At MDeverywhere, we have had a first row seat as effective patient collections have assumed a more and more important role in a practice's financial health. Simply put, collecting the patient portion consistently and quickly is often the difference between profitability or not for a practice. Insurance payments pay the bills, with patient responsibility making up the profit that enables a practice to grow and invest in new capabilities and services. Although cost shifting by payors has been a long-term trend in our industry, it has accelerated dramatically in recent years with the advent of high-deductible health plans (HDHP). In fact, patients enrolled in HDHP has increased nationally to 15.5 M in 2013. This has led to a dramatic increase in the consumer-driven dollars flowing into physician practices. Out-of-pocket expenses for insured patients are expected to grow from $250 B in 2009 to $420 B by 2015. A recent white paper by the transaction company, InstaMed, confirms this trend. In this report, the company reports that the average dollar amount of each payment is growing. In 2011 the average amount of a patient payment to a provider through InstaMed was $110.86. That number grew to $133.15 in 2013. Even in the face of these trends, however, our industry has been slow to change. We are still far behind other industries in making it simple and convenient for patients to understand their bill and make their payments. Traditionally, most providers relied on paper statements mailed to patient homes and would wait patiently for a paper check to arrive via the same route. As recently as 2013, 78% of providers typically sent more than one paper statement to collect a patient payment. Sometimes after the first statement. Sometimes after the third. Sometimes never at all. The cost and delay associated with this paper and mail oriented approach is significant and utterly avoidable. Paying their physician statements is often the primary reason that consumers still reach for the check books and stamps as most pay other bills via online or through their bank portal. What is needed is clear - price transparency through a discussion of estimated patient responsibility as the service or visit is being scheduled, collecting this upfront electronically prior to the visit, easy to understand electronic statements, online payment portals and well-structured payment plans that enable structured, automatic payments over time. This is how most industries operate, this is how healthcare needs to operate. Consumers will increasingly demand it and providers will increasingly require it to stay afloat.