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Patient Financial Engagement 2023
A High-Performing Market, though No One-Size-Fits-All Option
Author
Gordon Bishop
Author
Alex McIntosh
Author
Tyler Sycamore
Patient financial engagement solutions help healthcare organizations deliver a more consumer-oriented experience and support patients’ financial needs. Patients are more likely to have a satisfactory healthcare experience when they have a strong understanding of their cost of care. This report examines customer satisfaction with patient financial engagement solutions—including functionality, integration, and the overall impact on patients.
Note: This report reflects customer feedback gathered between January 2022 and January 2023. Ongoing research on these solutions can be found on the KLAS website.
Patient Financial Engagement Vendors High Performing Overall, with Unique Strengths & Challenges
Across vendors, most customers are highly satisfied—the average overall score is 90.3 (out of 100.0) and only 3.3 points separate the highest- and lowest-scoring vendors. While client satisfaction is similarly strong, each vendor has some unique benefits and challenges.
Customers quick to cite patient satisfaction as a key benefit. Payment portal is easy for patients and providers to use. Technology works well. Some decline in support since Waystar purchased Patientco, linked to high turnover and lack of responsiveness. Midsize to larger organizations are much more satisfied (by 10+ points) than small inpatient hospitals (<200 beds).
Viewed by customers as the most robust platform available. Support and proactivity have improved in the last year. Respondents like that they can search historical zero-balance data. Biggest opportunity for improvement is the patient portal; some confusion for patients when balances are incorrect or the system takes a while to update after payment.
Largest overall improvement in the last year, especially for service and support. Often seen as a partner and has worked to develop strong client relationships. Integration with third-party systems (especially EMRs) still lagging. Some respondents experience bugs, which they attribute to system customization.
Receives high marks for patient ease of use and accessibility. Development process is reportedly collaborative, though slower than customers want. Some frustration with delays from HealthPay24’s third-party statement vendor. Respondents more likely than other customer bases to mention cost concerns.
*Limited data
[C] Component
Only available to existing Epic customers. Excels in integration (a common weak spot for best-of-breed vendors) with other Epic solutions; patient financial engagement offering is part of Epic’s integrated platform. Clients feel Epic has a well-defined development strategy and road map. Customers feel development delivery has been slower than they want and often misses on specialty-specific needs; upgrades increasingly buggy.
Viewed by clients as an innovative company embracing technology and proactively working to meet future needs. Receives strong marks for ease of use. Clients feel planned development (e.g., previsit functionality) is headed in the right direction. Speed of development slower than customers want, and communication from Cedar on this front needs improvement.
Note: Insufficient data to share R1 Entri Pay performance in this report.
Vendors Delivering on Patient Satisfaction; Simplicity of Experience for Patients and Staff a High Priority
Across vendors, almost all interviewed organizations say their patient financial engagement software positively impacts the patient experience (which ties into both revenue and patient loyalty), and nearly three-quarters indicate a high positive impact. Ease of use is one crucial factor in a smooth, easy-to-navigate patient experience. While solutions across the market are strong, organizations feel their vendors can make technology easier to use—including around sign-up, login, billing, payments, online portal navigation, and easy-to-read statements. Waystar leads in ease of use, receiving praise on both the patient and staff sides. Customers describe the product as straightforward and say it is simple for patients to set up alerts, create payment plans, and view and pay balances. Provider users find it easy to search for accounts and help patients. Flywire customers are also highly satisfied and mention how patients praise the portal for its omnichannel payment capabilities. RevSpring customers say patients find it easy to set up payment plans, though there can be some difficulty navigating the process of actually making payments. Approximately one-quarter of Epic respondents feel training has not kept pace with the frequency of upgrades.
With No Comprehensive Solution, Organizations Want More Functionality and Integration
A major industry-wide challenge is the lack of a single vendor who can manage the full scope of patient financial engagement (not to mention patient engagement generally). Some organizations use multiple vendors for different functionality, and two-thirds of responding organizations feel their vendor is missing some important functionality. Chatbot technology is most often missing, and organizations see it as an integral part of the ongoing shift to a more digital patient engagement experience. Text-to-pay technology is another common gap, along with statement functionality—which can either be insufficient or need improvement in terms of aesthetic/delivery method (e.g., eStatements). Across vendors, respondents want greater ability to use propensity-to-pay and other data modeling for more targeted outreach to increase collections. RevSpring customers are the most likely to mention their vendor having a robust product that meets all their current needs.
Integration is another key area often mentioned as a pain point. Flywire is most likely to have customer respondents mention integration issues; these organizations point to their own possible overcustomization of the product, resulting in unforeseen issues with integration. Provider organizations using Cedar rate the solution lower for integration, and they often cite that the solution is less mature and that certain aspects of the solution are still being built out and are not yet available. HealthPay24 customers describe how well their system interfaces with their EMR, and Waystar rates high on integration in general, with integrated payments and EMR integration being two important factors. Epic customers often talk about how well the patient financial engagement tool integrates with their other Epic systems; many are hoping to see Epic develop the software more quickly to eliminate their need for third-party bolt-ons.
Price Transparency and Previsit Technology at the Heart of Forward-Looking Development
Healthcare organizations’ top two priorities for future development are price transparency (driven by increased pressure from the US government’s 2022 No Surprises Act) and previsit patient engagement. Accurate up-front estimates are also important for quickly collecting payments, early patient consideration of long-term payment plans, streamlined patient communication around debt collection, and early outreach to patients that qualify for financial assistance, such as Medicaid. Overall, customers want a broader end-to-end service for both pre- and post-visit activities. Many organizations are also focused on the growing digitization of healthcare, including patient financial engagement. Customers want to continue shifting away from paper statements and phone payments towards broader payment offerings, including Apple Pay, Google Pay, and text-to-pay technology. AI, especially around chatbots, will also be important to facilitate less patient interaction with call centers and customer support.
Interviewed customers view the RevSpring and Waystar products as more mature and, as a result, are more likely to consider them because of functionality that supports customer success. HealthPay24’s solution is viewed by some customers as slim and easy to use, but many respondents feel it doesn’t provide all the functionality bells and whistles of some other solutions. Customers say Cedar and Epic offer less-mature solutions, citing the systems’ relative newness, but respondents are excited for both products’ future direction based on development road maps.
Vendor Perspectives on the Future of Patient Financial Engagement
What does patient financial engagement look like in the long term?
The following responses were shared directly by each of the vendors and do not reflect KLAS’ opinion.
Cedar: The financial burden on patients today is higher than ever. For a single hospital encounter, consumers might have to navigate multiple, siloed interactions beyond the payer and provider. Cedar believes the only way to rebuild trust with healthcare consumers is to provide a simple financial experience they can rely on. We believe in a connected model for financial health, where providers, payers, and other stakeholders work together to put consumers at the center of the financial experience. It is time for a new approach to financial engagement that applies a consumer lens oriented around resolving a bill rather than simply collecting a receivable.
Epic: Patients value a personalized financial experience with up-front, transparent information about their healthcare costs and convenient self-service options to manage their balances. These options need to be integrated into the patient’s overall healthcare experience. Organizations using Epic have a platform that tailors financial interactions to each patient in an intelligent and nimble way. We plan to give patients the ability to set up payment plans prior to service so they have the peace of mind in knowing financial arrangements are already in place. Patients will also have a unified financial experience, even if they receive care from multiple independent organizations.
Flywire: Patient financial engagement will likely involve increased transparency, digital tools, flexible payment plans, preventive care, and patient education. By actively involving patients in their healthcare financial decisions and responsibilities, healthcare providers can improve patient satisfaction, reduce financial stress, and help to make healthcare more affordable and accessible for all.
HealthPay24: Focusing on patient financial engagement will be an important part of the patient healing process and the future of payments. We know that patients are looking for affordability options and ease of use from their device of choice. HealthPay24 leverages our 25 years of experience working with providers and patients to develop a consistent and flexible approach to payments that increases revenue for the provider while improving patient satisfaction. It is time to move what the patient needs to the center of true patient financial engagement, providing both the patient and provider with peace of mind and understanding.
RevSpring: The market needs more self-service and modern digital options and experiences that match the patient’s experience as a consumer in other industries. These include helping patients understand the cost of their care prior to service, making it easy for them to compare prices and customize prepayment options to their financial ability and needs. Also needed are improved mobile experiences that make it easy and efficient for patients to complete payment action on their own device. Every touchpoint—including print, digital, in person, on the phone, or online—contributes to the patient’s experience.
Waystar: Patient payments are just one aspect of a full suite of solutions that can empower provider teams to collect fuller reimbursement while enabling a better patient experience. By augmenting payment capabilities with complementary solutions—such as price transparency, advanced propensity-to-pay analysis, patient estimation, agency management, and charity screening—vendors can deliver more value for providers and a better experience for patients.
R1 Entri Pay (not rated in this report): As labor shortages and bad debt continue to rise, a single partner that can manage the entire patient obligation pool is needed now more than ever. Health systems can offer a holistic approach to patient financial engagement by combining easy-to-use technology with compassionate, comprehensive human services. In doing so, they will save costs, simplify and align their vendor landscape, and increase revenue. Through a digital-first approach, health systems can backstop patient self-servicing with expert agent assistance for more complex situations, while getting leading technology in the hands of more patients more quickly than before.
About This Report
Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 12 months using KLAS’ standard quantitative evaluation for healthcare software, which is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.
To supplement the customer satisfaction data gathered with the standard evaluation, KLAS also created a supplemental evaluation, which asked customers to share what functionality (if any) was missing from their patient financial engagement solution.
This report reflects customer feedback gathered between January 2022 and January 2023. Ongoing research on these solutions can be found on the KLAS website.
Sample Sizes
Unless otherwise noted, sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique customer organizations interviewed for a given vendor or solution. However, it should be noted that to allow for the representation of differing perspectives within any one customer organization, samples may include surveys from different individuals at the same organization. The following table shows the total number of unique organizations interviewed for each vendor or solution as well as the total number of individual respondents.
Some respondents choose not to answer particular questions, meaning the sample size for any given vendor or solution can change from question to question. When the number of unique organization responses for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.
Product Designations Used in This Report
- Component [C]: Product that typically includes most but not all components that comprise a complete system or that serves only a subset of the market. Epic is marked as component because their patient financial engagement solution is only available to existing Epic customers.
Writer
Amanda Wind
Designer
Jessica Bonnett
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2025 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.