PayZen Report: Costs Drive More Than 2 in 5 Patients Toward AI Instead of a Doctor

PayZen’s State of Healthcare Affordability: The Patient Perspective 2026 focuses on addressing unaffordability, payment options and AI-powered financial guidance

SAN FRANCISCO, Oct. 06, 2026 (GLOBE NEWSWIRE) -- Today, PayZen, the leading AI-driven patient affordability platform, released its third annual State of Healthcare Affordability: The Patient Perspective 2026. Based on a nationwide survey of 1,000 adults, the report reveals how unaffordable health care costs are fueling anxiety for patients seeking and paying for care.

Report findings uncover how the financial experience is increasingly shaping the overall patient experience, at some times overshadowing the clinical one. One in four patients cite cost as their greatest concern before care, above treatment effectiveness, pain, medical risk or logistics. As patients seek greater clarity around the cost of care, 60% say they would be likely to use a hospital-provided AI tool to understand a bill, explore payment options or determine their eligibility for financial assistance. These findings point to an emerging role for AI helping health systems provide trusted financial guidance throughout the patient journey.

“Health systems have an opportunity to prevent cost of care from becoming a barrier to receiving care by giving patients clearer financial guidance and connecting them with affordable ways to pay,” said Itzik Cohen, CEO of PayZen. “Our data shows that AI can play an important role in creating that experience. But when concerns about cost are driving patients to turn to chatbots instead of their doctors, that should be a wake-up call.”

Key findings include:

Cost concerns are driving patients toward AI.

• 42.5% of patients have used an AI chatbot instead of seeing a doctor because of cost concerns.
• More patients said they had done so repeatedly (22.1%) than had done so only once (20.4%).

Affordability challenges extend into the middle class.

• Households with income between $75K and $90K reported the highest rate of cost-driven care avoidance, with 38.3% skipping or postponing medical care due to cost.
  • They were also the most likely income group to cite cost as their biggest concern before care, at 35.7%.
• For patients earning under $30K, groceries and rent are the biggest concerns, but when household income exceeds $30K, out-of-pocket medical expenses become a consistent top concern.
  
  

Healthcare insurance coverage does not guarantee affordability or a stress-free experience.

• 57% of Marketplace patients reported that their premiums increased in 2026. 1 in 4 said the increase was significant enough to make premiums difficult to afford, while 40% skipped or postponed care because of cost.
• 47% of Medicare patients and 51% of Medicaid patients described their most recent hospital bill as stressful or unresolved, rising to 69% among patients with employer-sponsored coverage and 74% among Marketplace and individual plan holders.

Payment plan communication remains reactive, not proactive.

• Nearly half of patients (47%) either learned about a payment plan only after the bill was sent or had to ask for it themselves.
• Among patients who were offered a payment plan, only 20.7% heard about it before care, while 32.5% learned about it after the bill was sent and 15.2% had to ask for the payment plan themselves.
• Nearly 60% of patients describe paying their most recent hospital bill as stressful or unresolved.
  
  

Early affordability and flexibility conversations could give hospitals a competitive edge.

• Two-thirds of patients (63%) say flexible payment options would make them more likely to choose a hospital for future care.
• 9 in 10 patients lose trust in a provider that does not proactively communicate about payment plans or financial assistance.

“The opportunity for health systems to build a more connected affordability strategy starts well before the bill arrives, with upfront cost clarity, transparent communication and easier access to financial support,” said Tobias Mezger, co-founder and CRO of PayZen. “AI can help bring those pieces together by giving patients a simpler way to understand what they owe, navigate payment options and find the assistance available to them across the care journey.”

To download the complete report and learn more about how PayZen is making affordability part of a better patient experience, please visit: payzen.com/patient-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