In an era where digital convenience defines end-user expectations, healthcare remains one of the few industries still operating with a payment system that can feel pre-internet.
In many industries, friction is seen as a necessary evil. In healthcare, it has been normalized for decades. From opaque billing processes and surprise medical charges to antiquated invoicing and fragmented insurance approvals, patients often experience more financial confusion than clinical care.
After all, modern healthcare payment flows are notoriously fractured. Payers, providers, clearinghouses, third-party administrators and banks each operate on legacy systems built for different eras. Claims may take weeks to process. Denials are frequent. And the administrative overhead to manage it all. estimated at hundreds of billions annually in the U.S. alone, is enormous.
But a burgeoning revolution is underway that promises to make the payment part of healthcare a little easier for patients, and providers. And it’s not being led by hospitals or insurers alone, but by FinTech disruptors and artificial intelligence (AI)-native platforms reimagining how money moves through the healthcare system.
Read more: Healthcare Delivery Models Have Changed, Why Haven’t Payment Processes?
From Paper Bills to Embedded Platforms
Embedded finance refers to the integration of financial services such as payments, lending, insurance and investment directly into non-financial platforms. In consumer contexts, it’s already ubiquitous. Think of “buy now, pay later” (BNPL) at online checkouts or rideshare apps offering instant driver payouts.
In healthcare, the same logic is being applied to patient payments, insurance adjudication and provider reimbursements, seamlessly within care delivery platforms. The idea is simple: meet the patient where they are, e.g. during intake, during telehealth, at point-of-service; and reduce complexity at every financial touchpoint. But beneath the simplicity lies a complex stack of infrastructure modernization.
As generational changes ripple through the marketplace, these solutions are becoming fundamental to meeting younger patients. Findings in the June 2025 PYMNTS Intelligence “Generational Pulse” reporthighlights that the healthcare industry’s technological shift to digital health services has a festering sore spot: Payment friction, particularly for Gen Z and millennials. While these consumers are more likely to use remote healthcare and digital monitoring through apps, they also report greater problems when navigating the complexity of healthcare payments. Per the report, 70% of Gen Z consumers find paying for healthcare to be a headache.
Separate PYMNTS Intelligence in the report “How Modernizing Payments Is Revitalizing Healthcare” found that 67% of executives and decision-makers in healthcare payer organizations state their manual payment platforms reduce efficiency. Still, more than 4 in 10 small healthcare practices sent paper checks in 2024.
Against this backdrop, embedded finance in healthcare is not about bolting on a payments button but about creating invisible infrastructure that makes financial processes feel native to care delivery.
Automated billing, real-time adjudication, and digital pre-pay tools can help reduce the need for large back-office billing teams. Embedded finance platforms can also reduce claim errors and speed up remittances, leading to healthier revenue cycles. In a sector where margins are razor thin, these gains can ultimately be meaningful.
The marketplace is already responding. CVS Health reportedly plans to invest $20 billion over the next 10 years to build a “tech-enabled consumer health experience” that will encompass the company, its vertically integrated businesses, and other companies, including competitors, who want to join. Elsewhere, at the start of June, Paytient secured $40 million from Trinity Capital to expand its employer- or health plan-embedded cost-smoothing solutions to new markets.
Read more: 90% of Healthcare Execs Already See Positive ROI From GenAI Investments
How Payments Can Help Create a New Healthcare Loyalty Loop
When patients understand their financial responsibility upfront, and have tools to manage it, they are more likely to engage proactively with their care than without the information. Embedded finance helps encourage what behavioral economists call “cost salience” — awareness of cost at the moment of decision-making — which can reduce overutilization and increase adherence to care pathways.
Healthcare providers that offer effective and user-friendly payment plans for out-of-pocket expenses not only improve the patient experience but also strengthen their customer base, according to the PYMNTS Intelligence report “Managing Healthcare Costs: How Patients Use Payment Plans.”
Looking ahead, the next frontier is not just payments — it’s platforms. Embedded finance, when fully realized, will allow health organizations to act more like consumer platforms — offering patients bundled services, personalized pricing, loyalty incentives and seamless digital interactions. It will also enable new business models, from subscription-based primary care to embedded insurance within employer wellness platforms.
发表回复