Patient Cost Estimates in 2026: Only 45% Get One

Only 45% of patients received an estimate of the cost of care in 2026, up from 41% in 2025, according to Experian Health's 2026 State of Patient Access survey. In the same survey, 73% of providers said patients at least occasionally delay or forfeit care when they cannot get an estimate.

Experian Health published the results on March 24, 2026. It surveyed more than 1,000 patients and 200 healthcare decision-makers in early 2026.

How many patients get an estimate, and how accurate it is

The share of patients who received an estimate rose 4 points, from 41% in 2025 to 45% in 2026. Estimates also got easier to read. Experian found that 71% of patients said their estimate was easy to understand, up from 60% in 2025.

Accuracy improved sharply. Last year, 44% of patients said their final bill was "much more expensive" than their estimate. This year, 26% said so, an 18-point drop. Experian also reported an 18-point increase in the number of people who receive estimates sent directly to their mobile devices.

Measure	2025	2026	Change
Patients who received a cost estimate	41%	45%	+4 points
Patients who said the estimate was easy to understand	60%	71%	+11 points
Patients who said the final bill was "much more expensive" than the estimate	44%	26%	-18 points
Providers who rate their insurance verification as effective	54%	74%	+20 points
Providers who say staffing shortages reduce patient access	57%	64%	+7 points
Providers who say patient access improved	36%	46%	+10 points

Source: Experian Health, 2026 State of Patient Access survey (more than 1,000 patients and 200 healthcare decision-makers, early 2026), published March 24, 2026. Percentages are shares of surveyed patients or surveyed providers, as Experian reports them.

What a missing estimate costs patients and practices

Patients say paying for care is getting harder. In the Experian survey, 32% of patients said paying for care got worse since last year, and 14% said it got better. Among patients who reported a worse payment experience, 55% cited affordability. Fewer than two in five patients feel confident in their ability to pay.

Cost information helps. 40% of patients said that knowing the cost of care in advance makes paying easier. Around three in ten said that not understanding costs or coverage before treatment made their experience worse. Among patients who reported improvements, 49% said the reason was that they understand what their insurance covers. Payment plans matter too: 63% of patients said they would feel more confident if a provider offered tailored payment plans.

Cost also shows up in appointment no-shows. An Aug. 11, 2026 MGMA Stat poll of medical groups (190 applicable responses) found that 32% of groups reported higher patient no-show rates year to date than in 2025. Another 58% reported about the same rate, and 10% reported a lower rate. MGMA titled its write-up "About 1 in 3 medical groups see higher no-shows in 2026 as patients face higher costs."

Estimates start with insurance verification

A front desk cannot quote a patient's share without coverage data. On that front, providers report progress: 74% now rate their insurance verification as effective, up from 54% last year, a 20-point rise.

Providers also see gaps. 86% said delivering a faster review of coverage is urgent, and 84% said automating authorizations is urgent. Improving the speed, accuracy and completeness of patient insurance searches was the top challenge, chosen by 39% of providers.

Patients report problems on their side. 28% of patients experienced care delays due to insurance verification issues, and 36% had difficulty with authorizations for a procedure.

Staffing limits what the front desk can do

64% of providers said staffing shortages reduce patient access, up from 57% in 2025. Mindy Fortson, Chief Client Officer at Experian Health, said in the release: "Technology is helping close operational gaps in patient access, but the industry still must address financial and staffing pressures."

Providers and patients rate access differently. 46% of providers said access improved, up from 36% in 2025. 18% of patients said the same, a 28-point gap. Another 64% of patients said their access experience was about the same as last year, and 18% said it got worse.

On tools, 35% of providers called automation non-negotiable, and 28% said the same of AI.

What CMS and MGMA data add

CMS sets a rule for good faith estimates. Its "Medical bill rights" page says: "Usually, providers must give you a good faith estimate of how much your health care will cost if you request one or schedule services at least 3 business days in advance." The same page says a patient can sometimes dispute a bill that is at least $400 more than the estimate.

MGMA polled medical group leaders on Oct. 21, 2025 (247 applicable responses) about patient balance collections. Of the leaders, 66% reported collections about the same (40%) or better (26%) than a year earlier, and 29% said worse. MGMA's article on the poll also reports that time-of-service collection of copays fell from about 90% in 2019 to 56% in 2022.

A practice can track four measures against these figures:

The share of scheduled visits that get an estimate before the visit. In Experian's survey, 45% of patients received one.
The gap between final bills and estimates. In the same survey, 26% of patients said the bill was much more expensive than the estimate.
How often verification finds a coverage problem before the visit, since 28% of patients reported care delays from verification issues.
Time-of-service collection of patient-due balances, which MGMA's article puts at about 15% in 2019 and 39% in 2022.

Sources

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