Milwaukee, United States, April 14th, 2026, NewsDirect
Longitudinal Analysis Finds Medical Trend Significantly Below National Benchmarks, with Care Shifting to Lower-cost Settings and Utilization Consistent Across Credit Profiles
HPS/PayMedix today released new longitudinal data showing that employers with self-funded health plans that use its medical payments and interest-free financing platform are outpacing national benchmarks on several important measures. The independently validated analysis compares HPS/PayMedix employer groups to the 2025 Milliman Medical Index and demonstrates materially lower medical trend, greater use of lower-cost professional settings, and similar care utilization patterns across all household credit score levels.
“In an environment where many employers are seeing medical trend around 9 percent, the fact that our clients are coming in at 4.5 percent is a meaningful and growing advantage,” said Tom Policelli, CEO of HPS/PayMedix. “The data continues to align with our thesis that encouraging early and consistent care by removing financial barriers leads to healthier, more engaged consumers and lower costs for employers.”
Data from the analysis highlights significant advantages to employers, providers, and employees that leverage the PayMedix platform across four key measures:
- Medical trend far below national benchmark — The analysis compared annualized medical trend for PayMedix employer groups to the 2025 Milliman Medical Index (excluding pharmacy) and found that one-year annualized medical trend is one-half lower (49%) than the national benchmark on a relative basis (4.5% vs. 8.8%). It proves that PayMedix employers can contain healthcare costs for their organizations while maintaining quality and improving access for their employees.
- Members receive more care in lower-cost settings — The study also found that PayMedix members are more likely to access care in professional and non-hospital settings compared to Milliman’s benchmark (48% vs. 35%) and are less likely to require inpatient (14% vs 22%) or outpatient hospital care (33% vs 41%) than national averages. These data suggest that members are getting preventive and routine services earlier and avoiding some higher-cost hospital stays, which helps drive better outcomes at a lower total cost.
- Care utilization remains consistent across credit scores — PayMedix also examined 2025 utilization patterns by household credit score for members who were active for a full year and had at least one claim. The analysis showed similar levels of healthcare use regardless of credit worthiness. Nearly 25% of PayMedix members would not qualify for traditional/commercial credit. By removing upfront cost barriers to care, consolidating the patient responsibility and information, and providing guaranteed interest-free payment plans, PayMedix reduces traditional inequities in access to care. With PayMedix, all employees can utilize their health benefits similarly regardless their credit score or financial situation.
- Fewer members delaying care until year-end — The analysis shows a clear shift in member behavior over time. As members adapt to the PayMedix model, they become less likely to delay care until year-end (a common pattern when individuals wait to meet deductibles before seeking non-urgent treatment). In the first year with PayMedix, a larger share of healthcare spending occurs later in the year. By year five, however, spending is more evenly distributed, with approximately 24–26 percent of annual allowed spend occurring in each quarter. This shift suggests that members are accessing care when they need it. As a result, they benefit from earlier diagnoses, better adherence to treatment, and more predictable costs for employers.
“Across all of these measures, the pattern is consistent: lower trend for employers, better access and fewer financial barriers for employees, and guaranteed, complete payments for providers,” said Brian Marsella, president of PayMedix. “That alignment is why we’re seeing strong satisfaction and retention across our member, employer, and provider base.”
About PayMedix
PayMedix is transforming how people access, use, and pay for healthcare by simplifying and consolidating healthcare information and payments for consumers and providers. Through guaranteed payments to providers, the SuperEOB, and complete interest-free financing for consumers, PayMedix is the only platform that unifies all stakeholders through a single system. PayMedix has processed over $7 billion in medical payments for hospital systems and physician practices, and has achieved 100% provider retention, 95% employer retention and more than 90% consumer satisfaction. The acquisition of TempoPay in 2024 expanded the company’s interest-free financing platform to include pharmacy, dental, and vision expenses. For more information, visit www.paymedix.com.
Contact
Senior Director of Marketing
Hattie Ninteau
PayMedix
[email protected]