Patients are expecting more flexible payment options, both in terms of how and when they pay their balances. Yet hospitals—and to a slightly lesser extent group practices—don’t appear to be providing all the tools patients have requested, according to a survey released by the Medical Group Management Association (MGMA) and Navicure.

Roughly one in four (26 percent) of hospitals responding to the survey said patients may be taking more than six months to pay their balances in full—above the 13 percent of group practices reporting the same issue, likely because of the higher cost of care at hospitals. One way to alleviate this issue would be asking a patient to keep a credit card on file for balances under $200, which providers acknowledged would reduce bad debt and the cost of collections. An earlier patient survey from Navicure found 77 percent of patients would provide that information, but despite patient demands and the perceived benefits, only 28 percent of providers are offering the option. Only 9 percent said they preferred patients to pay via a credit card on file.

Instead, providers have favored more traditional payment options. The majority of respondents (77 percent) still send paper bills to patients, even though 52 percent prefer electronic billing.

“A comparison of our recent studies indicates a strong need for digital payment options to improve patient collections processes and increase patient satisfaction,” Phil Dolan, chief marketing officer of Navicure, said in a press release. “The organizations that can fully embrace digital payment options, such as credit card on file, automated payment plans and patient cost estimation, stand to benefit the most as healthcare consumerism continues to impact the industry.”

Different payment options are being offered, but the survey didn’t identify a consistent method being utilized by most providers. Some 35 percent reported allowing patients to make partial payments when requested, 27 percent offered online bill payment and 11 percent offered a healthcare credit line through a third party.

Providers did report a greater recognition of the need to be upfront about costs. Some 79 percent of ambulatory organizations said they can provide cost estimates upon request, above the 69 percent of hospitals which said the same. Among organizations that can’t provide estimates, 36 percent said they plan to begin doing so in the next year.

“Our analysis finds group practices are more advanced than hospitals in offering advanced electronic payment solutions that patients want to use,” Mariann Lowery, qualitative analyst at MGMA, said in a statement. “However, provider organizations in general still track far behind patient preferences. Patients are used to allowing other service providers to use their email address and credit card number to receive and pay their bills. Just look at the explosion of e-commerce. Healthcare organizations of any size have the opportunity to be just as safe and convenient, and provide a better patient experience.”