Patient Relationship Revenue Exposure Calculator
Poor billing practices do not have to make a large number of patients leave to create meaningful revenue risk.
Executives don't have the time to sit down and do the math on how much revenue is lost when a patient leaves their system. Taken individually, these numbers can seem insignificant, but at scale, attrition due to poor patient experience becomes a very real driver of revenue loss.
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.
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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