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Healthcare payments and consumer finances: Where do we go from here? | Viewpoint


AccessOne’s 2023 consumer survey paints a vivid picture of the average American’s financial struggles and what healthcare organizations can do to help them.

Healthcare spending and costs continue to rise, and it’s impacting everything from consumer morale to the broader economy.

Image: AccessOne

Mark Spinner

Less than one-third of Americans (28%) said they paid their most recent medical bill in full and on time, according to AccessOne’s 2023 consumer survey. Additionally, nearly one out of three survey respondents (30%) said they are “not confident at all” that they could pay a medical bill of $500 or more.

Healthcare payment woes aren’t just affecting young Gen Z adults – they’re also impacting the most vulnerable seniors, including Americans with multiple chronic health conditions. This reality is having a ripple effect not only on individual health outcomes, but also hospitals’ revenue cycle management performance.

Here’s how trends unearthed in this consumer survey could impact healthcare organizations in 2024 – and what healthcare leaders can do to boost patient financial engagement.

6 Key Healthcare Payment Trends

Nearly every respondent to the annual AccessOne survey said rising healthcare expenses had some level of impact, though there were notable differences based on age, income level, and geographic location.

  • While 44% of Americans said they saw a rise in their healthcare costs, the increase was more widely reported by Americans in the northeast (53%), as well as among individuals ages 35-44 (50%) and those with household incomes of $100K or more (55%).
  • One-third of respondents ages 18-34 said they’ve gone so far as to postpone needed care to reduce healthcare expenditures, compared with 7% of respondents ages 65+ and 19% of 55- to 64-year-olds.
  • Younger generations (38% of Gen Zers and millennials) are more likely to not fill a prescription or delay a prescription to cut back on medical spending than their Gen X and Baby Boomer counterparts.
  • 27% of millennials have delayed needed care or treatment to cut back on medical expenses. These findings are similar to a Gallup healthcare poll, which noted that in 2022, 38% of Americans said they or a family member had skipped or delayed medical care to avoid the expense.
  • As many as one-third of consumers (32%) charged a medical bill of $500-$1,000 on their credit card.
  • Among those who wait to pay their medical bill, 68% say it’s because they can’t afford to pay their bills on time.

Given this data, it’s unsurprising the desperate measures consumers are willing to take to gain financial relief from medical bills, including crowdfunding. But these efforts frequently fall flat.

According to a recent survey of nearly 165,000 pandemic-related campaigns for help with medical bills in 2021, more than four in 10 received no donations at all. And while some celebrities, like Mary Lou Retton, raise thousands of dollars in minutes, the average charity appeal raises less than $100.

Rethinking the patient financial experience

So what can medical institutions make of these handful of trends? Moreover, how can they help their patients afford healthcare?

Survey data points to a few solid and timely strategies healthcare organizations can leverage:

1. Focus on transparency and flexibility. Knowing what a health procedure will cost out of pocket is a must, especially for younger consumers. What’s less widely reported is the growing desire for simplified payments and flexible healthcare financing opportunities. Per the AccessOne survey, two out of three respondents say they would be more likely to seek care if they were given a payment plan option ahead of time.

2. Lean into digital. While snail mail isn’t dead, when it comes to healthcare billing, simpler is better – and the ease and convenience of digital invoicing and payments can’t be beat. While 19% of survey respondents said they prefer being contacted by secure text message when a healthcare balance is due—and 32% prefer email notifications – a generational breakdown highlights interesting differences: As many as 30% of Gen Z respondents prefer being contacted by secure text message, as do 22% of millennials, 19% of Gen Xers, and 11% of Baby Boomers. What this means: More and more patients would rather bypass the mailbox or having to log into a portal. They’d prefer a payment experience that’s as easy as ordering something on Amazon.

3. Gauge feedback regularly. When polled on their satisfaction with their healthcare providers’ payment options, 17% of survey respondents said they are dissatisfied with what they’re being offered. Knowing what’s causing their malaise is key. Is it an existing digital payments program? A lack of communication? Healthcare organizations need to be willing to investigate – say, by asking patients on what they are unhappy about (beyond their clinical diagnosis).

That bad news is that healthcare costs will likely continue to rise in the foreseeable future. However, knowing where consumers are struggling and what they want more of can help healthcare organizations serve them better. In particular, helping patients access tools that enable them to plan ahead, stay organized, and avoid surprise bills that are difficult to pay is a win-win for all.

Mark Spinner is the CEO of AccessOne.

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