In a significant shift from traditional billing practices, an increasing number of hospitals and surgery centers are now requiring patients to pay in full for procedures in advance, according to a new report.

The move aims to alleviate the burden on healthcare facilities of pursuing payments post-treatment, which often involves sending multiple invoices and engaging debt collectors. However, the change is causing distress among patients, particularly those facing serious health conditions, as they struggle to secure the necessary funds upfront, The Wall Street Journal reports.

“We need those patients who are able to pay to do so,” a spokeswoman for University of Arkansas for Medical Sciences, Leslie Taylor, tells the paper.

Advance billing practices have been adopted for a variety of medical procedures, including knee replacements, CT scans, and childbirth. While federal law mandates that hospitals provide emergency care regardless of a patient’s ability to prepay, the focus on advance payments pertains to non-emergency treatments.

Advocates of this approach argue that it mitigates the financial and administrative challenges associated with collecting unpaid bills, which has historically been costly for healthcare institutions. According to data from Kodiak Solutions, a healthcare consulting and software firm, hospitals collected 23 percent of what patients owed before treatment in the first quarter of this year, up from 20 percent during the same period in 2022.

The push towards transparency in healthcare costs has gained momentum in recent years, with Congress and regulatory bodies urging hospitals to disclose prices more openly and curb surprise billing. The demand for clarity aligns with patients’ desires to understand the potential costs of their medical care in advance.

Despite these efforts, securing funds for healthcare remains a daunting challenge for many Americans. A survey conducted by the health policy nonprofit KFF revealed that half of adults in the U.S. would be unable to afford a medical expense exceeding $500 without borrowing.