HME COLUMN

Modernizing Patient Payments

Practical strategies for better financial outcomes

By Jennifer Leon

After nearly 20 years working alongside home medical equipment (HME) providers, I've watched the patient payment conversation change dramatically. What was once a relatively small part of the revenue cycle has become one of the biggest operational and financial challenges providers face today.

Patients are responsible for a growing share of the cost of care. Higher deductibles, coinsurance and the continued growth of Medicare Advantage have fundamentally changed how providers get paid. The average single-coverage deductible reached $1,886 in 2025, up 17% over the past five years, and approximately 41% of adults in the United States carry some form of medical or dental debt. As the financial responsibility of patients has grown, patient payments have evolved from a back-office billing function into an important driver of cash flow and financial performance.

Those trends are changing more than the economics of HME; they're changing how providers think about patient payments. For years, the conversation centered on collections. Today, the bigger opportunity is creating experiences that make it easier for patients to understand what they owe, choose how they want to pay and stay engaged throughout every step of the payment journey.

That perspective became even more personal when I experienced our healthcare system from the patient side. Navigating billing and payments made me notice every point where the financial experience became harder than it needed to be. Behind every balance is a patient trying to understand what they owe, when it’s due and how to pay. Every confusing bill, delayed payment or missed communication creates more work for staff and more frustration for patients.

One of the biggest shifts I've seen is recognizing that payment isn't the end of the patient journey—it's part of the patient experience. When organizations make paying simple, transparent and convenient, they strengthen both the patient experience and their financial performance.

Modernizing patient payments doesn't require a complete overhaul. In my experience, small workflow changes often produce the biggest results. Here are some suggestions.

1. Make it easy to do business with you.

One thing I've learned is that one of the biggest barriers to timely payment is that paying is often not easy.

If a patient must search for a paper statement, wait on hold or remember to mail a check, you've already created friction. Every extra step increases the likelihood that payment will be delayed.

Patients already manage most of their financial lives digitally and healthcare should be no different. Giving patients the flexibility to receive bills electronically, pay online and access self-service tools lets them pay in the way that's most convenient.

Electronic delivery is one of the simplest changes providers can make. Replacing paper statements can save up to $0.50 per invoice, improve payment rates by up to 15% and help payments arrive three to five days faster than traditional mail. It's a straightforward way to reduce friction while lowering costs and improving cash flow.

2. Start the conversation before payment becomes a problem.

Too often, the first meaningful financial conversation happens after a statement is mailed or a payment is overdue.

The most successful providers I've worked with start those conversations much earlier. During intake or onboarding, explain how billing works, set expectations and introduce convenient payment options, including electronic billing and securely storing a payment card on file for future balances.

For example, consider moving digital billing and card-on-file enrollment to the beginning of the patient relationship instead of waiting for the first invoice. That relatively small workflow change can reduce follow-up calls and make payment feel like a natural part of the care experience rather than a separate administrative task.

For patients receiving recurring rentals or ongoing supplies, securely storing a payment method removes another barrier to timely payment. By the time the first statement arrives, patients already know what to expect and, when appropriate, have enrolled in convenient payment options. Making payment easy from the beginning creates a better experience for both patients and provider staff.

3. Use automation to give your staff time back.

When I talk with providers, they're rarely looking to automate for automation's sake. They're looking for ways to give their teams time back so they can spend more time helping patients.

Administrative staff are managing more work than ever while reimbursement pressures continue to mount. Workforce shortages are making it even harder to scale manual processes as patient volumes grow.

One metric I always encourage providers to watch is cost to collect. Beyond labor, manual payment processes create hidden costs through printing, postage, repeated outreach and payment posting. Every manual step takes time away from helping patients.

Automation isn't about replacing people. It's about giving them more time to focus on patients instead of paperwork. Routine payment tasks can happen automatically so staff can spend more time answering questions and supporting patients.

4. Let payment insights guide your decisions.

Most organizations have access to payment data but often aren't using it to improve performance. Looking at how patients prefer to pay, which communication channels yield the best response and where payment delays occur can reveal opportunities to improve.

Sometimes the most valuable insights are simple. Patients may respond more quickly to text notifications than mailed statements, while those who enroll in digital billing early often require fewer follow-up touches.

By using these insights to improve efficiency, you create a better financial experience for patients.

5. Remember that every payment interaction shapes the patient experience.

Patients don't separate their financial experience from the care experience. To them, it's all part of one relationship.

A confusing bill, limited payment options or difficulty getting answers can leave a lasting impression, even when the clinical care itself has been exceptional. Clear communication, convenient payment options and a transparent billing process build trust while making it easier for patients to meet their financial responsibilities.

Patient experience and financial performance go hand in hand. When patients understand what they owe, receive communications through the channels they prefer and have an easy way to pay, better financial outcomes follow.

Modernizing Patient Payments Starts With Small Steps

Patient financial responsibility isn't going away. Give providers an opportunity to rethink payment as part of the overall patient experience, not simply the final step in the revenue cycle.

The organizations making the greatest progress aren't making sweeping changes. They're simplifying the payment experience, reducing unnecessary work for staff and removing barriers that make it harder for patients to pay. Those improvements add up over time.

After two decades in this industry, that's where I believe the future of patient payments is headed. Success isn't about working harder to collect balances. It's about making it easier for patients to pay, giving staff more time to focus on care and building a stronger financial foundation for the future.

Jennifer Leon has led Brightree’s patient collections division for 20 years, helping healthcare providers improve revenue recovery and patient financial engagement. A recognized post-acute care leader, she frequently speaks at national conferences on operational efficiency, digital transformation, and patient payment strategies. Visit brightree.com.