3RD ANNUAL REPORT
State of Healthcare Affordability: The Patient Perspective
When the Bill Overshadows the Care
Insights from 1,000 U.S. adults who recently had a surgery or hospital visit show how deeply cost shapes the care journey.
1 in 4 patients say cost is their top concern before receiving care.
KEY FINDING
Affordability is Breaking in the Middle
Patients with household incomes of $75K–$90K, roughly 1 in 13 U.S. households, reported the highest rate of cost-driven care avoidance of any income bracket. They earn too much to qualify for meaningful assistance, but not enough to comfortably manage the costs their health insurance leaves behind.
Care Deferral Due to Cost
Patients earning $75K–$90K reported the highest rate of cost-related care deferral.
42%
of patients received no financial guidance
at all before, during, or after their visit.
KEY FINDING
Hospitals Are Still Missing the Pre-Care Window
42% of patients received no financial guidance around their most recent hospital visit or surgery. No cost estimate. No payment plan offer. No financial assistance information. No conversation with a financial counselor.
KEY FINDING
42% of patients have used an AI chatbot instead of seeing a doctor because of cost concerns.
Frequently Asked Questions
Patients earning $75,000 to $90,000 a year, roughly 1 in 13 U.S. households, report the highest rate of cost driven care avoidance of any income group, at 38.3 percent.
Middle income households often earn too much to qualify for financial assistance programs, but not enough to comfortably absorb the costs left after insurance. This gap leaves them more likely to delay or skip care than any other income bracket.
42 percent of patients report zero financial touchpoints before, during, or after their most recent hospital visit or surgery, meaning more than 4 in 10 patients go through a care episode with no cost guidance at all.
Hospitals can offer 0 percent APR payment plans by structuring them so a third party assumes the default risk instead of the hospital. This typically involves upfront reimbursement to the hospital, automated affordability underwriting to set realistic payment terms, and automated collection methods that reduce missed payments.
Health systems can flag affordability risk before or at the time of service using pre-visit cost estimates, eligibility screening, and automated segmentation, so patients get routed to the right support (assistance programs, flexible payment plans) before a bill becomes a barrier to care.
Read The Full Report
As affordability becomes inseparable from the patient experience, health systems have an opportunity to identify financial risk earlier, connect patients with affordability, and make support easier to access across the care journey.