The future of healthcare transparency: Addressing patient frustrations and the need for digital solutions

Today’s patients continue to face challenges that not only affect their health but also their financial well-being. New data¹ collected from 2,500 patients across the U.S., focusing on price transparency and prior authorization process evolution, reveals growing frustrations surrounding the lack of accurate cost estimates, unexpected medical bills, and delays due to prior authorizations (PA).

These frustrations highlight a systemic issue in healthcare that requires more attention as costs shift to patients through high-deductible health plans and rising out-of-pocket expenses. Healthcare transparency is needed, but the system also requires a digital overhaul to manage the entire process more efficiently.

The growing burden on patients

The findings highlight a deeper dissatisfaction with the current state of healthcare pricing transparency. Nearly half of respondents (45%) reported difficulty obtaining accurate cost estimates before receiving care, while 63% were ultimately billed more than they were initially quoted.¹ This discrepancy is not just an inconvenience to patients, but a barrier to receiving timely and informed healthcare decisions. With unpredictable costs, patients struggle to make financially responsible choices, leading to unnecessary delays in seeking treatment.

Many patients are also calling for digital tools that provide real-time healthcare cost estimates, enabling them to plan and make decisions with greater certainty. A substantial 73% expressed interest in solutions that offer more accurate pricing upfront and help avoid surprise bills, which continue to be a significant pain point in healthcare.¹

Additionally prior authorizations (PA) remain a significant challenge for patients, further complicating their ability to access care in a timely manner. A notable 81% of respondents reported that PA requirements negatively impacted their ability to receive timely care.¹ This further illustrates the burdens patients face when navigating the administrative hurdles of the U.S. healthcare system.

The push for price transparency

The Trump administration's push for healthcare price transparency is a step in the right direction, however the data suggests that the problem is far from solved. A significant 64% of patients indicated¹ that price transparency is “very important” when selecting a healthcare provider, which aligns with the broader goal of lowering costs and improving pricing clarity. Despite these efforts, the reality is far from ideal.

A staggering 97.5% of those who received a cost estimate prior to care were still hit with unexpected medical costs, indicating that estimates often fail to reflect the true costs of care. Furthermore, 75% of respondents found that their actual bill was higher than what they were initially quoted, further amplifying the frustration and financial strain patients face.¹

Despite these ongoing challenges, 25% of patients reported improved satisfaction with healthcare price transparency and prior authorization processes compared to late 2024, indicating that, while the issues are not fully resolved, there has been some progress in the right direction.¹ The overwhelming majority of patients still face significant discrepancies between what they are quoted and what they are ultimately billed, highlighting the continued need for more robust solutions in price transparency.

A comprehensive digital approach

Addressing the issue of healthcare transparency is only one part of the issue. As healthcare continues to change, a digital approach to cost management is needed, including not only price transparency but also a comprehensive solution for managing the entire process, from estimates to payment plans, insurance negotiations, and post-care billing.

Digital platforms that integrate both cost estimation and prior authorization (PA) processing could transform the entire patient experience. By offering a unified solution that streamlines cost transparency and PA management, these tools can minimize delays, reduce the administrative burden, and eliminate much of the frustration patients face. Patients will benefit from a seamless, integrated experience that provides clear, real-time pricing information and ensures that prior authorization processes are efficiently handled before treatment.

This modernized approach would enable patients to better plan for their care, ensuring that they are well-informed and prepared financially. It would also help to reduce the common errors and miscommunications that currently plague the healthcare system—issues that lead to billing discrepancies, unexpected costs, and unnecessary delays in receiving care. By digitizing these complex processes, healthcare providers can improve operational efficiency, reduce overhead, and ensure that patients receive timely and accurate information about their care.

Bridging the gap with digital tools

A more efficient and patient-centric approach is essential as healthcare costs continue to climb. To bridge the gap between patients, providers, and insurers, digital solutions must be integrated into the healthcare system. By utilizing digital tools, patients can access real-time cost estimates and have prior authorization (PA) processed more swiftly, enabling them to make well-informed decisions before even stepping into a doctor’s office.

Ultimately, the introduction of digital solutions into healthcare pricing and prior authorization systems can lead to a more transparent, predictable, and patient-centered experience, aligning healthcare delivery with the needs and expectations of modern patients. By focusing on simplicity, efficiency, and clarity, these tools have the potential to transform how patients interact with the healthcare system, ensuring that financial concerns no longer overshadow the pursuit of necessary care.