The trend: Cleveland Clinic will cancel appointments for people who can’t pay their copays at the time of the visit starting June 1. It does not apply to emergency care, inpatient hospital stays or Medicaid patients, but does apply to scheduled office visits and procedures, and outpatient diagnostics like imaging and scheduled lab work.

What’s driving it: Copays provide predictable revenue and reduce collection costs.

• Cleveland Clinic said the change will help its financial stability. It said that in 2024, half of its copays were not made at the time of service.

Why it matters: The national wait time for a doctor’s appointment is increasing. Patients who aren’t able to pay their copay up front may have to choose between waiting for another provider’s next available visit, or going to a place of service where there is no required pre-payment to receive care, such as the emergency room..

• It now takes an average of 31 days for new patients to get into a doctor’s office, up from 26 days in 2022, according to AMN Healthcare’s 2025 appointment time study of 15 metropolitan areas.
• Wait times increased across all six therapy areas since the last survey three years ago, including family practice, which rose from an average 20.6 days to 23.5 days.