US Healthcare Trends Payments Report

Every year, InstaMed releases the Trends in Healthcare Payments Annual Report to track the trends that are impacting consumers, providers and payers. This year’s report reveals the ongoing turmoil of two years in a pandemic. High costs, demands for price transparency and the prevalence of paper continue to affect the relationships between these three stakeholders. 

However, data from the report shows the industry is making progress on the consumer experience and efficiency, resulting from the digital acceleration brought on by the COVID-19 pandemic. The report’s findings offer hope that healthcare can make necessary changes to make real progress in removing the friction in healthcare payments for all. 

Here are three key takeaways from the 12^th annual Trends in Healthcare Payments Report.

1. The promise of better payment experiences for consumers through digital connections

The last two years of the pandemic have sent consumer finances on quite a journey, including record unemployment rates and direct stimulus payments; the burden of healthcare costs only complicates this financial chaos. 48% of American households had healthcare expenses in the past 12 months, with 17% facing costs in excess of $1,500¹.

Adding to the financial stress for consumers are surprise medical bills. There are multiple dependencies that determine the amount consumers will owe for medical care, and this complexity keeps consumers in the dark:

• Only 20% of consumers always know what they will owe²
• 87% of consumers were surprised by a medical bill in 2021³

The federal government is working to alleviate the problems in the current consumer payment experience through surprise billing mandates. The true answer to eliminating consumer friction may lie in the opportunities created by digital connections made in and accelerated by the pandemic. Digital connections became a lifeline during the pandemic as telehealth adoption continued to soar in 2021. Digital adoption also grew in healthcare payments, and trends show it may be here to stay: according to the InstaMed Consumer Healthcare Payments Survey 2021, 65% of consumers want to keep using virtual and self-service options offered for healthcare payments due to the pandemic. 74% of consumers prefer online payments for medical bills.

2. Healthcare providers need new solutions two years into a pandemic

Providers across the healthcare economy continue to get hammered by the impacts of the COVID-19 pandemic. Worse yet, the current labor market has added another uphill battle for providers as more jobs remain open and staff calls in sick. 

• Staff shortages ranked #1 among provider CEOs’ top concerns in 2021⁴ 
• 73% of medical practices rank staffing as their biggest pandemic challenge heading into 2022⁵

At the same time, providers face new requirements to increase price transparency for consumers due to recent US federal legislation. However, the laws do not seem likely to transform many providers’ slow, disparate payments processes that keep consumers confused and frustrated:

• 39% of providers say billing and collection efforts have no impact on the patient experience⁶ 
• 49% of consumers would consider switching providers for a better healthcare payments experience⁷  

Many providers do not see the connection between payments and the overall consumer experience, but the impacts of this disconnect could be costly. The key will be connecting to consumers in new ways that allow them to pay on their terms.

3. Tapping into growth opportunities for payers and member engagement

Employers represent a crucial segment of payer businesses and have been under extreme pressure amid the pandemic, including navigating the ‘Great Resignation’ and increasing healthcare costs. Trends suggest payers should watch how employers move forward in the years to come, especially the role that self-funded health plans will play:

• 82% of covered workers at large firms are enrolled in a self-funded plan⁸ 
• 45% of employers anticipate increased employee cost-sharing to mitigate cost increases⁹

There are opportunities for payers to tap into the current and future growth in the individual market. Yet, more work is needed to fully connect with these consumers, particularly for premium collections. 

• 65% of consumers would prefer to schedule automatic payments for premiums; 30% cannot do this now¹⁰ 
• 41% of payers were challenged collecting premiums¹¹

The member experience stands to benefit from a digital strategy focused on increasing engagement through payment touchpoints. 

The Trends in Healthcare Payments Twelfth Annual Report highlights quantitative data derived from the InstaMed platform and features qualitative, proprietary, independently-gathered survey data from consumers, providers and payers nationwide.

Download the full report, free of charge, at: www.instamed.com/trends.