Healthcare affordability in the United States continues to make headlines — and not in a good way. Even those covered by health insurance are not immune to financial strain.

Nearly 38% of insured adults under 65 express concern about paying their monthly premiums. Many with employer-sponsored or Marketplace insurance rate their coverage as "fair" or "poor" regarding both premiums and out-of-pocket costs. 

The problem is so dire that thousands of people have turned to crowdfunding to raise money from friends, family, and strangers to help pay medical expenses, according to a recent study published in Health Affairs Scholar.

While medical practices cannot solve this complex macroeconomic challenge alone, they play a significant role. Here are 8 steps practices can take to improve accessibility and make healthcare affordable for everyone.

Empowering patients with upfront pricing helps them make informed financial decisions and choose lower-cost options. To facilitate this, practices can post self-pay prices for common procedures and services, provide real-time cost estimates, and use patient-friendly billing statements. When it comes to combating rising healthcare costs, knowledge is power.

Well-managed patients have fewer hospitalizations and fewer ER visits, which reduce downstream high-cost care. Practices can leverage care management services (e.g., chronic care management and transitional care management) as well as remote patient monitoring and annual wellness visits. These touchpoints help keep patients on track, so they don’t need care (and incur rising healthcare costs) later on. Cost containment helps make healthcare affordable for everyone.

Administrative expenses account for approximately 15% to 25% of total national healthcare expenditures. By improving front-end processes (e.g., eligibility checks, registration, and insurance verification), reducing denials, and automating repetitive tasks when possible, practices can lower these expenses. Streamlining operations helps to mitigate the systemic burden of rising healthcare costs.

Through care coordination, reduced service duplication, and value-based payments, CINs have the potential to lower costs for patients. Physicians can ask these 5 questions to determine whether a CIN has the potential to move the needle on rising healthcare costs:

“Becoming a part of a CIN gives hospitals and practices (especially smaller ones) more bargaining power with insurance providers, while at the same time improving the cost and quality of care for patients,” Jesse P. Houghton, MD, FACG, senior medical director of gastroenterology at Southern Ohio Medical Center, says. “The decision of whether or not to join a particular CIN will take some homework and due diligence, however it is almost certainly worthwhile in the long term."

Practices can act as financial navigators by referring patients to lower-cost imaging centers or labs, maintaining a vetted list of pharmacies with the best cash prices, and formalizing financial hardship policies. 

Helpful tools to share with eligible patients include:

Unexpected bills drive patient anxiety. An in-house payment plan can divide the total cost of care into manageable patient payments over time. Similarly, leveraging a third-party finance partner can give patients flexibility while promoting smooth cash flow and reducing bad debt for your practice. 

Using evidence-based EHR tools helps avoid low-value tests and procedures that would otherwise increase the cost of care unnecessarily. 

Beyond decision support, artificial Intelligence (AI) is rapidly becoming an important part of many practices. AI has the potential to streamline decision-making, scheduling, patient interactions, and clinical documentation. While adopting AI requires due diligence, it ultimately increases efficiency and lowers overhead by freeing up your nurses and providers from mundane tasks. This efficiency will also save money.

Cost-aware prescribing means clinicians consider clinical efficacy and patient out-of-pocket cost at the moment they choose a medication. The goal is to reduce prescription abandonment, improve adherence, and lower the total cost of care.

Using real-time benefit tools in the EHR helps physicians identify cheaper — but equally effective — alternatives. Even small savings add up over time and help make healthcare affordable for everyone.

Medical practices don’t control the entire healthcare economy, but they do control the daily decisions that determine whether care is affordable for the patient in the exam room.

Practices can enhance healthcare affordability by reducing administrative inefficiencies, promoting transparency, and mitigating disease progression — all while maintaining clinical autonomy.

Ready to learn more? Book a Tebra demo today and see how AI tools can support your processes so you can make healthcare more affordable.