Community hospital leaders spend a lot of energy keeping patients local: recruiting specialists, adding service lines, marketing to the community. The bill rarely makes that list. It should.
Your patients already have options, and they use them
In a study of 3.1 million rural residents’ hospital stays across 16 states, 50.7% happened at a hospital other than the patient’s closest one (Sheps Center, UNC, 2020; 2014–2016 data).
The hospitals patients bypassed most were small. 89% of high-bypass hospitals were Critical Access Hospitals, averaging 25 beds. Much of that is about services: patients who bypassed were twice as likely to have a major surgical procedure (38.8% vs. 19.1%). But it means patients in your community are used to choosing where they go.
A hard bill keeps patients away
In KFF’s national survey, adults with health care debt were more than twice as likely as those without it to say someone in their household had put off needed care because of cost in the past year (64% vs. 28%). And 15% of adults with health care debt said a provider had denied them care because of what they owed (KFF Health Care Debt Survey, 2022).
For a community hospital, that’s care that may happen later, somewhere else, or not at all. The bill is the last interaction a patient has with you after they go home, and it shapes whether they feel they can come back.
Younger families carry the most debt
The same survey found health care debt peaks among adults ages 30 to 49, with 52% currently owing money for medical or dental bills. Parents carry it far more often than other adults: 58% of parents have health care debt, compared with 35% of non-parents.
Those are the parents bringing in children and, increasingly, the adult children managing a parent’s bills. Losing them costs you the next generation of your community, not just one visit.
A better bill doesn’t have to be a big project
“Going digital” can sound like a big project: a new portal, a patient app, a long IT timeline. For a community hospital with a lean team, that’s enough to keep it on the someday list.
It doesn’t have to be that big. It starts with one change: send the bill by text first, and make it easy to pay from that message. A bill that keeps patients:
- Arrives by text the day it’s ready, not after a print-and-mail cycle
- Opens with no login, using information the payer already has
- Offers choices: pay in full, a plan, financing, or what they can today
84% of bills paid through PayGround are paid digitally.
Digital-first isn’t digital-only
The most common concern we hear is about patients who aren’t comfortable with technology. That’s fair, and it’s why digital-first keeps paper in the mix. A paper statement still goes out when the patient asks for it, when there’s no mobile number or email on file, or when a text goes unopened for a set number of days.
Everyone still gets a bill. Most get it faster.
Where to start
If you’re planning the move, here’s a practical order:
- Check your contact data. How many patients, or the people who pay their bills, have a mobile number or email on file? That’s your starting digital audience.
- Set your paper rules. If there’s no mobile number or email on file, send a paper statement right away so no one waits for a bill. Then decide when paper should follow for people who don’t respond to a text or email.
- Make paying simple. No login, no account number to look up, no app to download.
- Connect it to your EHR. Payments should post back automatically, so staff aren’t keying them in. PayGround integrates with many revenue cycle systems through HL7, FHIR and flat-file connections.
- Tell your staff what changes. Expect fewer mailed checks and fewer “how do I pay?” calls, and plan for what your team will do with that time.
See what your patients would see
Visit our patient experience page and pay a sample bill on your phone. Then ask: is this better than what our patients get today? If so, book time with us.