1 in 4 Americans skip care, cost crisis has become a trust crisis
OHIO, UNITED STATES — One in four Americans is skipping care because of cost. Only one in three trusts the healthcare system at all, MedCity News reports.
Speaking at the Healthcare Financial Management Association’s 2026 annual conference, industry leaders argued the affordability crisis has crossed into something more corrosive: a systemic loss of patient confidence the industry has barely begun to measure.
Affordability crisis breaks healthcare consumer trust
The numbers come from The Beryl Institute, which surveys Americans on care barriers twice yearly. The HFMA panel featured Jason Wolf, president and CEO of The Beryl Institute; Scott Hawig, CFO of BJC HealthCare; and Seema Verma of Oracle Health and Life Sciences.
“I don’t know any other industry that doesn’t at least understand how their consumers engage with them,” said Wolf.
77% of healthcare executives say the delivery model has reached an existential tipping point — and 90% say the United States healthcare system is financially unsustainable.
Hawig pointed to a failure of patient navigation as a core driver of disengagement. Health systems expanded access points without guiding patients through them. “We provided very little navigation,” he told conference attendees.
90% of executives call system unsustainable
The structural problem, according to panelists, is not primarily a technology or financing gap. It is a design problem.
“We are a sick system — we are built for when people get sick,” said Verma, former CMS administrator under the first Trump administration.
The U.S. healthcare system scores 35.9 out of 100 on Vitalic Health’s U.S. Vitals Tracker, while 84% of health systems plan to increase AI spending in the next 12 months — investing in a system that panelists say is structurally misaligned with patient needs.
Wolf’s closing concern captured the room: the industry could redesign a technically sophisticated system and still fail to make it work for patients.
The fix, panelists agreed, requires starting with the patient — how they experience cost, how they navigate care, and why they walk away.
The healthcare outsourcing sector — spanning patient access coordination, navigation support, prior authorization, and revenue cycle management — operates directly within the gap between what patients need and what health systems currently provide.
Outsourced care coordination and administrative teams reduce friction at the access points where trust is most commonly lost.
For health systems in a trust deficit, fixing the financial model is necessary. Fixing the patient experience is what rebuilds the relationship.
