The patient access blind spot, with Mindy Fortson of Experian Health

Nearly half of the health care organizations surveyed for Experian Health's 2026 State of Patient Access Survey say patient access improved over the past year. Fewer than one in five patients agree. Both groups are looking at the same system and measuring entirely different things.

Medical Economics Managing Editor Todd Shryock sat down with Mindy Fortson, chief operating officer of Experian Health, to work out where that gap comes from and what a practice can do about it.

They cover the 73% of practice-side respondents who say patients delay or forfeit care without an up-front cost estimate, how much of the prior authorization burden is fixable inside the practice rather than at the payer, and why training gaps keep surfacing in front-end registration roles. Fortson also walks through the survey's most counterintuitive result: after years of pushing patients toward portals and mobile billing, paper is coming back.

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Music Credits:

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A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 – 0:26 | Cold open. Fortson names the survey finding that unsettled her most and explains why she reads it as a public health problem rather than a billing one.

0:26 – 1:39 | Introduction. Austin Littrell introduces the episode, the guest and the perception gap at the center of the survey.

1:39 – 1:53 | Meet Mindy Fortson. Todd Shryock introduces the guest and the 2026 State of Patient Access Survey.

1:53 – 3:04 | Why practices and patients score access differently. Forty-six percent of organizations say access improved. Eighteen percent of patients agree. Fortson traces the split to two groups measuring different outcomes: staffing and digital adoption on one side, affordability and speed on the other.

3:04 – 4:07 | Prior authorization and what a practice can actually fix. Thirty-six percent of patients reported authorization difficulties. Fortson puts most of the burden on payer and policy reform, since requirements are plan specific and carry heavy clinical review.

4:07 – 5:43 | Insurance verification delays. Twenty-eight percent of patients hit one. Fortson frames these as administrative rather than clinical problems and points to front-end coverage discovery, eligibility checks and MBI lookups as the automation targets.

5:43 – 7:42 | The cost estimate problem. Seventy-three percent on the practice side say patients at least occasionally delay or forfeit care without an up-front estimate. The bright spot: surprise billing has fallen considerably where estimate tools are in place.

7:42 – 8:55 | Why training deficits keep surfacing. Thirty-nine percent cite insufficient staff training. Every payer is different and every encounter is different, which makes front-end registration a heavy manual lift.

8:55 – 9:46 | P2 Management Minute. Keith Reynolds shares practice management tips and invites listeners to submit their own workflow ideas.

9:46 – 11:28 | Where automation and AI pay off first. Fortson on the 28% AI figure, which the survey did not track a year ago, and why she expects AI to move out of pilots and into general infrastructure within one to two years.

11:28 – 12:46 | Ninety-three percent say patients struggle to pay. Fortson on Medicaid uncertainty, regulatory ambiguity and employers shifting costs onto employees.

12:46 – 14:33 | Access to practitioners, four years running. Still the top patient-reported challenge at 27%. Scheduling and portal tools help, but a meaningful share of patients either lack a smartphone or will not navigate a portal.

14:33 – 15:41 | The paper billing surprise. Snail mail metrics jumped this year against the mobile trend. Fortson points to regulatory and HIPAA notices that default to mail, plus cybercrime anxiety about entering personal information online.

15:41 – 17:17 | The metric to watch next year. Speed to access shows up as both a top frustration and a top success, depending entirely on whether the practice has adopted the tools.

17:17 – 18:35 | Closing thoughts and outro. Littrell points listeners to the survey in the show notes and wraps the episode.