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Healthcare affordability crisis sparks calls for better billing communication

Surveys show consumers need a better patient financial experience, flagging AI as a tool to improve price transparency and communication about medical bills.

Sara Heath
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Published: 07 Oct 2026

The healthcare affordability crisis is quickly becoming a patient financial experience crisis, with new survey data from health IT company PayZen revealing a need for better communication about medical bills and payment plans.

The survey of 1,000 adult healthcare consumers, completed by Censuswide in July, found that a quarter of patients are concerned about healthcare costs before they've even set foot inside a clinic or hospital. And that level of anticipatory stress is deterring many from accessing healthcare at all.

Notably, having stable income and insurance coverage isn't enough to insulate people from financial stress, the survey added.

Folks with incomes between $75,000 and $90,000 were among the most likely to skip care because of costs (38%) and most likely to cite cost as their biggest concern before accessing care (35.7%). These patients are also among the most likely to use an AI chatbot to avoid the costs of an office visit, the report showed. That's because these folks earn too much to qualify for assistance, but not enough to manage high healthcare costs.

Healthcare organizations are well positioned to mitigate these stressors, according to Itzik Cohen, CEO of PayZen.

"Health systems have an opportunity to prevent cost of care from becoming a barrier to receiving care by giving patients clearer financial guidance and connecting them with affordable ways to pay," Itzik said in a press release.

But according to the survey, hospitals and health systems are falling short of that guidance, creating a patient financial experience defined by poor communication and zero navigation.

Patients want info about financial responsibility

Around 4 in 10 respondents said their healthcare provider offered zero financial touchpoints, meaning there was very limited financial navigation offered to them.

Information about payment plans or financial assistance was particularly opaque, with 48% of respondents saying they learned about payment plans after their bills came, and only 18% saying they'd learned about financial assistance before their visits.

This is problematic, the report indicated, because learning about affordability options might persuade a cost-conscious patient to access care. More than half (61%) of healthcare providers agree that patients should receive information about payment plans and financial assistance before their visits, but few organizations are equipped to scale such efforts.

Most systems are built to screen for low-income people, people without insurance or otherwise self-pay patients to communicate financial assistance. But given that the pool of healthcare consumers struggling with costs has expanded to middle-income people with certain types of private insurance, it'd be worthwhile for organizations to reconsider how they screen for financial needs.

Those efforts would likely pay off with greater patient loyalty, which is significant as organizations seek to increase market share.

More than half (63%) of respondents said access to flexible payment options would make them more likely to visit a provider again in the future. Conversely, 9 in 10 respondents said they'd lose trust in a healthcare organization that is not communicative about payment plans.

AI helps patients navigate medical bills

AI could be ripe for this type of more granular communication.

"Our data shows that AI can play an important role in creating that experience," Cohen said. "But when concerns about cost are driving patients to turn to chatbots instead of their doctors, that should be a wake-up call."

Healthcare consumers are generally open to the idea of an AI chatbot designed to help explain medical bills, assess payment options or determine whether the patient is eligible for financial assistance. This was most common among patients aged 25-44.

This is a departure from where AI has excelled in the revenue cycle.

The technology has been popular in mid-cycle and back-end functions. Implementing AI into more patient-facing processes, including patient registration, could help patients get better payment information before their visits. AI could also offer clarity to what are often confusing or complex medical bills.

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.

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