Nicole Rogas is the President of RevSpring.
getty
Imagine a patient with a nagging shoulder injury. She thinks she’ll need to see a specialist and wants to find a provider who can give her high-value care at an affordable cost.
Her search starts with pricing it out. She might check her insurer’s cost estimator, run a search through her plan’s portal or even ask an AI assistant what to expect in her area. Before she commits to booking a visit, she wants to have a number in mind.
This scenario is increasingly common across healthcare today. For most patients, their first interaction with the healthcare system (for non-emergency care) isn’t a call to schedule an appointment or even to sit in the waiting room; it’s searching for the cost of the likely treatment, determining coverage and weighing affordability before they commit to seeking routine or specialist care at all.
This behavior represents a shift in how people make healthcare decisions, and I believe it exposes a blind spot most healthcare systems aren’t set up to manage.
The Importance Of Financial Clarity
For health systems, financial engagement begins around the appointment, often providing estimates during intake, payment at check-in or invoicing after. It completely excludes the pre-care search, where patients make their decisions, yet that part of the journey is what many health systems can’t see or influence.
When patients are unsure about cost, they may turn to another provider or skip care altogether if they feel the cost is out of reach. When that happens, there’s a higher likelihood of delayed diagnosis and more emergency room visits, which, over time, cost patients, payers and providers much more.
Financial clarity is critical. In response, providers can move personalized cost information much further upstream. But that doesn’t mean just adding a price estimate tool to a website; it means that providers orchestrate intelligent engagement across the full patient journey.
Affordability As A Growing Patient Concern
Between inflation and rising out-of-pocket expenses, patients have started making healthcare decisions like other major retail purchases, such as buying a flight or a car.
While the first reason patients are doing the math earlier concerns affordability, secondly, is that patients have access to more tools to help them search.
Price transparency rules have led to the rise in cost estimators, and AI-assisted search is something that most consumers are comfortable using. In fact, a 2026 survey from TD found that more than 78% of Americans report using AI-powered tools in their daily lives, with 67% reporting that their proficiency has increased in the past year.
Patients can easily find cost information to help them estimate the bill on their own before they speak to anyone in a doctor’s office. A provider who assumes that search doesn’t happen, or that it doesn’t shape the outcome, is planning around a version of the patient journey that no longer exists.
To Seek Care Or Not To Seek Care, That Is The Question
When patients must first determine if the cost of care is feasible with a clear, credible answer, the consequences reach far beyond a patient’s frustration or a provider’s billing and engagement systems. In fact, patients often delay, avoid or abandon care, even when managing a chronic condition.
This is a gap that most providers can’t see forming. It won’t show up as a collections problem because a patient who never books an appointment never becomes a receivable. However, when a patient books an appointment but doesn’t show up, that can be costly, too. In fact, research shows that missed medical appointments cost the U.S. healthcare system $150 billion annually.
The scale of this situation is clear. A recent Gallup survey found that fewer than half of Americans can regularly afford healthcare. When the cost estimate isn’t available or if the information available doesn’t feel credible, the answer to seek care can quickly become “no.”
Patients often don’t have the information they need to confidently choose and book care. Providers have improved the financial journey during and after the visit with better estimates at check-in and more personalized, flexible billing. But the decision that comes first, whether to book an appointment at all, still happens largely outside of their view.
Creating Financial Trust Before Clinical Trust
This is why I believe that health systems need to treat financial clarity as essential as clinical clarity. That means building cost and coverage information optimized for the patient’s search, not just for those who are booking appointments and coming into the office.
Affordability options, such as payment plans and financial assistance, should be visible before scheduling happens and not something that a patient sees for the first time on a bill months later. And the same plain-language and low-friction standards providers already apply to clinical information need to be applied to financial information, too. A cost estimate that requires a phone call, holding in a queue and a callback isn’t clarity, no matter how accurate the estimate turns out to be.
First Steps To A More Transparent Journey
I recommend that health systems form a cross-functional senior team to map the journey from first search to final payment in order to own it together. But that team needs more than marketing and revenue cycle at the table.
While marketing shapes how patients find you, patient access is often the first to discuss financial obligation with the patient through estimates and copay collection. In a recent customer conversation I had, marketing and revenue cycle each believed they were responsible for the patient experience and had never spoken to each other. This led to patient access sitting between them with no clear ownership.
The team should publish price transparency information and estimate options for the likely service, listing the payment plans and financial assistance available for it. Patients and AI assistants both search for this information, so the team should supply verified provider and cost data wherever they look.
Estimates get stronger as they are compared to the final bill, and patients are more empowered when they understand their financial obligations earlier.
A Call For Providers
As AI-assisted search and price transparency tools keep improving, a patient’s pre-care research promises to become more visible and more impactful. Providers who wait for that shift to fully arrive before adjusting will be reacting to their patients’ decisions based on another provider’s or payer’s data.
This is a call for providers to give patients accurate information early enough that affordability, not guesswork, drives the decision to seek care. Patients’ lives depend on it, and so does your bottom line.
Forbes Business Council is the foremost growth and networking organization for business owners and leaders. Do I qualify?
