PayZen Report: Healthcare Financial Pressures Mount as 73% of Systems Elevate Patient Payment Balances to a Top Priority

PayZen’s State of Healthcare Affordability: The Provider Perspective 2026 report highlights rising focus on better financial experiences, limited payment flexibility, and AI acceleration

SAN FRANCISCO, May 12, 2026 (GLOBE NEWSWIRE) -- Today, PayZen, the leading AI-driven patient affordability platform, released its second annual State of Healthcare Affordability: The Provider Perspective 2026. Based on a nationwide survey of more than 200 healthcare revenue leaders, the report uncovers how health systems are navigating mounting financial pressures, changing patient expectations, and increasing operational complexity.

This year’s findings reveal a healthcare system under strain as patients increasingly become the primary payer. In response, health systems are evolving to engage patients earlier, expand flexible financing options, and leverage generative AI to scale operations. While interest in improving the patient financial experience has surged year over year, organizations continue to navigate rising patient responsibility, constrained in-house financing models, and uneven adoption of generative AI.

That pressure is particularly evident in patient collections. While patient billings now account for 12% of total net patient revenue (NPR), health systems collect just 31% of patient billings on average, underscoring the gap between what is owed and what is realized. And much of that revenue remains delayed. Nearly a quarter (23%) of patient collections are tied up in active payment plans, extending time to resolution and limiting cash flow, even as organizations work to provide greater flexibility for patients.

“The data shows that revenue leaders are no longer just focused on collections. They are being forced to rethink the entire patient financial journey,” said Itzik Cohen, CEO of PayZen. “Health systems are trying to solve for revenue stability, patient experience, and operational efficiency all at once. Those that succeed will be the ones that embrace more flexible financing models and smarter, AI-driven workflows.”

Key findings include:

AI adoption gains momentum across health systems.

• More than 1 in 3 health systems (37%) are already using generative AI within the revenue cycle, with interest nearly universal—85% of those not yet using it report being interested or very interested in adoption.
• Large health systems are leading adoption, with 48% already using the technology.
• Denials-related workflows are the clear entry point, with nearly half (45%) of health systems applying AI in this area.
• Meanwhile, adoption within larger health systems is quickly expanding beyond the back office, with organizations deploying AI across prior authorization (20%), patient access and scheduling (20%), and financial assistance and eligibility workflows (20%).

Revenue priorities are shifting toward patient experience.

• While increasing collections remains the top priority for revenue leaders (49%), interest in improving the patient financial experience has more than doubled year over year—rising from 19% in 2025 to 41% in 2026. This is nearly tied with reducing bad debt (41%) as a core strategic focus for revenue leaders.
  

A persistent financing gap is limiting performance and visibility.

• 57% of hospitals cap in-house payment plans at two years or less, not giving some patients enough time to pay off larger medical bills.
• 72% of organizations do not know their default rates for in-house payment plans, pointing to a major visibility gap.
• Adoption of third-party financing is growing, but fewer than half of health systems (44%) have implemented these solutions.
  

Pre-service payment strategies are expanding, but results show limited growth.

• More than 90% of health systems now have pre-service payment policies in place, yet the average collection rate in 2026 only modestly improved over 2025.
• Organizations that require payment at the time of estimate significantly outperform others, collecting nearly three times more upfront.

Revenue leaders want earlier Medicaid eligibility checks, but execution lags behind.

• Nearly two-thirds (61%) of revenue leaders want Medicaid eligibility checks and financial screening at scheduling, yet only 21% do it today, signaling a major operational shift ahead.
• Most organizations still screen for Medicaid eligibility later, such as at the visit itself (27%), though just 4% believe in-visit screening should remain the standard.

““Healthcare organizations are evolving quickly, but many revenue leaders still lack the resources – both people and budget – to evaluate the data and tools required to make confident decisions around AI, patient financing, and revenue cycle performance,” said Tobias Mezger, CRO of PayZen. “There’s real momentum, but there’s also fragmentation. The next phase is about driving transparency, consistency, and personalization across the patient financial experience at scale.” 

To download the full report and learn more about how PayZen is helping providers improve financial performance while supporting patients, please visit: https://payzen.com/provider-perspective-2026

About PayZen
PayZen is the AI healthcare affordability platform making care accessible for patients and sustainable for health systems. With the most comprehensive AI data platform and a patient-first mindset, PayZen delivers custom payment options tailored to the individual, helping patients afford the care they need while improving financial outcomes for providers. Recognized by KLAS Research as the top vendor in the space, PayZen is backed by leading investors and led by experienced technology leaders with a proven track record of helping millions of Americans overcome financial challenges. Learn more at payzen.com.

Media Contact
Walker Sands, on behalf of PayZen
360-535-9160
payzen@walkersands.com

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