Patient Relationship Revenue Exposure Calculator
Poor billing practices do not have to make a large number of patients leave to create meaningful revenue risk.
How this calculator works: We do not assume all patients are exposed to billing risk. We first narrow the population to patients who receive a statement or have patient responsibility. From there, national research suggests about 1 in 5 people recently received a medical bill they disagreed with or could not afford. Separately, 56% of patients say poor billing could make them likely to switch providers. Because stated intent does not fully translate into action, we apply a conservative behavioral discount and assume only 5% to 15% of stated switchers actually leave. In the base case, this puts roughly 0.45% of annual patient relationships at risk — about 4 to 5 patients per 1,000. The revenue impact is calculated using your own annual NPR per unique patient.
Not every patient receives a statement or has patient responsibility. Select a percentage that is closest to your own statement volume or self-pay-after-insurance guarantor count.
A JAMA Health Forum study found that about 1 in 5 people recently received a medical bill they disagreed with or could not afford.
A 2023 survey found that 56% of patients said they would be somewhat or very likely to switch providers because of a poor billing experience. Furthermore, according to the JP Morgan 15th Annual Trends in Healthcare Payments Report, 72% of consumers under the age of 35 have switched providers, or are willing to do so, for a better healthcare payment experience.
We should not assume everyone who says they may switch actually leaves. Academic research on the intention-behavior gap shows that stated intentions are meaningfully related to behavior, but imperfectly; Sheeran’s review reported an average intention-behavior correlation of about 0.53 across 422 studies.
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For healthcare, actual switching is likely constrained by insurance network, physician relationships, geography, access, referrals, and appointment availability. The percentages listed below are a conservative modeling range.
Patient relationships at risk
Revenue per patient
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Annual revenue exposure
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What this means: Based on your inputs and assumptions, approximately relationships may be at risk annually, representing approximately
in potential revenue exposure.
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