Healthcare Scorecard from Patients with Chronic Illness

Healthcare costs, insurance barriers, and medical debt are preventing patients with chronic illnesses in the US from accessing essential treatments and medications. That’s according to the PAN Foundation’s Center for Patient Research State of Patient Access Report initiative.

The latest survey1, released in March, found patients living with chronic health conditions rated the overall state of healthcare access a C (75.2). Overall, more than one in five patients reported that prescriptions are not affordable (23%), and they find it difficult to pay for drugs (22%). In addition, a quarter of patients (25%) said their lives are greatly impacted by the financial toxicity of healthcare costs. It’s clear that change is needed.

Methodology

Launched in 2024, the State of Patient Access Report gathers insights directly from adults with chronic health conditions through a nationwide survey conducted by The Harris Poll. Survey results are then synthesized and organized across five categories to develop an annual scorecard. Scores are calculated for the total patient population and for various subgroups to identify disparities in access to care.

Key 2025 findings

In addition to an overall score,the 2025 report also highlights the aggregate scores for each category:

• Relationship with healthcare professionals = B (84.3)
• Affordability of prescription medications = B- (80.8)
• Overall access to care = C+ (78.9)
• Access to treatment through healthcare plans = D- (63.1)

Some other key takeaways include:

1. Healthcare access and affordability isn’t getting better. Compared to the 2024 report, this year’s survey shows little progress in patient access. Most composite measures did not move materially between 2024 and 2025, with affordability of prescription drugs and financial toxicity declining.

2. Having health insurance does not guarantee access.Once again, access to treatment through healthcare plans earned a “D-,” the lowest overall grade across all categories. The score fell to an “F” for American Indian/Alaska Native, Hispanic, and LGBTQIA+ patients, highlighting continued differences in health outcomes.

3. Prescription affordability continues to be a challenge.The Rx affordability score dropped from 82.3 in 2024 to 80.8 this year. Overall, 22% of patients struggled to pay for prescriptions, and 21% could not access needed medications due to cost.

4. Financial toxicity remains a serious issue for many. Sentiment fell to a “D+”, from a “C-” in 2024, with 25% of patients significantly affected by healthcare costs. Over half (56%) of LGBTQIA+ respondents reported high financial toxicity, nearly double that of non-LGBTQIA+ respondents (24%).

5. Medical debt is a leading concern among patients. New to this year’s report, questions related to the negative impacts of medical debt were included. Two in five respondents (40%) reported having medical debt, with an average of $729. Notably, medical debt is unevenly distributed, with patients of color averaging $983 in debt compared to $584 for patients identifying as white.

Potential solutions

This year’s findings show that healthcare access remains a significant challenge for many Americans and there is urgent need for lasting policy solutions. Groups such as the PAN Foundation remain committed to working with policymakers, patients, healthcare professionals (HCPs), and patient advocacy organizations to help break down access barriers.

• But we also encourage individual action in this effort, which could look like:
• Contacting your policymakers to share your story and ask them to prioritize policies around access and affordability.
• As patients, educating yourself about how to better navigate your healthcare journey and available resources.
• As HCPs, talking with patients about their access and affordability challenges.
• As patient advocacy organizations, keeping abreast of evolving patient opinion and experience, to further emphasize the access challenges they face.

About the Author

Amy Niles is chief mission officer at PAN Foundation.

Reference

1. 2025 State of Patient Access Report. PAN Foundation. https://www.panfoundation.org/state-of-patient-access/