Healthcare Digital Payments Surge but Revenue Cycle Performance Lags, Elavon Study Reveals

A new survey from Elavon reveals a significant gap between patient-facing payment modernization and back-office efficiency in healthcare. While 68% of organizations offer diverse digital payment options, only 15% report excellent revenue cycle performance. For fintech providers, this highlights a massive opportunity to solve fragmented workflows and manual reconciliation issues through integrated processing.

What was announced

Elavon, a subsidiary of U.S. Bank, has released findings from a survey of 150 senior-level healthcare professionals and decision-makers across finance, operations, and payments. The data, collected in March and April 2026, highlights a disconnect between the front-end patient experience and back-end financial performance. While 68% of enterprise healthcare leaders believe they provide the payment options patients desire, a mere 15% rate their end-to-end revenue cycle performance as excellent.

The research identifies fragmented workflows and manual intervention as the primary obstacles to efficiency. Specifically, 76% of respondents reported that their staff spends between 5% and 20% of their time managing exceptions or correcting errors. These operational frictions have significant consequences for financial reporting, with 83% of leaders stating that payment errors or reconciliation delays impact their monthly close processes at least 25% of the time.

To address these administrative burdens and delayed collections, nearly all surveyed professionals indicated plans to explore generative or agentic AI within their patient payment operations. Furthermore, 56% of respondents identified scalability as a critical factor when selecting strategic partners to manage increasing complexity as their organizations grow.

"Despite healthcare providers investing in more ways for patients to pay, our survey reveals that integration gaps and fragmented workflows still exist, delaying patient collections and putting pressure on healthcare revenue cycle operations."

Wally Mlynarski, CEO of Elavon

The companies involved

Elavon is a major global payments provider and a wholly owned subsidiary of U.S. Bank. The company serves as a critical component of U.S. Bank’s broader strategy to modernize financial operations for healthcare organizations, focusing on connecting payment acceptance with receivables and reporting. As a subsidiary of one of the largest banking institutions in the United States, Elavon leverages significant scale to provide end-to-end processing and servicing.

U.S. Bank itself has been actively expanding its business banking footprint, recently targeting growth in regions such as Florida, Georgia, Texas, and Arizona. The relationship between the bank and its payment subsidiary allows for a unified approach to treasury management and merchant services, particularly in highly regulated and complex sectors like healthcare. Elavon’s market position is defined by its ability to integrate global payment capabilities into enterprise-level software to streamline operations for large-scale organizations.

What FF News has reported before

FF News has previously covered Elavon’s efforts to embed financial services into enterprise workflows, including a report on how Elavon Embeds Global Payment Capabilities into SAP Applications to Streamline Enterprise Operations. The company has also been active in the UK market, as seen in the announcement that Metro Bank and Elavon Partner to Streamline Business Payments and Cashflow. Additionally, its parent company’s regional growth was highlighted when U.S. Bank Expands Business Banking Footprint Across Florida, Georgia, Texas, and Arizona. These stories reflect a consistent focus on reducing manual friction and improving cash flow through integrated technology.

What this means

This survey confirms that the "last mile" of healthcare payments remains broken. While the industry has successfully modernized the patient-facing interface, the back-office infrastructure is struggling under the weight of legacy fragmentation. This creates a significant opening for fintech firms that can offer deep integration rather than just another payment gateway. The high percentage of staff time lost to manual errors suggests that healthcare providers are reaching a breaking point where traditional staffing cannot solve reconciliation issues. The shift toward agentic AI indicates that the sector is looking for autonomous solutions to handle exceptions, putting pressure on legacy payment processors to evolve or risk being replaced by more intelligent, automated platforms.