Staffing shortages, training gaps, and insurance verification delays are the primary issues affecting patient access, with nearly all of these problems landing on the administrator’s desk. According to the 2026 State of Patient Access Survey by Experian Health, nearly half of the health care organizations surveyed say patient access improved over the past year, but fewer than one in five patients agree.
The discrepancy suggests that both groups are looking at the same system but measuring different things. Mindy Fortson, chief operating officer of Experian Health, attributes this gap to the fact that health care organizations and patients are focusing on different outcomes.
Fortson notes that 46% of organizations say access improved, while only 18% of patients agree. She believes this split is due to the different measures used by each group, with organizations focusing on staffing and digital adoption, and patients focusing on affordability and speed.
The survey also found that 36% of patients reported difficulties with prior authorization, which Fortson believes is largely the responsibility of payer and policy reform. She notes that requirements are plan-specific and carry heavy clinical review, making it challenging for practices to fix these issues on their own.
Fortson identifies insurance verification delays as an administrative problem that can be targeted with automation. She suggests that front-end coverage discovery, eligibility checks, and MBI lookups can be automated to improve patient access.
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The survey highlights the importance of providing patients with up-front cost estimates. 73% of practice-side respondents say patients delay or forfeit care without an estimate, but the use of estimate tools has been shown to reduce surprise billing.
Fortson also discusses the issue of training deficits, which 39% of respondents cite as a major challenge. She notes that every payer is different, and every encounter is different, making front-end registration a heavy manual lift that requires significant training.
They expect AI to play a larger role in patient access in the next one to two years, moving out of pilots and into general infrastructure. Mindy Fortson also notes that 93% of respondents say patients struggle to pay, citing Medicaid uncertainty, regulatory ambiguity, and employers shifting costs onto employees.
Access to practitioners remains a top patient-reported challenge, with 27% of patients citing it as a major issue. While scheduling and portal tools can help, a significant share of patients lack a smartphone or are unwilling to use online systems for account access.
Paper billing is making a comeback, with Fortson noting that after years of pushing patients toward portals and mobile billing, paper is coming back.
