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The Affordable Care Act instituted by the Obama administration has caused unpaid patient debts to pile up that hospitals are now implementing procedures to make patients pay upfront before care is provided.

Initially the Affordable Care Act was able to help hospitals manage debt caused by the uninsured who were unable to pay their bills. Obamacare was able to cover the cost of the bills of the lower-income brackets from those who had higher insurance premiums. Now whether they are in the Obamacare plans or in private health plans with employers, people are choosing insurance plans with lower monthly payments which make patients pay upfront before they get care and higher out of pocket costs, Reuters reported.

To avoid the bad debt some healthcare providers are experimenting on prepayment strategies that make patients pay upfront and longer repayment options for those who opt to avail of hospital-based loans.

With private practice however, some offer the direct primary care model. This system does not accept insurance because the current format of the Affordable Care Act creates instances where doctors are not compensated properly if they are to do more for patients. The doctors are more inclined to divvy up care to make most of the payments from the government and insurance providers if they are covered by health insurance and make them go back for a second visit, The Federalist reported in their website.

What the direct primary care model used by Dignitas Health in Virginia does is take out the higher premium that policy holders pay for and just charge a membership fee. The $60 monthly fee covers standard checkups, laboratory tests and charge for just the cost of supplies in minor surgeries. This helps the patient by knowing how much the cost is upfront and focus more on getting insurance policies that cover serious emergencies and large hospital bills.

While in big hospitals, the upfront payment may delay people from getting treatment and cost more because of that delay, the direct primary care model only asks you to pay for the service to get that service.