Coming off a year of substantial growth in health-care credit charge volume, both MasterCard and Visa U.S.A. Inc. are predicting continued gains in 1995.

Visa reported $4.96 billion in health care volume in 1994, according to yearend statistics, while MasterCard estimated $3.7 billion. Both figures were approximately 25% above their 1993 totals.

"Deductibles and copayments continue to increase, putting pressure on consumers and providers to find alternatives," said Les Mann, vice president of health-care marketing at Visa.

With annual out-of-pocket health care costs estimated at $600 a consumer, credit cards are increasingly used to pay significant medical bills.

Payments by Visa cardholders for deductibles, copayments, and services not covered by insurance plans averaged $143 for each health-care transaction in 1994.

Approximately 70% of dentists and 95% of hospitals in the United States accept credit cards payment. Just under half of all physicians nationwide now accept them, an estimate that some executives say has been misinterpreted as demonstrating considerable resistance to credit cards within the profession.

Credit cards are accepted by 95% of large-group pediatricians, 70% of midsize-group doctors, and 40% of solo practitioners, Mr. Mann said.

"The more sophisticated management systems have tended to move more quickly in implementing credit card acceptance," he added.

Smaller practices may not encourage their patients to use credit cards because of they are reluctant to pay transaction fees.

But Gary Grosso, MasterCard's vice president of health care marketing, contends this perception is slowly changing, because doctors understand it may be costing them money.

"Doctors are realizing that billing patients and waiting 75 days to get paid is not in their best interest," said Mr. Grosso. "The larger the practice, the more automated it's likely to be."

Mr. Grosso says that doctors collect only 85 cents for every dollar they charge due to payment defaults. "It's a problem," he said. "Households tend to put medical payments low on the list. They pay mortgages and utilities first."

Both MasterCard and Visa say they will cultivate the growing health care market this year. Enhancing point of sale transactions is a priority for MasterCard.

"We will be developing terminals that have multiple functions so physicians can do background checks,"said Mr. Grosso.

Visa says its main goal is to increase usage in existing accounts, then concentrate on adding new ones.

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