57% of health plan members say their experience is getting worse
NEVADA, UNITED STATES — Fifty-seven percent of health plan members reported worsening healthcare experiences over the past year — a finding that a new Healthcare IT Today roundup connects to persistent staffing shortages, fragmented access, and automation adoption that varies widely across health systems.
Staffing gaps drive patient experience decline
The figure comes from Bob Farrell, CEO at mPulse, in a Healthcare IT Today poll of health IT community leaders on patient access, communication, and continuity of care.
“As members are acting more like consumers in healthcare, they’re searching for partners in navigating their complex care journeys,” Farrell said.
Experian Health‘s 2026 State of Patient Access survey provides operational context. Access to practitioners remained the top patient challenge for the fourth consecutive year.
Sixty-four percent of providers reported a direct staffing impact on the patient experience in 2026 — up seven percentage points from the prior year.
Fewer available providers and increasingly fragmented scheduling are creating friction that technology is being asked to absorb.
Automation and AI Close access gaps
Providers are deploying digital tools across patient financial and access workflows — but adoption rates vary.
Forty-four percent of health systems are automating insurance coverage review. Forty percent are automating prior authorizations.
Providers that delivered more accurate patient cost estimates saw an 18% drop in patient dissatisfaction, according to Experian Health’s 2026 findings.
“While technology is helping close operational gaps, providers must still address staffing pressures that impact the patient experience,” said Mindy Fortson, chief client officer at Experian Health.
AI-driven outreach tools are emerging as a continuity lever — using behavioral data to anticipate patient needs, trigger follow-up care, and personalize communication across preferred channels and languages.
For payers and health plans, this means proactive engagement rather than reactive response to missed care.
The result, where fully implemented, is a more connected care journey. Where technology is absent or fragmented, members report the 57% experience: harder to reach, harder to navigate, and harder to trust.
The healthcare outsourcing sector — a multibillion-dollar industry covering prior authorization support, revenue cycle management, clinical documentation, and telehealth support — provides a structural path to scaling operational capabilities that health systems cannot build fast enough in-house.
For organizations navigating workforce and patient experience gaps simultaneously, the question is no longer which problem to prioritize. It’s which operational functions can be lifted off clinical staff quickly enough to close both gaps at once.
