Research released last week shows that healthcare providers collect just 31% of patient bills on average, with much of the remainder tied up in extended payment plans. The report, published by healthcare finance startup PayZen, was based on surveys of 205 revenue cycle leaders from health systems across the country.
Even as providers struggle to collect patient payments, those payments are accounting for a growing portion of overall revenue. On average, patient billing makes up 12% of a health system’s total net patient revenue, the report stated.
In response, health systems are increasingly exploring ways to improve the patient financial experience. Interest in developing a stronger patient finance strategy more than doubled between PayZen’s 2025 and 2026 surveys, rising from 19% to 41%.
Tobias Mezger, PayZen’s co-founder and chief revenue officer, thinks the most striking finding from the report is the disconnect between health system leaders’ awareness and action.
In his eyes, health systems broadly agree on what a good patient financial experience should look like, but adoption of those practices remains slow, despite the fact that financial pressures are getting worse for both providers and patients.
“It would have been more understandable if there was a big debate about what the right path is. But that’s what struck me — just that we’re still moving pretty slowly,” Mezger remarked.
This could stem partly from providers’ disappointment with prior vendors selling payment software, he said.
“[Providers] have been burned before. Frankly, a lot of the vendors that have been traditionally in our space were more about financial engineering rather than getting the patient the right solution and having a proper integration with the health system and their workflows,” Mezger explained.
He understands why providers might be a bit reluctant to overhaul their existing payment workflows or commit to new vendors, but he thinks the time to act is now because there are clear gaps in patient demand for flexible payment options and what health systems currently offer.
Mezger noted that many providers cap in-house payment plans and often do not partner with third-party financing companies — even as rising healthcare costs are causing more patients to need these types of flexible payment options.
He also pointed out that there hasn’t been much adoption of pre-care payment workflows, which he finds troubling.
First and foremost, Mezger believes the ideal patient financial experience is one where patients know their out-of-pocket costs before scheduled care. Beyond that, he also thinks patients should be able to understand and access all available options — such as Medicaid eligibility, financial assistance and payment plans — before they receive care.
Financial conversations between providers and patients become much more difficult after care is delivered, Mezger stated.
He noted that the patient financial experience can be directly linked to loyalty and retention, with patients being more likely to return to a health system if they receive financial education and flexible payment options.
Mezger also argued that improving patient finance is not just about satisfaction — it can also improve the provider’s collections.
“If you make it hard or confusing for a patient, or don’t give the patient the flexibility they need to make this work with their income, then you get paid less. You’re leaving money on the table,” he declared.
He added that when patients fall behind on payments, providers usually lack the processes needed to support them. Mezger stressed that most patients on payment plans want to pay, but their changing financial circumstances usually require more active engagement from health systems.
As patient responsibility for healthcare costs continues to rise, Mezger thinks providers will need to move faster to modernize their payment workflows — or risk worsening their revenue performance.
Photo: Maskot, Getty Images
