3 Patient Payment Trends Specialty Practices Can’t Ignore in 2026
Getting paid has never been simple in healthcare. In 2026, patients are absorbing more of the financial burden of their own care. Reimbursement models are shifting and payment workflows that proved successful five years ago are falling short in an environment where margins are thinner and patient expectations are higher.
Below are three 2026 patient payment trends that are reshaping how healthcare organizations approach collections, and what you can do about each one.
1. Surcharging Is Gaining Momentum
Surcharging is becoming a top revenue option for healthcare organizations. Credit card processing fees chip away at revenue with every transaction, and surcharging offers a way to recoup those costs by passing them to the patient. The approach is gaining traction: 25% of healthcare transactions now include a surcharge, representing a 2x year-over-year increase, and roughly 30% of healthcare executives are either using or actively exploring it.
However, the reality of surcharging is complex and the rules are complicated. While only a few states prohibit credit card surcharges outright, many impose specific restrictions, disclosure requirements or guidelines from attorney general offices.
Top-earning healthcare organizations are both considering surcharging and looking for additional opportunities to strengthen payment capture.
The time to explore the pros and cons of surchargingis now. Dive deeper into how surcharging may work for you and alternative payment strategies. For example, patient-led kiosks with tap-to-pay and card-on-file capabilities, customized pre-visit cost communication and automated point-of-service collections are all top areas to consider.
Practices using these approaches have increased collections by 154%. Before jumping on the surcharging trend, it’s worth considering whether your practice has fully optimized its existing payment capture strategies first. Here are 6 alternativesto look into.
2. Rising Patient Costs Are Threatening Revenue and Retention
When patients struggle to afford their out-of-pocket costs, they delay appointments, skip follow-up visits and avoid treatments altogether. Not only does this mean lost revenue today, but it also means declining patient loyalty over time.
The numbers reinforce what most practice leaders already feel. Patient-generated revenue now accounts for roughly 30% of total provider revenue, a figure that continues to climb year over year. The payment experience you provide now matters as much as the clinical experience.
What does a strong payment experience look like? It starts well before the patient arrives. Automated cost estimations give patients a clear picture of what they’ll owe, which helps them prepare financially and increases the likelihood they’ll pay at the time of service. Practices that have implemented a hands-off, automated estimation approach have seen meaningful lifts in self-pay collections.
At check-in, the opportunity continues. Patient-led registration tools that prompt payment privately, whether through a kiosk, mobile device, or tablet, remove the uncomfortable front-desk conversation that so often ends with a patient saying they’ll “pay later.”
Practices using patient-led kiosks are seeing a 154% increase in time-of-service collections, fueled by a 96% patient adoption rate. The takeaway: when you make it easy and private for patients to pay, they do.
One practice leader described the shift in patient behavior after implementing kiosks:
“The kiosks help patients see their financial responsibility upfront. Instead of ignoring mailed statements, they now recognize outstanding balances and make payments on the spot.“
3. Coverage Instability is Creating Preventable Bad Debt
Between ongoing Medicaid disenrollment affecting 25 million people, annual plan switches, employer coverage changes and shifting federal policy, patient insurance information goes stale quickly.
When a practice doesn’t catch those changes before an appointment, the downstream effects result in denied claims, billing stalls, write-offs and time-consuming rework for billing staff.
The practices handling this well have moved away from manual, periodic insurance checks and toward instant, automated eligibility verification that runs multiple times before every appointment. Combining this approach with a smart eligibility dashboard that flags discrepancies in advance enables staff to quickly focus their attention where it’s actually needed, rather than chasing issues after the fact.
One Director of Administrative Services at an oncology practice put it simply:
“If there’s an insurance change, we know about it and we act on it. The eligibility dashboard has been a huge relief for our billing and claims processes.”
As coverage instability grows, the practices with the strongest verification and data capture workflows will be the ones that avoid absorbing preventable bad debt and the high costs of recouping payments. Pairing eligibility verification with a comprehensive patient engagement platform ensures that insurance checks, registration accuracy, and payment collection are all working together rather than operating separately.
Stay Ahead of the Payment Curve in 2026
All three of these 2026 patient payment trends point in the same direction. The practices that treat payment strategy as a proactive, patient-led, technology-enabled priority will protect their margins and build stronger patient relationships.
Want to learn more? Download the full guide to see all 5 Trends Specialty Healthcare Leaders Can’t Ignore in 2026 and build your strategy for the year ahead.