Sep 1, 2022 | Blogs

New Generational Research Reveals how to Improve the Patient Financial Experience

Research conducted in 2021 found that half of all Americans have medical debt and 46% have medical debt in collections.[1] It’s not hard to understand why so many carry medical debt considering 40% of American surveyed said they wouldn’t be able to cover a $400 emergency expense with cash, savings, or credit.[2]

When patients have a hard time covering their medical costs, providers have a hard time collecting. The best way to overcome this hurdle is by making it easier for patients to pay. But to do that, providers must understand each patient’s unique financial situation, payment preferences, and what they consider a “patient-friendly” billing experience.

iVitaFi set out to discover these nuances to help providers understand how to better serve their patients and improve patient collections. What we uncovered was eye-opening, especially when it comes to the differences between age groups.


In collaboration with Eliciting Insights, we surveyed 435 consumers who had received care at a hospital in the previous 24 months, either from an urgent event or a service already scheduled. Of those surveyed, 18% were Gen Z (born 1996 – 2000), 33% were Millennials (born 1977 – 1995), 23% were Gen X (born 1965 – 1976), and 26% were Baby Boomers (1946 – 1964). Half the respondents had a commercial health plan, 43% had a government-provided health plan, and 7% were solely self-pay.

Financial concerns

When asked if they were worried about how they were going to pay for their recent hospital service, Baby Boomers were more than twice as concerned as were Gen Y and three times more concerned than Gen Z.

When it came to how likely they were to cancel or skip a service due to concerns about paying, the tables were turned. Gen Y was more than twice as likely to put off or skip care than Baby Boomers at 39% and 17% respectively, likely due to an increase in chronic conditions for older individuals.

Payment preferences

The research found a good deal of disparity between the age groups in terms of when a patient prefers to pay. Gen Z was three times more likely than Baby Boomers and nearly two times more likely than Gen X to prefer paying before leaving the hospital.

When it comes to how survey participants actually paid, the majority did pay prior to leaving the hospital, although Baby Boomers were more likely to wait to pay until they received their first statement. As Baby Boomers have Medicare, they may be conditioned to waiting to see what Medicare takes care of before paying their bill.

What patients actually paid

We asked participants if they had a responsibility and, if so, what portion they paid. Overall, only 20% paid their bill in full prior to leaving the hospital while 33% paid more than half or all. Sixty-seven percent paid less than half or none. Baby Boomers where the most likely (87%) to pay less than half or none.

Implications for providers

When we think of patient satisfaction, we typically think about the clinical experience. However, research shows that the patient financial experience weighs heavily on overall patient satisfaction. In fact, 63% of patients say they would switch providers to receive a better patient financial experience.[3]

A great way to ensure a positive patient financial experience is to make it easier for patients to pay. Doing so can improve patient loyalty, brand reputation, and collections.

As part of our survey, we asked patients how satisfied they were with their recent hospital payment experience. Overall, less than 50% said the hospital’s billing practices were “very patient friendly.” Gen Z had the worse experience and Baby Boomers the best, although none of the age groups’ experiences were outstanding.

One thing that stood out as an opportunity for providers to improve the patient financial experience was offering more payment options. The majority indicated they would have appreciated having additional payment options offered to them, especially extended payment options. In reality, 41% had to use options outside of those offered by the hospital to pay their bill, which included borrowing money and using credit cards with high interest rates.

When asked if having extended payment options would cause survey participants to return to the same hospital for future healthcare needs, 70% said yes.

A simple solution: Improving the payment experience

Just 11.8% of patient accounts are ever completely resolved.[4] Whether accounts go to collections or they’re written off, the implications are significant for the bottom lines of both patients and providers. Offering patients extended payment options can help providers increase collection rates as much as 70% to 90%, while improving patient satisfaction at the same time.

There has never been a more important time to prioritize improving your patients’ financial experience. As patients take on a larger portion of their healthcare costs, they become more involved in both the delivery of their care and how they pay for it.

The bottom line

Patient satisfaction ratings dropped drastically during the COVID-19 pandemic.[5] And with ongoing staffing shortages, they’ve been slow to recover. This only adds to the challenges providers face on the long road to post-pandemic recovery. The research by iVitaFi indicates that providers can significantly improve collections and patient satisfaction simply by offering an improved patient financial experience, easier ways to make payments, and options such as self-enrollment and digital communication.

Contact iVitaFi today to discuss ways your organization can improve patient payments. We look forward to helping you improve cash collections and the patient financial experience.

(888) 504-8482

[1] “Many Americans Still Can’t Pay Off Less than $5,000 in Medical Debt,” (

[2] “40% of Americans don’t have $400 in the bank for emergency expenses: Federal Reserve,” May 24, 2019, ABC News, (

[3] “63% of Patients Will Switch Healthcare Providers if Their Payment Experience Doesn’t Cut It,” October 20, 2021, (

[4] iVitaFi Data Study Findings

[5] “COVID-19 influenced decrease in patients’ likelihood to recommend services, survey finds,” November 8, 2021, Becker’s Hospital Review (