State of the
Patient Financial
Experience 2021 Patientco's Annual Survey Report


The Patientco 2021 State of Patient Financial Experience Report contains quantitative data from 3,116 patients and 46 healthcare providers. To obtain the patient survey data, Patientco used SurveyMonkey to obtain insights from a random sampling of people across the United States over the age of 18. Patientco also used SurveyMonkey to poll revenue cycle employees at large healthcare organizations, most with 300 beds or more to better understand how healthcare providers currently address or plan to address the current patient financial engagement challenges.

More Patients Cite Cost Concerns Than Covid-19 as Reason for Skipped Care

Concerns about out-of-pocket costs are the #1 reason patients skip or delay recommended healthcare treatment.

Have you ever skipped or delayed recommended healthcare treatment? If so, why?

  • 32% Yes, I was worried about what I would owe.
  • 29% No, I’ve never skipped or delayed care.
  • 27% Yes, I was worried about exposure to Covid-19
  • 24% Yes, for other reasons.
  • 15% Yes, I did not have insurance.

Nearly Half of Patients Need Financial Assistance for Bills over $500

For medical bills that exceed $500, 45% of patients would need financial assistance and for bills that exceed $1000, the percentage is even higher, as 66% of patients would need assistance.

At what price point would you have to seek assistance in order to pay an unexpected healthcare bill?

  • 7% $0-100
  • 6% $100-200
  • 8% $200-300
  • 5% $300-400
  • 6% $400-600
  • 13% $500-1000
  • 21% $1,000-5000
  • 16% $5,000-10,000
  • 18% $More than $10,000

Medical Bills Leave Patients Confused & Conventional EOBs Do Not Alleviate This

More than half of patients have felt confused when paying for healthcare services because it’s difficult to understand what their health insurance covered and what they owe.

What causes confusion when paying for your healthcare services?

  • 52% Difficulty understanding what my insurance covered (what I owe)
  • 27% I’ve never been confused
  • 27% I received too many bills for one visit
  • 19% I am being billed for out-of-network services even though I went to an in-network provider (surprise bill)
  • 13% I was confused for other reasons not listed
  • 6% I did not know where to go to pay the bill
  • 5% I do not know how much money I have in my FSA/HSA account

Providers Focused on Getting Patients Back in For Care after COVID-19

After COVID-19, revenue cycle teams are most focused on getting patients back in for care with 64% of providers citing this as a key focus, followed by solving for price transparency, which 51% of providers cited.

After COVID-19, what problem areas are your revenue cycle team most focused on solving for in 2021?

  • 64% Getting patients back in the door
  • 51% Price transparency
  • 28% Reducing costs by streamlining processes and/or consolidating vendors
  • 28% Talent and resource constraints
  • 28% No Surprises Act
  • 21% Improving health equity
  • 13% Low patient payment rates
  • 8% Accepting policy changes from the new administration

Patients Continue

to Skip Care over

Cost Concerns

34% of women have skipped or delayed care because of cost and 30% of men have deferred care over cost Cost concerns top COVID-19 as #1 reason patients skip care For patients under 60, 41% skipped care because they were worried about what they would owe For patients 60 years and older, concerns about COVID-19 were cited more than cost concerns as the reason for skipping care

Less than 1 in 5 providers use bill balance to assess patient eligibility for financial assistance

How does a patient become eligible for charity care or financial assistance at your health system?

  • 72% Patient’s income is below a certain amount
  • 69% A combination of the above answers options
  • 60% The patient is uninsured
  • 18% Patient’s bill balance exceeds a certain amount

Unclear Financial


Confuses Patients

Less than half of patients could make sense of their EOB Over half of patients struggle to understand what their health insurer covered Even for patients with a Ph.D. or higher, over half had difficulty understanding what they owed and what insurance covered

While EOBs are intended to help patients understand their medical expenses, not all patients found them helpful, nearly 1 in 4 patients said their EOB didn’t make sense to them.

Health Systems Reshape the Status Quo with Digital Investments Post-Pandemic

Over half of revenue cycle teams focused on re-engaging patients & new regulatory requirements
Nearly 8 in 10 providers will make their telehealth & work from home policies permanent
  • Currently using
  • Plan to implement within the next 1-2 years
  • Electronic billing that sends paper statement if patient does not open digital bill

    49% 36%
  • Real-time chat

    40% 26%
  • Patient self-service payment plans or financing options

    68% 21%
  • Touchless payment options (e.g. Apple Pay, Google Pay

    47% 24%
  • Presenting HSA/FSA information in the Patient Portal

    40% 24%

What Our Clients Are Saying

“Patientco is the best thing since sliced bread. We love the system. I give the system a high rating for ease of use. The feedback I have received from our patients is that the system provides a great user experience for paying bills."

"Our end users find the system to be very easy to use. If people need information on their accounts, they can access it online with the security code from their statement. I haven't heard any complaints. I would strongly recommend Patientco."

“ I love the product. It has impacted patient satisfaction. Our A/R days have decreased because of the ability for patients to use the online bill pay. Even when I am a patient, I love the technology. I get an email saying when I have a statement, and I can click on it to go pay my bill right then and there. As a patient, I love that aspect."


Cost remains a Top Barrier to Care

Patients are struggling to keep up with rising healthcare costs. These fears often prevent patients from seeking the medical care they need. In fact, concerns about out-of-pocket costs are the #1 reason patients skip or delay recommended healthcare treatment.

Patients struggle with unclear financial communication

When patients do seek out and receive treatment, they often feel confused, stressed or disempowered when making financial decisions related to their care. More than half of patients have felt confused when paying for healthcare services because it’s difficult to understand what their health insurance covered and what they owe.

Healthcare providers digital investments

Healthcare providers realize that digital investments will be vital to their organization’s success and getting patients back in for care following the pandemic. Patients across demographics value the ability to communicate with their provider digitally, especially since the pandemic fueled adoption of technologies such as telehealth.

About Patientco

Patientco, recently named Best in KLAS for Patient Financial Engagement Platforms, is the only vertically-integrated payment technology company that was founded specifically to rethink the patient payment experience in healthcare. We provide greater connectivity, advanced analytics and more, so that health systems only need one patient payments partner and technology platform. Patientco improves financial care across the entire patient journey, from pre-service to post-service, while increasing payments and revenue for today’s top health systems.

Get the Full Report Here.


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