How Do Health Care Leaders See The Future Of Payments?

by ACI Worldwide

March 31, 2017

75 percent of payers are responding to member and business demand by adding new billing and payment options.[i] As they make transformational changes payers will focus on centralizing and simplifying.

The remaining quarter of payers will sacrifice enrollment and retention by following RadioShack’s example of not changing as fast as the market.

To help you create a more engaging and efficient future we conducted in-depth surveys of members and payers. They shared their plans for the most important moment in the relationship – billing and payment. Paying signals the moment of truth when members and businesses officially begin or renew their relationship with you.

Members and businesses need an all-encompassing revolution to billing and payment experiences. Let’s explore how payers will meet this demand!

Payers will centralize billing and payment

Payers will replace separate bill presentment and payment experiences with a single platform. This one platform will give members management of their full financial liability and replace the middlemen that slow down payments today.

electronic bill presentment and payment for health insurance platform

Unify bill presentment and payment platforms

President and CEO of Cambia Health Solutions, Mark Ganz says “The healthcare industry is undergoing a tectonic shift, not because of the Affordable Care Act, but because consumers are demanding the straightforward, transparent retail experience they enjoy in other aspects of their lives. To meet their expectations, we have a historic opportunity to create seamless, end-to-end healthcare experiences.”[ii]

To create seamless experiences payers will launch one platform to power all

  • Payer to provider payment and remittance advice
  • Premium billing and payment
  • Member liability payments sent to providers

This will not only deliver higher member engagement and loyalty but significant cost savings.

Furthering the need to consolidate, members say one of the top things they want is an easy to read bill.[iii] Payers are listening and will respond with consolidated billing.



Empower members to see and pay full financial liability

Payers will go beyond centralizing their back office systems and give members a unified way to manage all of their health care expenses. Going beyond, payers will allow members to pay providers from the payer website.

United Healthcare and Aetna pioneered giving members the option to pay providers from their website.[iv] This approach boosts loyalty from members as well as providers which are grateful for ways to improve their revenue cycle.

Single platform for receiving premium and making provider payments

Payers will also simplify how they pay providers by increasing their usage of electronic payments and electronic remittance advice. Today payers turn to different systems to receive payment, pay providers and to allow their members to pay providers. But going forward payers will use a single platform to satisfy member and business demand for effortless experiences.

Replace middlemen used to send payments today

Seventy-two percent of payers are evaluating removing the toll-booths along the roads that payments run on today.[v] They are looking to connect directly to banks. Fortunately 90 percent of banks want to work with payers to help payers reduce their cost of payments.[vi]

Removing the middlemen will bring

  1. Lower cost card payments by reducing the number of parties charging fees
  2. Stronger security by cutting down transmission of sensitive payment information
  3. Higher revenue when engaging members with real-time money movement and cross-sell offers

Payers will create simpler billing and payment experiences

Centralizing will bring simplicity, but members, businesses and CFOs require more simplicity to meet their needs. Payers will respond with higher levels of automation, moving to the cloud and offering any time anywhere access that grows their business while lowering costs.

Automating billing and payment

Increasing online billing and payment promises both satisfaction and savings. But most payers aren’t getting both. Sixty-four percent of payers plan to increase investment in payments in the next 18 to 24 months, up from 49 percent last year.[vii]

It’s great to see payers prioritizing members and businesses by investing in better payment experiences. It’s also troubling that payers aren’t approaching upgrades in ways that will save them more money through automation and consolidation.

Listening to members is the only way to achieve savings and satisfaction. Eighty percent of members who make call center and walk-in payments will switch to lower cost digital payments if the online payment service offered[viii]:


Meeting these needs will create $100 million in annual savings for payers.


Payers can enjoy an additional $140 million in annual savings by migrating paper bills to eBilling.[ix]

eBilling for health insurance bills is popular across generations. While Millennials are more likely to view your bill electronically, they’re not more likely to stop receiving the paper bill.[x] To achieve the potential savings payers will make their eBilling experience much better than the paper bills. Payers will add video, audio and personalized messages into their most frequent member interaction – the eBill.

eBilling cost savings opportunity in health insurance

Raise convenience with any time anywhere health care management

Payers are competing with one another to make it easier for members and businesses to view and pay bills. 76 percent of payers say competitive pressure is driving their increase investment in payments.[xi] To keep up with the competition, payers will raise convenience throughout the member and business lifecycle from initial enrollment through to retention.


With companies like Amazon and Apple setting the bar for convenience, members will expect greater ease of managing their health insurance and hospital bills. Members now expect to be met on the devices from which they live their lives. Payers are listening, and the majority are currently embedding billing and payment capabilities in new devices (see chart below).


As Internet access grows from watches to cars and beyond, complication could easily occur for payers providing billing and payment access to new devices. Instead, payers will use a single payment platform with robust APIs to connect to new devices.

Cloud investment will grow by 42 percent

It’s becoming harder than ever for payers to keep up with fast changing member and business demand. To get new convenient features to market faster, payers are turning to the cloud. In fact they will increase spending by 42 percent from 2016 to 2021.[xii]

Conclusion: central + simple billing and payment = a bright future for health care

Members and businesses raising their expectations at an exponential pace. Payers are responding central and simple experiences that grow enrollment, raise retention and shrink costs. These rewards will come as payers overhaul their entire billing and payment operation with an emphasis on:

  1. Giving members a consolidated view and management of their full financial liability
  2. Replacing the middlemen used to send payments today
  3. Any time anywhere access powered by the cloud

As we build a brighter future we’re fortunate to have examples to follow. See how Horizon Healthcare Services grew enrollment 400 percent with a new insurance payment system.

[i] Ovum and ACI Worldwide, Global Payments Insights survey, 2017,

[ii] Modern Healthcare, Three leaders on the future of healthcare payment, July 2016,

[iii] Aite Group and ACI Worldwide, How Americans Pay Bills survey, January 2017,

[iv] United Healthcare and Aetna,,

[v] Ovum and ACI Worldwide, Global Payments Insights survey, 2015-2017,

[vi] Ibid

[vii] Ibid

[viii] Aite Group and ACI Worldwide, How Americans Pay Bills survey, January 2017,

[ix] Ibid

[x] Ibid

[xi] Ovum and ACI Worldwide, Global Payments Insights survey, 2017,

[xii] Ovum, Market Sizing, 2016