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Do No Harm. The Right Role of Credit in Healthcare.

The Biden administration has warned Americans not to use high-interest medical credit cards or installment loans with confusing terms. While credit is necessary for Americans to live fuller lives, it can ensnare people in a treadmill to nowhere and rob their legacy. Paytient was founded to build a healthier financing solution for healthcare, and its Health Payment Account (HPA) was purpose-built to solve this problem.

African American girl in a purple sweater sits on a couch as she types in the numbers from her credit card onto her phone.

Far too many Americans are experiencing preventable financial harm from getting sick.

Yesterday, the Biden administration warned Americans not to use high interest medical credit cards or installment loans with confusing terms. We wholeheartedly agree with this warning and welcome the Consumer Financial Protection Bureau’s spotlight on practices of financial institutions reaping billions of dollars of interest by profiteering on the plight of patients in the very difficult moments we’ve all experienced in our lives.  

Credit is the unseen, but felt, electricity of the economy. Without credit, the engine sputters, slows, or stops. We all rely on credit, in its various forms, to live fuller lives. At best, it helps bring the American dream of higher education, home ownership, and business ownership within reach— enabling us to raise our standard of living and contribute positively to our communities. But at its worst, it ensnares us on a steeper and steeper treadmill to nowhere and robs our legacy.

I founded Paytient in 2018 to build a healthier financing solution for healthcare just like we have for housing, education, and starting a small business. My hope was that employers, providers, and payors would sponsor the cost because when out of pocket costs are fully funded and more people can more easily access care— they benefit. 

Today we’re proud to serve nearly 1,000 enterprise clients, including Fortune 500 employers, ACA insurers in seven states, and hundreds of small and medium-size businesses across the U.S. We’ve processed millions of dollars in healthcare payments since 2018, yet Paytient cardholders have paid $0 in interest. 

For many people, medical credit cards or loans are the choice of last resort, and too many avoid care altogether. Gallup reported a record 38% of Americans said they or a loved one deferred care due to cost in 2022. With inflation squeezing families' wallets and insurance cost-sharing at an all time high, too many are forced to choose between physical and financial health. Consumer frustration was apparent when Biden’s warning made the news.

Tomie's Liver on Twitter Screengrab saying "Then pay for our healthcare!! We don't have an option aaaaaaaaa @whitehouse"

Employers, providers, payors, and lawmakers have a responsibility to help change this. Americans will not be able to forego high interest financing, especially when it’s offered at the doctor’s office, unless they have lower costs or a better way to afford the cost.

Health Payment Accounts are a healthier way to finance care

Our Health Payment Account (HPA) was purpose-built to solve this problem. 

For a low fee, a sponsoring organization can set up HPA access with a small credit allowance, typically $500 to $5,000 to match the deductible. Their group is then invited to activate their card with no credit check, just a short financial wellness check that satisfies federal regulations for responsible lending. 

From there, the Paytient Visa card can be used to pay for care with any provider in approved categories like Medical, Dental, Vision, Pharmacy, Mental Health, and even Veterinary care. A cardholder can pay $100, for example, and set up a plan to repay the balance in 4 payments of $25 or 10 payments of $10 with no interest or fees. Payments are automatically deducted from future paychecks, a bank account, or an HSA.

Our members have paid for millions of dollars in care with no impact to their credit, and they’ve given us 4.8 stars on Trustpilot and an NPS of 90 because they love the experience so much. 

How is the HPA different from other financial wellness benefits? 

Here are a few of the biggest differences—

  1. HPAs are introduced in advance of care needs. Unlike financing offered in providers’ offices, the Paytient HPA is offered by an employer or insurer, typically alongside benefits like health insurance, HSAs, or FSAs. This means consumers have a payment option ready whenever a health issue pops up. They’re more likely to seek early treatment instead of putting off care until their condition is more serious.
  2. HPAs are more affordable than HSA contributions and less risky than FSAs. HSAs, while important, are only available to those enrolled in a compatible health plan, and contributing to HSAs is expensive for employers. FSAs, while available to any benefit eligible employee, are more risky because dollars are fronted by the employer. If an employee spends their FSA dollars early in the year and leaves the company, the employer has no recourse to collect.
  3. HPAs have a revolving allowance that can be used over and over again. Most HPAs have relatively low credit limits so employees don’t take on too much at once. However, when employees repay their balances, they’re able to put new charges on the card, making it a renewable resource that can be used again and again. 
  4. HPAs have no credit check and no impact to the cardholder’s credit score. There is no credit check required to activate the Paytient HPA and credit scores are never pulled or impacted. 

The Impact of HPAs

As a result of offering Paytient HPAs to their employees, employers are seeing a measurable improvement in retention rates and health equity. 

In a 2023 analysis of 68 groups with 11,000 employees, turnover rates dropped 23% for Paytient cardholders compared to those who didn’t activate the card. In today’s labor market, this can be a huge advantage for employers focused on improving employee attraction and retention.

In an analysis of card activation and utilization by geography, we found that eligible employees living in below average income zip codes were 12% more likely to activate the card and 16% more likely to be used to it to pay for care. These populations are more exposed to social determinants of health, which drive up higher rates of physical and mental health conditions. In short, HPAs are used most where there are greater healthcare and financial needs.


It’s right to warn consumers of the dangers of deferred interest medical financing offers, but people are in need of a healthier financing alternative for healthcare. 

A purpose-built product like Paytient’s HPA is less expensive and less risky for employers to sponsor, introduces valuable retention and DEI benefits, and delivers an experience members love. 

We believe the HPA can be a spark to get the engine of healthcare moving back in the right direction with more people accessing earlier care and leading healthier lives. If you’re a health benefits leader or advisor and this resonates with you, we’d love to talk. After all, as Dr. King said, “The time is always right to do what is right.”

To learn more, check out Amy’s story, listen to our podcast, or get in touch with our team.

Financial Wellness
The Business of Healthcare
Healthcare Equity
Access to Care
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