assurance that patients will pay," the Journal reports. Under the program -- which will be launched in Texas, with voluntarily enrollment by employees and medical providers -- UnitedHealth will pay patients' portion of medical bills as soon as insurance claims are processed and will then collect from patients. Deductions from paychecks will not begin immediately; the insurer first will look to an available patient account, such as a flexible spending or health savings account. Patients can opt to skip this step and pay the bills out of pocket. If patients do not have such accounts or if the bill is bigger than the account balance, UnitedHealth will seek payment within 20 days. After that, payments will be deducted from patients' paychecks. UnitedHealth will charge interest at the prime rate, currently 7.5%. UnitedHealth said providers and patients will choose to enroll in OnePay largely because of convenience.

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"This is one way to move all of the minutiae back into what we do and make the experience simpler for all the people that matter here -- patient, doctor and their employer," Tracy Bahl, CEO of UnitedHealth's consumer-driven health care unit Uniprise, said. Tenet Healthcare has enrolled 14 Texas hospitals in the program, and Tenet is likely to accept discounted payments from the program. Stephen Mooney, Tenet vice president for patient financial services, said, "Any sacrifice we would make would be offset by the gain we would get on those additional collections." Gail Shearer, director of health policy analysis for Consumers Union, said automatic-payment programs "can offer some convenience to customers." She added that the programs can cause problems if patients "are concerned that because of their health status they may not be able to monitor the bills as carefully as they'd like." According to the Journal, some observers have expressed concern that patients might not review medical bills adequately under an automated payment structure, and typically they will be unable to challenge errors before a payment is made (Rubenstein, Wall Street Journal, 3/13).

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