REPORT: Third-party credit products and public hospitals

More than a quarter of public hospitals partner with third-party companies to offer credit cards and payment plans to patients.

Scenario: A patient can’t pay a hospital bill right away. On the hospital’s website, they find an option to enroll in a medical credit card or payment plan, which sends them to a third-party site to sign up.

How common is this at U.S. public hospitals? These taxpayer-funded institutions serve many low-income or uninsured patients. Could they be jeopardizing those patients’ financial health even as they care for them?

Consumer advocates and federal regulators have warned that high APRs and deferred interest often accompany medical credit products. Worse still, patients who qualify for financial assistance, including free care, may sign up for these products instead.

We reviewed the websites of 631 public hospitals in the U.S. and found that 163 (26%) partnered with a third-party vendor to offer a credit card or payment plan.

States where public hospitals have third-party credit partners

Key takeways

• Of 631 public hospitals, 163 (26%) offered a credit card or payment plan via a third-party vendor. 
• CareCredit, either offered directly (22 hospitals) or via MDSave (11), was the most common third-party vendor. Their credit card has interest rates as high as 32.99% APR. 
• In addition to credit cards, third-party payment plans like ClearBalance (17) and Payzen (13) are offered.
• States like Connecticut, California, and Maryland have instituted consumer protections. These include setting limits on how and what credit products can be offered, requiring healthcare providers to offer in-house payment plans with specific terms, and restricting providers from reporting medical debt to credit agencies.

Public hospitals that partner with third-party credit vendors

Methods

We included public hospitals from the 2026 Lown Institute’s Hospitals Index of Social Responsibility. To determine whether a hospital is publicly owned, we used the Lown Institute’s ownership classification, which draws on IRS records, CMS data, and manual verification of ambiguous cases. We define a public hospital as a non-federal hospital owned or controlled by a government entity — a city or county, a state, or a hospital district or authority.

Data was collected from March through October 2026. We screened hospital websites for credit products and payment plan information, which means only public-facing information was reviewed. Hospitals were flagged with a third-party product if they had any mention of a company offering these services or a link to their website.

Media inquires should be directed to atoleos@lowninstitute.org.