Nearly two-thirds of patients say tailored payment plans would increase their confidence in paying medical bills, yet a growing share continue to struggle with rising healthcare costs, according to Experian Health’s 2026 State of Patient Access Survey. For organizations collecting on medical debt, the data highlights a widening gap between patients’ ability to pay and providers’ efforts to improve access, with financial friction increasingly driving delays in care, lower collections, and more complex revenue cycle challenges.
The report, based on surveys of more than 200 providers and 1,000 patients, paints a mixed picture. While 46% of providers say patient access has improved, only 18% of patients agree, underscoring a disconnect that has direct implications for payment behavior and collections outcomes .
From a financial perspective, the most notable trend is worsening patient affordability:
- 57% of providers say patients sometimes struggle to pay, while 36% say they often struggle
- 32% of patients report that paying for healthcare has gotten worse over the past year
- Only 14% say their ability to pay has improved
This financial strain is already impacting revenue. According to the report, 73% of providers say patients will delay or forgo care if they cannot obtain an accurate cost estimate beforehand. That delay not only reduces immediate revenue but can also lead to larger balances later, increasing the likelihood of accounts moving into collections.
Cost transparency and payment structure are emerging as key levers. Among patients who reported a better payment experience, the top drivers were:
- Understanding insurance coverage
- Knowing costs before care
- Having access to payment plans
Notably, 63% of patients said they would feel more confident paying if offered payment plans tailored to their financial situation, reinforcing the importance of segmentation and flexibility in collections strategies.
The report also shows that operational improvements are helping, but not fast enough to offset financial pressure. More patients are receiving cost estimates, and fewer report large gaps between estimates and final bills, with “much more expensive than expected” bills dropping significantly from 44% to 26% year over year .
For collection agencies, debt buyers, and healthcare revenue cycle teams, the takeaway is clear:
- Patients’ ability to pay is deteriorating, not improving
- Upfront cost clarity directly impacts downstream collections
- Flexible, personalized payment options are becoming table stakes
As healthcare costs continue to rise and financial responsibility shifts further to patients, organizations that align their collection strategies with these realities will be better positioned to improve recovery rates while reducing friction in the patient experience.
