Cedar goes beyond propensity to pay to bolster patient billing

Healthcare financial engagement company, Cedar, recently announced new AI capabilities to deliver even more personalized patient financial experiences.

The company unveiled an expansion of its AI-powered decision engine, Cedar Intelligence, to help providers tailor billing journeys at scale. The platform will now include AI capabilities for patient experience, including personalized outreach, timing, channel, tone and resolution options, as well as medical bill navigation for patients, an agent copilot to support teams with real-time patient context and an AI voice agent to help providers engage patients who tend to be more difficult to engage.

Cedar aims to use AI to go "beyond one-size-fits-all billing and toward a model that can intelligently match each patient with the right financial experience, at the right moment, through the right channel," according to the announcement.

New AI capabilities will draw on over 1.5 billion patient interactions from clients, including $10 billion in processed patients and 50 million patient journeys nationwide. They will then analyze more than 80 patient attributes to identify the best financial experience for individuals. These attributes include bill size, payment behavior, coverage context, prior engagement and sentiment expressed during patient support interactions.

These attributes build on traditional propensity-to-pay models that use more static attributes, like payment history, ZIP code and credit history, to predict patient financial outcomes.

Patient financial behavior is more complex than that set of characteristics, Cedar explained.

Identifying additional attributes using AI advancements can help providers create more personalized, outcome-driven patient billing paths, the company continued. The platform will also be able to adapt in real time, rather than solely using historical data, to guide patients to a preferred payment option.

This AI expansion builds on Cedar's broader AI strategy, the company added. Cedar previously introduced Kora, an AI voice agent for patient billing support. With the new AI capabilities, Kora will be able to help providers prioritize patients and conduct personalized outbound calls.

The move comes as patients "become a larger and more consequential source of payment," Florian Otto, CEO and cofounder of Cedar, said in the announcement.

"What has been missing is a way to tailor billing experiences to the real needs of each patient, in real time," he continued.

Healthcare organizations are facing a significant shift in payer mix under the Trump administration's federal spending law -- known as the One Big Beautiful Bill Act (OBBBA) -- signed on July 4, 2025.

Providers expect payer mix to shift away from Medicaid and insurance coverage toward a higher percentage of self-pay and uninsured patients, as 10 million additional people are expected to lose coverage through 2034. They are also anticipating tens of billions of dollars in uncompensated care costs from these Medicaid reforms, as well as the loss of enhanced premium tax credits for Affordable Care Act Marketplace plans.

The patient financial experience is already a mixed bag, straining both patients and providers. Only 65% of patients report a satisfactory financial experience, according to Cedar's recent national patient sentiment survey. And that rate dropped to just 45% among financially at-risk patients.

Patients may generally want a more transparent, digital-first experience that is easy to navigate. However, data increasingly shows a disconnect between patient types and what they seek from their healthcare financial experience.

Jacqueline LaPointe is a graduate of Brandeis University and King's College London. She has been writing about healthcare finance and revenue cycle management since 2016.