Even with insurance, out-of-pocket spending, appetite for digital solutions on the rise

The increasing cost of healthcare, along with insurance coverage constraints, may be causing many Americans to delay or entirely put off receiving the healthcare they need, according to a new survey from Madaket Health, a leader in provider-payer collaboration and data exchange. The study of 1,000 Americans 25 and older examined barriers to health coverage, navigating in-network care providers, and consumers’ willingness to try digital care models, even when already paying for health insurance.

Nearly half (47%) of Americans admit to putting off health care services due to cost barriers. Millennials (78%) are most likely to do so compared to 56% of Generation X and 30% of Baby Boomers. The majority (74%) are also likely to delay care if their provider is out-of-network. Nearly a quarter (24%) of respondents say they delayed routine specialty care, such as a dermatologist or eye doctor, due to cost, suggesting preventative medical care and screenings may not be occurring as recommended.

When it comes to selecting a health insurance plan, cost (68%) and access to in-network providers (59%) were cited as the most important factors.

“Our survey revealed some difficult truths about our fractured healthcare system. The fact that so many people are delaying care if their preferred provider is out-of-network highlights the importance of data accuracy,” said Madaket Health CEO Eric Demers. “When provider information is outdated or incorrect, patients can’t reliably identify affordable, in-network options, leading to unnecessary delays and higher costs.”

DIY approach to healthcare

Not only are Americans willing to delay care if their provider is out-of-network, but some are also going out of their way to pay for it themselves. More than one-third (38%) of respondents have sought out and opted to pay out of pocket for a service that was either out-of-network or not covered by insurance. Nearly seven out of 10 Millennials (68%) will take this approach compared to 44% of Gen X and only 21% of Boomers.

Even though Millennials are more likely to put off care due to cost barriers and lack of in-network providers, they are also not shying away from taking a more do-it-yourself (DIY) approach when it comes to healthcare.

For example, 43% of Millennials have accessed services like concierge medicine, where patients pay an annual or monthly fee for primary care or other services, compared to just 20% of Gen X and just 8% of Boomers.

From virtual visits to apps: openness to digital care

While Millennials may be more open than older generations to new ways of accessing healthcare, certain digital services are catching up, as 60% of total respondents admit to using online or app-based healthcare services. Of these services, online prescriptions (28%) and virtual primary care (24%) are the most popular across generations. 65% of Gen X and just under half (49%) of Baby Boomers have accessed these digital services, hinting at a greater openness to consume healthcare in new ways as they age.

Americans are not keen on all their services going the virtual route, as nearly half (47%) say they are not open to digital testing. However, over one-third said they would be open to receiving both their primary care virtually (35%) and their mental health services (33%) digitally.

About the study

The research was conducted by Censuswide, surveying a sample of 1,000 U.S. adults (age 25+) who have health insurance. The data was collected in May 2025. Censuswide abides by and employs members of the Market Research Society and follows the MRS code of conduct and ESOMAR principles.

About Madaket Health

Madaket Health targets billions of dollars in healthcare administrative waste by simplifying provider data management, revenue cycle, and exchange processes. Eighty percent of provider groups have exchanged data through the company’s platform, which validates, automates, and synchronizes provider data between payers and healthcare organizations to improve patient and member experience, enhance revenue, and ensure regulatory compliance. Learn how Madaket Health mitigates claims processing delays and stems lost revenue by addressing data problems at the source with a fully connected provider data analytics and insights platform at madakethealth.com.

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