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When Cleveland Clinic announced a new policy beginning on June 1 that requires patients to pay their out-of-pocket copays when they arrive for their scheduled appointments, it created controversy for the high-profile nonprofit system. If a patient isn’t able to pay upon check-in for nonemergent appointments, it results in the appointment being cancelled. Urgent care is not included in the new policy, so patients visiting any of the Cleveland Clinic’s 42 centers will not need to pay when they arrive. By requiring copays on the spot, the Clinic could make it harder for low-income patients to access necessary care in a timely manner, experts told local news outlet Cleveland.com. Those who are turned away might reschedule, but they could also seek care from one of the other dominant health systems in the area that don’t have an upfront payment requirement. In a press release, the Clinic says it will not ask for upfront copays from Medicare and Medicaid enrollees or for cancer treatment, surgeries, or inpatient stays.
The bill is in the mail: The Clinic has long been criticized for a perception that it does not provide enough charity care in alignment with its nonprofit status, according to one assessment published by the Lown Institute earlier this year. The group estimates that the Clinic receives about $307 million in tax exemptions but only provides $101 million of community investment—a figure the Clinic disputes. In 2023, Cleveland Clinic provided care to 100,000 patients through $261.3 million in financial assistance, it says. At the same time, more than half of its copays are not paid at the time of service.