The challenges of healthcare affordability are widespread and undeniable. According to the KFF, 4 in 10 U.S. adults carry medical debt.
When patients can’t afford their care, the impact doesn’t stop with them. It becomes a systemwide challenge—showing up as bad debt, revenue loss, and billions in uncompensated care each year. PwC reports that hospitals have absorbed more than $36 billion annually in uncompensated care over the past three years.
These financial pressures compound clinical risks. Patients who delay or forgo care often return in crisis, driving higher costs and worse outcomes. Forward-thinking health systems are responding with smarter workflows and tech-enabled financial support—closing affordability gaps before they become unpaid care.
Three Systems Leading the Way
While affordability challenges are universal, solutions are not one-size-fits-all. Three providers—Advocate Health, MetroHealth, and a large health system—have each taken unique approaches to reduce cost-related barriers, protect patients, and strengthen their bottom lines. Their shared lesson? When organizations treat affordability as a strategic priority–and invest in smart technology–both patient outcomes and financial performance improve.
1. Advocate Health: $11M Secured Through Systemwide Standardization
Advocate Health, a large system serving over five million patients, faced a challenge familiar to many: fragmented financial assistance processes that varied widely across sites. Manual workflows and staffing limitations made it difficult to deliver consistent, equitable access to care.
To address this, Advocate Health implemented a technology platform and launched a multi-site committee to standardize processes across two states. The result: greater team efficiency, empowered staff, and $11 million in patient assistance secured in two years—including $2 million during the pilot alone.
By addressing costs up front, Advocate Health not only prevented patients from delaying therapy but also strengthened its financial resilience.
2. MetroHealth: 10x More Patients Assisted, 76% Drop in Specialty Copays
MetroHealth, a Cleveland-based health system with over 300,000 patients—two-thirds of whom are uninsured or on Medicare/Medicaid—faced growing demand for financial assistance. But their specialty pharmacy team was constrained by cumbersome processes and limited bandwidth.
By leveraging an affordability platform, MetroHealth significantly scaled its support model. Staff were able to help ten times more patients in need, while the average specialty medication copay dropped by 76%, down to just $5.
With this operational lift, MetroHealth expanded access without adding staff—boosting patient adherence while avoiding financial losses tied to unpaid care.
3. Large Health System: $55M in Assistance Unlocked by Centralized MAP Team
Serving 51 hospitals in seven states, one of the largest health systems in the U.S. sought to improve access for patients facing high out-of-pocket costs. Within one of its statewide networks, a dedicated Medication Assistance Program (MAP) team, operating out of a system-run charity pharmacy, took on the challenge of identifying eligible patients and managing hundreds of enrollments and renewals.
Inefficient processes, however, limited how many patients the team could support—delaying access and increasing the likelihood of unpaid balances.
By automating program matching, enrollment, and reporting, the MAP team achieved major gains: $55 million in assistance secured, 2,234 unique patients supported, and 3,170 program enrollments completed in just one year.
With improved capacity and visibility, the system was able to protect revenue streams and reduce the burden of uncompensated care.
What These Strategies Share in Common
Each of these organizations had a unique starting point, but these elements emerged as central to their success:
✅ Proactive Patient Identification
Flagging financial risk early using data from insurance, medication type, and SDOH indicators.
✅ Workflow Integration
Embedding financial navigation into pharmacy and clinical operations for faster intervention.
✅ Process Automation
Automating program matching, eligibility checks, and re-enrollment deadlines to reduce staff burden and human error.
✅ Comprehensive Reporting
Setting clear KPIs and measuring success to demonstrate program ROI.
Why It Matters: Cost Isn’t Just a Barrier. It’s a Risk Factor.
Each unpaid bill or delayed therapy represents more than lost dollars. It’s an avoidable care gap and a patient at risk for worsening health. For health systems, the stakes are both clinical and financial: quality metrics, reimbursement, and revenue all depend on addressing affordability head-on.
Final Thought: Affordability as a Standard of Care
If your organization is treating unpaid care as inevitable, it may be time to reassess. The real cost isn’t just measured in dollars. It’s measured in outcomes, equity, and trust.
📄 To learn more, download our case study highlights
▶️ Watch MetroHealth’s 1-minute video
📞 Talk to our team about addressing cost barriers and improving your system’s financial performance.
