Tag: state of patient access

Patient access is improving in some areas, but the journey is still being shaped by two major forces: administrative complexity and cost.

Rising healthcare costs refer to the increasing financial burden of medical care for patients and providers, driven by higher service prices, insurance complexity and out-of-pocket expenses. These rising costs are causing patients to delay care, increasing financial strain and creating new challenges for healthcare revenue cycles.

Experian Health’s latest State of Patient Access 2026 survey captures how patients and providers feel patient access has changed over the past year. This article highlights where progress is most visible, along with opportunities for further improvement, such as appointment speed, financial clarity and front-end data accuracy.

Experian Health’s State of Patient Access 2026 survey shows that timely access to care is the number one priority for patients. This article explains what patient access is, what makes it challenging, and how digital tools can help providers improve accuracy, efficiency and patient satisfaction.

When patient eligibility verification is conducted diligently and accurately, providers see improved cash flow, more staff efficiency and less bad debt.

Manual insurance eligibility checks are slow, error-prone and a leading cause of claim denials. Find out how automated insurance verification delivers real-time accuracy, fewer billing errors and faster reimbursements — helping providers protect revenue and improve patient care.

Key takeaways: Many eligible patients don't apply for charity care simply because they don't know it's available, leading to financial strain for patients and providers. Improving charity care communication helps patients understand their options early, builds trust and reduces uncompensated care for providers. Automating financial assistance screening with tools like Patient Financial Clearance supports compassionate financial conversations and ensures more patients are connected to support at scale. Patients face difficult choices when the cost of care feels out of reach. Some hesitate to proceed with planned services due to affordability concerns, even though financial assistance may be available. For providers, Medicaid rollbacks under the budget reconciliation bill could leave more patients without coverage, increasing the volume of uncompensated care and making revenue less predictable. Charity care programs provide a financial safety net – but only if patients know about them. This article looks at how improving charity care communication connects more patients to the financial support they need. Why clear communication about charity care matters Charity care programs are designed to remove financial barriers to care for those most in need. They provide full or partial discounts to uninsured or underinsured patients for medically necessary services, as set out in hospital policies and state-level regulations. However, according to a 2025 Lown Institute study, millions of eligible patients do not apply because they do not realize the support is available. This lack of charity care awareness could affect care decisions. Experian Health's 2025 State of Patient Access survey found that 43% of patients would consider cancelling or postponing care without an accurate cost estimate. Meanwhile, 34% report they often struggle to pay for healthcare, and 95% say they experience affordability challenges at least occasionally. Making patients aware of available support means they'll feel more confident about what they owe, build trust in their provider and reduce the risk of uncompensated care. The barriers patients face when learning about financial assistance Limited information isn't the only reason for low charity care uptake. Confusing eligibility rules and complicated application processes also make support harder to access. Socioeconomic factors, language barriers and poor digital literacy compound these obstacles. Without action, the challenge looks set to intensify. A Kaiser Family Foundation investigation found that hospitals in states with limited access to Medicaid generally had higher charity care costs. With the Congressional Budget Office projecting that changes under the “One Big Beautiful Bill” Act will result in a further 16.9 million Americans without insurance over the next decade, improving charity care and patient education is likely to become more urgent. Now is the time to rethink collections. This webinar shows how leading health systems are turning collections into a precision discipline using data, automation, and continuous monitoring to protect margins against uncompensated care. Watch now > Jason Considine, President at Experian Health, explains: “When coverage gaps widen, healthcare providers must be financial advocates for their patients. Hospitals can't afford to wait for patients to ask for help or default on bills. It will become even more important for providers to guide the financial journey. This includes helping patients qualify for financial aid or identify personal payment plans." He says, "Proactive financial screening must be embedded throughout the patient journey and providers need to take every opportunity to help patients understand their options. It's not just about protecting revenue, it's about ensuring that every patient has access to the care they need, regardless of their financial circumstances. That means offering clear education, transparent communication and robust charity care options at every touchpoint.” “When coverage gaps widen, healthcare providers must be financial advocates for their patients. Hospitals can't afford to wait for patients to ask for help or default on bills. It will become even more important for providers to guide the financial journey.”- Jason Considine, President at Experian Health How to build trust when discussing financial support to patients For many patients, discussing financial hardship can be uncomfortable. Providers must approach these conversations with empathy, clarity and consistency. When thinking about how to explain charity care to patients, staff should focus on using plain language, avoiding jargon and being as clear and compassionate as possible. Timing matters as much as tone: patients who understand their options early are more likely to meet their financial obligations. Alex Liao, Senior Product Manager for Patient Financial Clearance at Experian Health, says talking about financial support should be normalized as part of the standard intake process: "While we know a lot of patients worry about cost, there are also those who are unsure if it's okay to bring up,” Liao says. “When providers take the first step and lead the conversation, it takes the pressure off patients and gives them extra reassurance. They feel more comfortable having honest and judgment-free discussions about how to manage their bills." See how Patient Financial Clearance is helping Community Health System prepare for a potential rise in uninsured patients in 2026 by automating eligibility verification and coverage screening. Strategies for improving charity care awareness and understanding Liao says that providers need practical strategies for holding compassionate financial conversations: “Compassion isn't just about how we speak to patients. It's about making sure they trust and process the information they're given, and can act on it,” he says. “That means meeting patients where they are – financially, culturally and technologically. Staff should be trained to explain assistance options confidently and consistently, using standardized messaging, multilingual materials and awareness of culturally appropriate messaging.” Technology can further close the gap. Patient portals, SMS tools and mobile apps can deliver personalized financial messages and guide patients through eligibility pathways in a way that's particularly convenient for younger or mobile-first populations. Integrating charity care communication with eligibility screening Of course, these conversations depend on knowing who needs support in the first place. Automated screening processes make it easier to identify patients who qualify for assistance. This should be done as early as possible, so patients get early clarity about any support that may be available. Embedding charity care screening directly into scheduling, pre-registration and intake workflows means staff can proactively flag patients who need help before balances become unmanageable. By identifying eligible patients upfront, providers can reduce downstream bad debt and avoid the costs of collections and write-offs. On-demand webinar: Hear how Eskenazi Health boosted Medicaid charity approvals by 111% with financial aid automation Discover how Eskenazi Health partnered with Experian Health to automate the entire financial assistance process. How Experian Health supports better charity care communication at scale As states mandate charity care screening, Liao says these processes should be scalable: “We're seeing more states pass legislation that requires screening for financial assistance in hospitals. With other bills like Oregon's HB3320 being enacted, more patients will need to be screened for charity care eligibility. Because more individuals may now qualify, healthcare providers will need an efficient way to screen at scale and make sure patients are informed about their options. A tool like Patient Financial Clearance does well with volume.” Patient Financial Clearance helps reduce the manual burden of screening patients for financial assistance by automatically estimating the patient's income, household size and Federal Poverty Line percentage, and then scoring their propensity to pay. It can pre-populate charity care applications and help suggest custom-tailored payment plans to make patient bills more manageable. Automating key steps and communicating options early in the process helps staff and patients have better financial conversations. Patient Financial Advisor builds on that by allowing providers to contact patients directly with clear, upfront cost information before their visit. It sends a pre-service text message with a secure link to real-time estimates based on current rates and benefits data. Patients can easily see what they owe, explore available assistance and make secure payments, all through an intuitive, mobile-friendly platform. On-demand webinar: The X Factor - Using Experian data to drive financial assistance automation Discover how your peers are automating processes to meet new state charity screening regulations and finding new efficiencies. Empowering patients through transparent financial communication Too often, patients miss out on financial assistance simply because no one told them it was available. That communication gap creates a risk for patients facing unexpected bills, and for providers managing uncompensated care. Transparent financial conversations help remove barriers to care and build trust between patients and providers. With more patients likely to fall into eligible categories in the coming months and years, healthcare organizations need to rethink how and when they talk about financial assistance. Experian Health helps providers take a more proactive and compassionate approach to charity care communication, with scalable strategies that leave no patient overlooked. Learn more about how Experian Health's financial assistance solutions simplify charity care communication, so more patients get the help they need. Learn more Contact us

Key takeaways: As healthcare costs increase, the demand for patient financial assistance also rises as more patients find themselves without insurance coverage or facing economic hardship. Early identification of charity care eligibility reduces patient financial stress, makes the financial experience more compassionate, and protects providers from bad debt. Automated screening tools like Patient Financial Clearance, built on accurate, real-time data, are essential for flagging eligible patients before accounts go to collections and ensuring that no one misses out on vital support. Too often, patients who qualify for financial assistance aren't identified until after their accounts have been sent to collections. As healthcare costs increase and coverage becomes less certain, more patients will likely face financial challenges, making timely support even more critical. With estimated income data and financial behavior indicators, healthcare organizations can identify patient eligibility for charity care earlier, before the bills pile up. This article looks at how automated charity screening tools like Patient Financial Clearance can help providers support patients, protect revenue and remove the financial barriers that get in the way of care. The rising demand for patient financial assistance Demand for financial support is climbing quickly as economic pressures and policy changes make it harder for patients to keep up with medical costs. Nearly one in four adults are uninsured, often delaying or forgoing care because of high deductibles and out-of-pocket costs. Medicaid redeterminations have already resulted in more than 19 million disenrollments. At the same time, the Congressional Budget Office estimates that new federal spending provisions could push an additional 10.9 million people out of health coverage by 2034. As a result, revenue cycle teams will increasingly find themselves trying to collect payments from patients who are more likely to need financial help. "We're also seeing more states pass legislation that effectively mandates early screening for financial assistance before billing, such as Oregon's HB 3320," says Alex Liao, Senior Product Manager for Patient Financial Clearance at Experian Health. "These policies are becoming major drivers of financial clearance efforts. Identifying financial need early in the process helps patients avoid unexpected medical debt, and gives providers the insight they need to manage accounts appropriately and protect revenue." For providers, growing administrative costs, claim denials and underpayments mean less flexibility to absorb uncompensated care. Early screening protects against the burden of medical debt and facilitates the transparency and clarity patients need to manage their bills. Why does early identification of patient charity care eligibility matter? When charity care eligibility is missed or delayed, patients can quickly accumulate medical debt they can't afford. In an interview about the latest State of Patient Access survey, Clarissa Riggins, Chief Product Officer at Experian Health, explains why this is so important: "Cost is a major pain point," she says. "The report shows that 34% of patients struggle to pay for healthcare. That number is up from 23% last year. And nearly all patients, 95%, say they at least sometimes have trouble paying. It's clear that affordability is still one of the top reasons people delay care." Identifying charity care eligibility early on ensures these patients don't fall through the cracks. This reduces financial stress for patients and protects providers from avoidable write-offs and bad debt. When staff know which patients are likely to need support, they can have more compassionate and helpful financial conversations and connect patients with appropriate resources. Unlock patient charity care eligibility with automated screening  Manual charity care screening processes are often time-consuming and prone to delays, especially when staff have huge volumes of information to handle. Automated financial assistance screening tools use real-time data to identify patients who may qualify for charity care with greater speed and accuracy. For example, Patient Financial Clearance (PFC) helps providers screen patients earlier in the financial journey by automatically checking for eligibility at or before the point of service. It uses a range of estimated data points, including household income, household size and Federal Poverty Level (FPL) percentage, to assess whether a patient qualifies for charity care, Medicaid or other financial assistance. After calculating a risk score to evaluate the patient's propensity to pay, PFC can pre-fill application forms, reducing the need for staff input and accelerating enrollment. For those who may not qualify for charity care, PFC can recommend payment plan options that align with the provider's financial policies. This proactive, behind-the-scenes screening enables providers to flag eligible patients at multiple points in the care journey, ensuring more patients get the support they qualify for while minimizing manual work for staff. See how Patient Financial Clearance is helping Community Health System prepare for a potential rise in uninsured patients in 2026 by automating eligibility verification and coverage screening. Take a smarter approach to patient financial assistance with Experian Health Automated charity screening tools like Patient Financial Clearance are faster, more consistent and easier for staff to act on. But they'll fall short without reliable data. "Strong data practices are key," says Riggins. "That means better systems to catch errors before they become problems, regular staff training, and giving patients the chance to double-check their records… By automating tasks traditionally performed by human staff, healthcare organizations can save time associated with administrative intake and coverage verification. This also means solving for bad data in real-time, which can prevent billing and claim errors in the long run. Clean data makes everything easier, from billing to insurance verification to patient trust." Case study: How UCHealth wrote off $26 million in charity care with Patient Financial Clearance See how UCHealth partnered with Experian Health to create a more streamlined approach to providing charity care to patients who needed it. She gives the specific example of Patient Access Curator, which uses artificial intelligence to run multiple data checks at once, covering eligibility verification, coordination of benefits, Medicare Beneficiary Identifiers, demographics, and coverage discovery. When thinking about how to use data to find charity care eligible patients, tools like this lay the foundation for more proactive financial engagement. By cleaning up data and automating repetitive tasks, Experian Health's revenue cycle solutions enable providers to streamline their financial operations and give financial counsellors the details they need to engage patients at the right time and help them understand their options. The bottom line Automation and accurate data aren't just backend upgrades. They're essential to building a smarter, more compassionate financial experience, with fewer accounts going to collections. By embracing the best practices for identifying patients needing financial assistance, early action, better data quality, and automation, providers will be better placed to make sure no one misses out on the help they need. Find out more about how Patient Financial Clearance can help healthcare organizations automate financial assistance and identify patients eligible for charity care. Learn more Contact us

Key takeaways: Error-prone manual processes are a top reason for delayed reimbursements. Automation across the revenue cycle can help providers see quicker reimbursements. Many processes can be automated: patient estimates, eligibility verification checks, collections, claims management, and more. Prompt reimbursements are crucial for today's healthcare organizations. Delayed reimbursements can lead to a domino effect that impacts the entire revenue cycle. Provider productivity goes down along with quality of care, patients have poor experiences and the bottom line takes a hit. Reimbursement delays often stem from error-prone, outdated manual processes, overburdened staff and excessive administrative work. However, incorporating revenue cycle management automation can help providers overcome numerous reimbursement challenges and improve processes overall. With revenue cycle automation, providers can eliminate many persistent pain points in traditional revenue cycle management (RCM). Staff no longer lose time to tedious manual tasks, patients get their queries answered faster, and managers get the meaningful data they need to drive improvements. And the biggest win? It's easier for providers to get reimbursed for their services, faster and in full. What is revenue cycle automation and how does it work? Healthcare revenue cycle management knits together the financial and clinical components of care to ensure providers are properly reimbursed. As staff and patients know all too well, this can be a complex and time-consuming process, involving repetitive tasks and lengthy forms to ensure the right parties get the right information at the right time. This requires data pulled from multiple databases and systems for accurate claims and billing, and is a perfect use case for automation. In practice, revenue cycle automation involves using technology to complete tasks and processes that may have previously been manually completed. These tasks might include: Automatically generating and issuing invoices, bills and financial statements Streamlining patient data management and exchanging information quickly and reliably Processing digital payments Collating and analyzing performance data to draw out valuable insights. Understanding the challenges in traditional revenue cycle management When it comes to delayed reimbursements, providers lacking revenue cycle management automation typically face the following challenges: Inefficiencies in patient access According to The State of Patient Access 2025, front-end operations are still a source of friction for patients and providers. Four out of the five top patient access challenges reported by providers relate to front-end data collection. Top concerns include insurance searches, reducing errors, and speeding up authorization. Nearly 48% say data collected at registration is “somewhere” or “not” accurate, while 85% report an urgent need for faster, more comprehensive insurance verification. Rising claim denials due to manual errors The State of Patient Access also showed that manual, error-prone processes often lead to delays, claim denials and patient frustration. In fact, more than half (56%) of providers say patient information errors are a primary cause of denied claims. When claims are denied, reworks are often time-consuming, costly and place additional burdens on already overworked staff. Difficulty in managing patient collections Due to rising costs, confusion over estimates and a lack of patient payment options, providers are often left to deal with unpaid medical bills. According to Experian Health data, 29% of patients say paying for healthcare is getting worse. Affordability is a key factor, but patients are also struggling to understand how much their insurance covers and looking for convenient payment options, like payment plans. Download The State of Patient Access 2025 report for a full run-down of patient and provider views about access to care. Six ways revenue cycle automation accelerates reimbursements Revenue cycle improvement through automation can help speed up reimbursements for healthcare providers by: 1. Capturing accurate information quickly during patient access Gathering patient data manually is time-consuming. Errors in the process can lead to denied claims and roadblocks in patient care. Tools like Experian Health's Patient Access Curator use artificial intelligence (AI) to streamline patient access and billing, improve data quality and address claim denials from the outset. This solution also ensures that all data is correct on the front end by checking eligibility, coordination of benefits (COB), Medicare Beneficiary Identifier (MBI), demographics and insurance discovery. 2. Simplifying collections and focusing on the right accounts Healthcare collections are a drag on resources. Automating the repetitive elements in the collections process helps reduce the burden on staff. Collections Optimization Manager leverages automation to analyze patients' payment histories and other financial information to route their accounts to the right collections pathway. Scoring and segmenting accounts means no time is wasted chasing the wrong accounts. Patients who can pay promptly can do so without unnecessary friction. As a result, providers get paid faster. 3. Reducing manual work and staff burnout Chronic staffing shortages continue to plague healthcare providers. In Experian Health's recent staffing survey, 96% of respondents said this affected payer reimbursements and patient collections. While automation cannot replace much-needed expert staff, it can ease pressure on busy teams by relieving them of repetitive tasks, reducing error rates and speeding up workflows. 4. Maintaining regulatory compliance with minimal effort While regulatory compliance may not directly influence how quickly providers get paid, it does play a crucial role in preventing the delays, denials and financial penalties that impede the overall revenue cycle. Constant changes in regulations and payer reimbursement policies can be difficult to track. Automation helps teams continuously monitor and adapt to these changes for a smoother revenue cycle, often with parallel benefits such as improving the patient experience. One example is Experian Health's price transparency solutions, which help providers demonstrate compliance with new legislation and provide extra clarity for patients. 5. Improving the end-to-end claims process Perhaps the most apparent way RCM automation leads to faster reimbursement is in ensuring faster and more accurate claims submissions. Automated claims management solutions, like Experian Health's award-winning ClaimSource®, reduce the need for error-prone manual processes, while improving accuracy and efficiencies in the claims editing and submission process. Additional claims management tools, like Claim Scrubber, also help providers submit more complete and accurate claims. Other tools, like Denial Workflow Manager, can be used if claims are denied. With automation and its extensive data analysis capabilities, work lists are generated based on the client's specifications, like denial category and dollar amount, to identify the root cause of denials and improve upstream processes to prevent them. And as artificial intelligence (AI) gains traction, providers are discovering new ways to use technology to improve claims management. AI Advantage™ uses AI and machine learning to find patterns in payer behavior and identify undocumented rules that could lead to a claim being denied, alerting staff so they can act quickly and avert issues. Then, it uses algorithmic logic to help staff segment and rework denials most efficiently. Providers get paid sooner while minimizing downstream revenue loss. 6. Providing better visibility into improvement opportunities Finally, automation helps providers analyze and act on revenue cycle data by identifying bottlenecks, trends and improvement opportunities. Automated analyses bring together relevant data from multiple sources in an instant to validate decisions. Machine learning draws on historical information to predict future outcomes, so providers can understand the root cause of delays and take steps to resolve issues. A healthcare revenue cycle dashboard is not just a presentation tool; it facilitates real-time monitoring of the organization's financial health, so staff can optimize workflows and speed up reimbursement. Embracing automation for a more efficient revenue cycle Like any business, healthcare organizations must maintain a positive cash flow to remain viable and continue serving their communities. Revenue cycle automation strategies can cut through many of the common obstacles that get in the way of financial stability and growth and speed up reimbursements. Learn more about Experian Health's revenue cycle management technology and see where automation could have the biggest impact on your organization's financial health. 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