Survey finds just 18% of patients believe healthcare access has improved

Patients across the United States are skipping or postponing medical appointments because they cannot get a clear answer about what their care will cost, according to a new survey conducted by Experian Health. In fact, close to 50% of the 1,000 patients surveyed said they would not seek care if they didn’t have an understanding of what the services were going to cost them.

The survey, which also included more than 200 healthcare providers, found that 32% of patients said paying for healthcare has worsened since last year, and 73% of providers said patients at least occasionally delay or go without care if they cannot get an estimate.

“Delaying care because of not understanding what that price is is a huge concern,” Mindy Fortson, chief client officer at Experian Health, said in an interview.

But she pointed out that it's often difficult for payers to get an accurate estimate for each patient. “It’s complex. Contracts are all different based on the payers and the employer. There is insurance verification. And providers have to determine what the deductibles are. All of that plays into being able to give a more accurate estimate at the point of service,” she said.

The good news is that estimates are becoming more accurate. In 2026, there was a significant decline in final costs that were more expensive than the estimate received by the patient. Additionally, surprise bills have decreased. Both of these, Fortson said, are the result of investments in technology around price transparency efforts that are starting to scale.

The survey pointed to tailored payment plans as a meaningful differentiator in patient satisfaction. Providers who offer individualized payment arrangements — calibrated to what a patient can actually afford rather than a one-size-fits-all installment — are seeing better outcomes on both the financial and patient experience side, Fortson said.

She said Experian Health uses consumer credit data to help providers assess a patient’s capacity to pay and design an appropriate plan. Fortson advocates for providers to manage payment arrangements in-house rather than through third-party financing companies, noting that external credit products can carry high interest rates that erode patient trust. “If the payment plan is going to fail, you’ve solved nothing,” she said. "The whole idea is to have a successful payment plan so the patient feels comfortable and has their financial anxiey eased.

Disconnect between physician and patient

Another of the survey’s findings is that there is a growing disconnect between how providers evaluate their own performance and how patients experience the system, Fortson said. Providers, she explained, tend to measure success through administrative metrics — how quickly new tools are deployed and how efficiently staff are trained — while patients judge their experience by whether they can get an appointment promptly, understand their bill, and know what a service will cost before they receive it.

“Both perspectives are valid and needed,” Fortson said. “But there’s a gap in the way that providers and patients are both looking at their outcomes.” That gap, she added, appears to be widening rather than closing.

The survey found that nearly half of providers (46%) believe patient access is better than last year (up from 36% in 2025), while only 18% of patients believe it’s better (up from 16% in 2025).

“Providers are looking at and measuring how quickly they’re implementing the tools, how they’re training their staff,” Fortson said. “They're looking at different metrics from patients, who are looking at how quickly they can get into a provider and whether they understand their bill and the cost for the services.”

Additionally, the survey found that prior authorization remains a consistent obstacle for access. The administrative burden of prior authorization continues to consume significant provider resources with little sign of relief.

Because authorizations are payer-dependent, contract-dependent, and tied to clinical diagnoses and procedure codes, automating the process remains far harder than routine eligibility checks. Entire teams at health systems are dedicated to managing the back-and-forth with payers, and when authorizations are delayed or denied, patient appointments are rescheduled — compounding both access problems and billing delays.

Fortson expressed cautious optimism that AI and automation tools currently moving from pilot programs into core infrastructure may begin to ease the burden within the next few years. For now, however, prior authorization remains very labor-intensive for providers.