Report: Only One-Third of Patients Get Healthcare Cost Estimates Before Visits

Wellness has become paramount as consumers return to office visits with their healthcare providers and undergo elective procedures put off during the pandemic. Ninety percent of Americans have health insurance, with 53% holding policies covering their families. Yet, PYMNTS’ research finds that patients who live paycheck to paycheck can face barriers in accessing healthcare due to out-of-pocket costs and may be more likely to delay or skip a medical procedure because of financial challenges.

This is just one of the key findings we uncovered in Wellness And Affordability: How Payments Practices Create Positive Patient Experiences, a PYMNTS report with research sponsored by CareCredit. We analyzed the responses of 3,546 adult American consumers to learn how consumers define a positive wellness and payment experience and how healthcare providers using automated, user-friendly payments tools can boost customer loyalty by eliminating payments friction.

More key findings from the study include:

Health insurance coverage is a decisive factor in consumers’ determination to go to the doctor or undergo an elective procedure. Our findings reveal that 33% of consumers have opted out of seeking needed medical care, either by not making necessary healthcare appointments or abandoning needed treatment, and 21% of these patients report that cost was the top reason. The most important reason for 11% of consumers was that their health insurance plan would not cover the appointment or treatment.

Many consumers expect to pay a co-pay for their healthcare visits but want transparency into their treatment costs. When a patient can pay before a visit, they most likely know what treatment costs. Our research finds that 89% of respondents say knowing their bill and paying before their visit is an easy way to pay. This is more common for visits with behavioral health specialists and primary and specialist physicians, cited by 30% of patients.

Insurance coverage plays a crucial role in enabling patients to access necessary healthcare and is a fundamental consideration for consumers when choosing healthcare providers. Our data finds that most patients would switch their current providers if their insurance stopped covering their visits. Fifty-nine percent of patients surveyed said services not being covered was an important reason why they would consider leaving their healthcare provider.

To learn more on how payments practices create positive patient experiences, download the report.