With healthcare accounting for one-fifth of the U.S. economy and patient out-of-pocket costs climbing steadily, the payments infrastructure supporting this sector is evolving fast. Here are seven trends shaping healthcare payments in 2026.

1. AI-Powered Revenue Cycle Now Table Stakes

AI is no longer a futuristic concept in healthcare billing – it’s rapidly becoming the operational backbone. Healthcare organizations are deploying AI across the entire revenue cycle, from automated coding and claims scrubbing to predictive denial management and payer-specific rule enforcement. The shift in 2026 is toward "agentic AI" – systems that don't just flag issues but autonomously handle tasks like prior auth, eligibility verification, benefits checks, and patient inquiries.

2. Shrinking of Digital Payment Gap

There's a stark mismatch that's forcing change: 70% of consumers still receive medical bills via traditional mail, yet only 9% want to pay by paper check. Meanwhile, 37% want to pay online and 32% via mobile app. The generational divide is a major catalyst - PYMNTS found that 68% of Gen Z patients encountered at least one payment barrier during their last healthcare transaction, compared to just 18% of boomers. Contactless payments now account for nearly 60% of point-of-service healthcare transactions, and card-on-file convenience is becoming standard practice for medical offices in 2026. Providers who don't modernize risk losing younger patients entirely.

3. Acceleration of Surcharging

A few years ago, passing credit card fees to patients was nearly unthinkable. Today, 45% of independent medical and dental practices in the 2026 ProviderPay survey we recently fielded with Adyen say they add credit card surcharges. Veterinary clinics are even higher at 55%. Factor in office managers who say they may surcharge in the future, and we could see 85–90% of independent providers passing along credit card fees.

4. Adoption of Embedded Payments

Healthcare software platforms – EHRs, practice management systems, and even veterinary systems – are increasingly building payment processing directly into their software. In this embedded model, onboarding, processing, and fund flows live natively inside the software. According to our 2026 ProviderPay research, 32% of the 199 practices surveyed already use some form of embedded payments. The payoff: practices spend less time on payment-related admin, and platforms earn a greater share of revenue from processing. ModMed Pay (Adyen), Planet DDS Pay (Stripe), Curve Pay (Stripe), and Instinct Pay (Adyen) are great examples.

5. Introduction of Embedded Financing

Processors aren't stopping at payment transactions. Companies with embedded payments inside practice management software are layering on lending – especially working capital lines and patient financing. Affirm's partnership with RepeatMD to offer financing within cosmetic practice management is one early example, and both Stripe and Adyen are looking seriously at embedded lending in healthcare. Processors are positioned for this because handling a practice's payments gives them visibility into its cash flow. To offer these services, they either hold a bank charter, partner with a sponsor bank, or integrate a third party's product.

6. Rise of Real-Time and Automated Payment Processing

Healthcare payments are moving toward near real-time processing, a shift that promises faster reimbursements, reduced administrative costs, and better patient transparency. The trend extends beyond patient payments to the B2B side: payer-to-provider reimbursement, automated supplier payments, and real-time revenue insights. Virtual credit cards for provider payments are giving way to ACH, as providers pushed back against interchange fees. Zelis, ECHO Health, and InstaMed (JP Morgan) are leading the shift toward enhanced ACH, which delivers remittance data, faster settlement, and payment confirmation alongside the funds.

7. Banks Doubling Down on Healthcare

A handful of large commercial banks – JP Morgan, Bank of America, PNC – have built dedicated healthcare units over the last two decades. Now, other national and larger regional banks are investing in the vertical. Our industry conversations, including at the recent Fintech Meetup conference, confirm these institutions are rethinking product scope, bundling, and go-to-market approaches to win more healthcare business. Given the sector's size and the growth of patient responsibility, healthcare has simply become too big to ignore. But they better move fast. As noted in trend #5, new entrants offering embedded lending are going to eat into their traditional healthcare SMB lending business.