this The CDC estimates that 50% of written prescriptions are never filled in or taken incorrectly. We have long focused on coverage and price as the primary avenue of affordability. But even good coverage and fair prices are not enough if the bill appears before salary. Paid time is missing and should be the standard of care designed by the health plan.
The link to the cost and compliance costs of critical drugs has been well proven. A 2017 study of delayed or unfilled oral anti-cancer prescriptions showed an unsettling trend: While a total of 18% of prescriptions were abandoned, the tax rate for patients facing out-of-pocket expenses between $501 and $2,000 increased to 41%, while patients with a cost of more than $2,000 were nearly half the cost.
The ability to pay prices can affect patient decision-making and has clinical (and financial) implications for employers and health plans.
This is why the results of Pennsylvania medical research are so important. In 2023, patients with Medicare Part D coverage paid $110-20,000 to $20,000 for oral anti-cancer drugs. By 2025, their costs have been capped at $2,000. However, if patients choose to participate in the Medicare Prescription Payment Plan (M3P), they can manage $2,000 of $167 in a 12-month payment. With the average Social Security check of $1,999, M3P makes these previously inaccessible drugs more affordable.
The concept of “paid” is not limited to Medicare. It gained traction in business health plans, providing similar relief to millions of dollars.
- Alternative health plan: Some innovative programs aim to pay health care providers in full and then charge patients for out-of-pocket liability for installments.
- Health Payment Account (HPA): These accounts are often offered through partners and are becoming increasingly popular in employer-sponsored and personal market programs in many states. HPA cardholders can pay for medical expenses and convert them into an interest-free repayment program, usually managed through salary deductions or direct bank payments.
These models benefit everyone: patients can get the care they need without slashing upfront costs and providers pay in a timely and in full, which can reduce administrative burdens and potentially lead to payers negotiating more favorable rates. Paying is more than just a financial fix; it is one of the clearest ways to sustain medium- and long-term cost of healthcare in the United States.
Yes, efforts should be made to lower the overall drug prices. At the same time, paid options need to be integrated into health benefits design. This is a practical, reliable way to extend access, increase affordability and promote better outcomes.
To make health care more affordable in the short and long term, paid time must be an important part of every health plan and assume any out-of-pocket responsibility.
Payers should integrate it into the 2026 program design and actively encourage admission. Providers should use it to help patients begin (and continue) basic therapies.
Photo: Sorbetto, Getty Images
Brian Whorley, a former hospital executive, saw patients leave care-not because of lack of coverage, but because they don’t work. In 2018, he founded Paytient to address the cash flow crisis in healthcare. Today, payers and employers, payers and federal government partners provide flexible payment methods to over 25 million Americans, including Medicare Part D beneficiaries.
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