Balancing cost, access and accountability: A healthcare conversation with Sabrina Burnett.

As healthcare costs continue to rise and complexity grows, employers, providers and financial partners are rethinking their roles across the ecosystem. How can organizations balance affordability with access and quality? And what strategies are emerging to improve transparency, strengthen patient engagement and drive better outcomes? The answers are helping shape a more connected, consumer-focused approach to healthcare delivery and financing.

Sabrina Burnett, a Relationship Executive with CommerceHealthcare®, shares her perspective on these issues, exploring how employers are influencing health outcomes and equity, and how the financial experience can expand access and engagement. Drawing on nearly 30 years of experience across the healthcare landscape, she offers a practical view on strengthening revenue cycle performance while advancing more sustainable care and reflects on the challenges and opportunities ahead.

What role do employers have in the overall healthcare ecosystem, particularly when it comes to cost control, improving health equity, and holding providers accountable for quality outcomes?

Employers are under increasing pressure, with employer sponsored healthcare costs projected to grow by more than 9% in 2026 opens in a new window. Beyond benefit design, employers influence equity and outcomes by prioritizing transparency and affordability in the healthcare experience. Increasingly, employers are advocating for their workforce by offering programs that support healthy living, such as virtual care access, wellness and engagement tools, counseling, nutrition support, and programs focused on preventing chronic conditions. These investments help employees take a more active role in their health, improve outcomes, and reduce long-term costs tied to conditions like heart disease and diabetes.

Why is the Dallas–Fort Worth market a strategic focus for healthcare leaders, and how are financial strategies evolving to support providers in the region?

Dallas–Fort Worth is one of the country’s fastest-growing healthcare markets, driven by population growth, employer density, and intense provider competition. Health systems are scaling while managing tight margins, workforce strain, and rising patient responsibility. As a result, financial strategies are evolving beyond basic efficiency toward more consumer-responsive models such as greater automation, clearer upfront cost communication, and flexible payment structures that align with patient expectations, including interest-free options. These approaches help providers remain competitive, protect access, and support sustainable growth in a highly dynamic market.

Healthcare has become complicated and expensive. How is your company making it more simple and accessible, and what does that mean for your customers?

Affordability has become an access issue, as 29% of consumers opens in a new window delayed or skipped recommended care due to cost in the past year. Much of that burden stems from financial complexity rather than clinical care itself. We help healthcare organizations simplify the experience by combining clear communication, digital engagement, and patient financing options designed to remove barriers. When patients can receive upfront cost clarity, enroll seamlessly through digital channels, and pay over time with no interest, no credit barriers, and predictable terms, financial stress is reduced, engagement improves and access to care is better protected.

What is your outlook on rising healthcare premiums, and how are you working to manage them for clients or patients?

Healthcare premiums will remain under pressure as national health expenditures continue to grow faster than GDP. While no single lever can reverse this trend, patient financial engagement is often overlooked. Clear communication, predictable billing, and flexible payment options reduce confusion, delays in care, and downstream bad debt. By helping healthcare organizations strengthen financial engagement and operate more efficiently, we support affordability, margin stability, and more sustainable cost management without compromising access or experience.

As a leader, and considering that healthcare in the U.S. is such a hot topic, what keeps you up at night — and what gives you hope — about the future of healthcare?

What keeps me up at night is the widening affordability gap, as nearly half opens in a new window of Americans worry they won’t be able to afford needed care in 2026. Financial complexity, workforce shortages, and access challenges continue to strain the system. What gives me hope is the real momentum we’re seeing around automation, digital engagement, and collaboration across the ecosystem. Many organizations are making progress by simplifying financial experiences and prioritizing transparency and patient engagement. We’re supporting these efforts by helping strengthen the financial foundations that make that progress sustainable.

When payer and provider financial systems are aligned, is there a reduction in the overall administrative cost of collecting on healthcare claims? How has your company played a role in this alignment?

Yes. Fragmented payment and remittance processes create manual effort, delays, and rework, especially in a system where paper checks and disconnected workflows remain common. We offer solutions that help drive alignment through standardized data, automation, and consistent financial workflows. This reduces administrative burden, improves accuracy, and accelerates cash posting. When payer and provider financial systems are aligned, revenue cycle operations become more predictable and efficient, improving both cash flow and staff productivity.

What is often overlooked about the financial experience in healthcare, and why does it matter more now than ever?

The financial experience is often treated as a back-office issue, yet it is one of the most emotional and influential parts of a healthcare journey. As patient responsibility grows, confusing bills and fragmented processes can erode trust and even delay care. How organizations communicate, collect, and reconcile payments now directly affects access, equity, and patient confidence. Improving the financial experience is foundational to patient-centered care and long-term sustainability.

CommerceHealthcare^® solutions are provided by Commerce Bank.