More Americans will enter hospitals with health insurance this year than ever before, but many will have large personal responsibilities with the growth of high deductibles. President Barack Obama recently announced that 8 million Americans enrolled in private health coverage through the insurance exchanges established under Affordable Care Act (ACA). While not all of those enrolled in marketplace-offered plans have high deductibles, the vast majority have significant cost responsibilities.

With so many Americans now baring the responsibility for the vast majority of their medical payments, it’s imperative hospitals understand the true impact of such plans on bottom lines. The movement toward plans with large consumer responsibility will directly affect patient satisfaction, the ability to provide high-quality care and receive timely patient payments.

Here are the top four ways these plans may impact hospitals:

1. More price scrutiny
Health care costs have already come under fire by consumers, and high-deductible plans may only increase this scrutiny. According to Becker’s Hospital Review, recent research found 47 percent of those with high-deductible plans ask for generic drugs instead of more expensive brand names, and 33 percent also look up prices before receiving care. Patients with more cost responsibilities may ask to see various care options to determine affordability. This means hospitals that don’t adopt cost estimations could run into numerous issues providing patients with this information, possibly resulting in low patient satisfaction and patient volumes. In fact, another Becker’s article noted patients with more upfront care costs seek less care.

2. Higher rates of emergency care
Patients with high-deductible plans are more likely to hold off care, and may end up having to seek emergency medical services because of it. According to a Becker’s article, the ideal scenario is for those with high-deductibles to seek more preventative care, but this is often not the case. Many people would rather hold off care to see if they improve rather than take the chance of having a large bill for a minor ailment. For hospitals, higher emergency room use, more often than not, leads to higher costs for the organization and fewer timely patient payments.

3. Lower patient satisfaction
Price – and the ability to pay it – may even affect patient satisfaction. According to Modern Healthcare, patient satisfaction is linked with cost containment and improved health outcomes. If patients have high deductibles and are unable to seek care, their health outcomes may decline, their costs can skyrocket and their overall gratification with care can deteriorate.

4. Increased bad debt
All in all, high deductibles will raise bad debt for hospitals if patients aren’t able to provide medical payments for care. One of the Becker’s articles noted many health organizations have already said they have seen an increase in bad debt because of more consumers having these plans. According to Becker’s, Fitch Ratings estimates hospitals will need to embrace various cost-saving strategies if they want to reduce the impact of bad debt.

Methods like point-of-service collections and patient friendly billing may help hospitals protect their bottom lines as more consumers enroll in high-deductible plans. By providing patients with cost estimations, they are better able to understand their potential costs and understand how much certain services and treatments will cost them. In addition, collecting part of a patient’s payment right at the POS can help hospitals collect due payments immediately. POS collection can even improve patient satisfaction, because when consumers receive their medical bill they will see it is lower because they already provided part of the payment, benefiting patients and hospitals alike.