【摩根大通J.P.Morgan】2024年医疗行业支付趋势报告

Trendsin

HealthcarePayments

FifteenthAnnualReport

J.P·Morgan

HEALTHCAREPAYMENTS

TableofContents

03ExecutiveSummary

04About

Report

05TheStateoftheHealthcareEconomy

09HealthcareNavigatesEvolvingPaymentsLandscape

15LeadingtheFutureofHealthcarePayments

Sentiments

13ConsumerSentiment

26ProviderSentiment

35PayerSentiment

48Conclusion

49Methodology

2

3TrendsinHealthcarePayments2024

ExecutiveSummary

Thehealthcareindustrystandsatapivotaljuncture.

Atthestartof2025,anewpresidentialadministrationtookofficeandhasissuedseveralexecutiveordersthathavethepotentialtoreshapethehealthcarelandscape.Whileoptimismmaypermeatetheoutlookofthe

healthcareindustry,withmanyexecutivesanticipatinggrowth,thesectorisnotwithoutitschallenges.

Consumerdissatisfactionremainsapressingissue,drivenbyconfusionovermedicalbillsandalackofpricetransparency.

Inrecentyears,providershavestruggledagainst

atougheconomicbackdropthathittheirbottom

lineshard.Now,thetrendssuggestthatthefinancialsituationforprovidershasimproved,yetthespecterofcyberattacksloomslarge,underscoringtheurgentneedforrobustcybersecuritymeasures.Recent

large-scalecyberattacksserveasastarkreminder

ofthevulnerabilitiesthatpersistwithintheindustry.Meanwhile,thepromiseofinnovation,particularlyinartificialintelligence(AI),holdsthepotentialto

revolutionizehealthcare,thoughadoptionofanyinnovationremainselusive.

Adoption,indeed,willbekeytothefutureofhealthcarepayments.Currently,thepaymentecosystemisstill

dependentonmailandpaper-basedprocessesinthe

healthcareindustry.However,basedontheindustry

sentimentfoundinthisreport,fewstakeholderspreferthestatusquo.Instead,themajoritywantthesame

digitalandself-serviceoptionsfoundinpayment

experiencesinotherindustriestobewidelyavailableinhealthcare.

Thetrendsanddataindicatethatpaymentinnovationisemergingasakeydriverofindustrytransformation,withdigitalsolutionsgainingmomentumamong

consumers.Thetransitiontoelectronicworkflows

offerssubstantialcostsavingsandtimeefficiencies,

yetthecontinuedrelianceonpaperprocessesimpedesprogress.Aspayersandprovidersadapttothisshiftinglandscape,theimperativeforamoreefficientand

consumer-centricexperiencebecomesincreasinglyurgent.

4TrendsinHealthcarePayments2024

About

TrendsinHealthcarePaymentsAnnualReport

EachyeartheTrendsinHealthcarePaymentsAnnual

ReportispublishedbyJ.P.MorganHealthcarePayments

forthepurposeofobjectivelyeducatingthemarketandpromotingawareness,changeandgreaterefficiency.

Nowinitsfifteenthyear,themissionofthereport

hasnotchanged.Thereportusesquantitativedata

derivedfromtheInstaMedNetworkandqualitative,

independently-gathereddatafromtheInstaMed

HealthcarePaymentsSurveysofconsumers,providersandpayersnationwide.Third-partysourcesarealsousedtoanalyzethemarketfromtheperspectiveofallstakeholders.

J.P.MorganHealthcarePayments

J.P.MorganHealthcarePaymentssupportshealthcareorganizationsofallsizeswithanend-to-endsuiteofpayments,treasuryandbankingsolutions,includingInstaMedandHealthcareLink.TheHealthcare

Paymentsteamusesindustryexpertiseand

healthcare-specifictechnologysolutionstopowera

betterhealthcarepaymentsexperienceandconnectconsumers,providersandpayersforeveryhealthcarepaymenttransaction.

TheInstaMedplatformisbuiltonpatented,private

cloud-basedtechnology,whichsecurelytransforms

healthcarepaymentsbydrivingelectronictransactions,processingpaymentsandmovinghealthcaredata

seamlessly,andimprovingconsumersatisfaction.

HealthcareLinksimplifiesthecollectionofconsumerandpayerreceivablesacrosshealthcareorganizations.

TheStateofthe

HealthcareEconomy

Inearly2025,anewpresidentialadministrationtookofficeandissuedaflurryofExecutiveOrderswithmanypotentialimpactsforthehealthcareindustry.1Itremainstobeseenhowhealthcarewilladapttorelatedchangesandhowfuturetrendsinhealthcarepaymentswillbeaffected.

Shakingupthesizablehealthcareeconomywouldindeedbea

monumentalfeat.In2023alone,healthcarespendingreached$4.9trillion–upfrom$1.4trillionin2000.2Consumerpaymentsarea

significantpieceofthattotalamount.Yet,theconsumerdisconnectinhealthcareonlycontinuestoworsen.

5TrendsinHealthcarePayments2024

6TrendsinHealthcarePayments2024

Healthcare’sEconomicOptimismTemperedbyConsumerInfluence

FearsofarecessionandthenegativeimpactsoftheCOVID-19

pandemichaveseemedtodominatediscussionsontheeconomyinrecentyears.Nowinearly2025,businessleadersacrossindustrieshaveamuchmorepositiveoutlookontheeconomy.3

Ageneralsenseofoptimismseemstobepermeatingthehealthcarelandscapeaswell.Themajorityofc-suiteexecutivesfromlarge

healthsystemsandhealthplanshadpositiveoutlooksonrevenueandprofitability.

However,anyoutlookofthehealthcareeconomymustalsofactorin

theroleofconsumersandtheirpayments.Aspaymentresponsibilityhasskyrocketedinrecentdecades,consumershavebecomeafinancialstakeholderintheindustry.Sincethisreportwasfirstpublishedin

2011,therehasbeenanincreaseof133%ofproviderswhoidentifiedpatientcollectionsastheprimaryrevenuecycleconcern.7

Amajordriverofthisconsumertrendarehealthcarecostsdriven

bydeductibles.Alargemajorityofcoveredworkersnowhavea

deductiblethatmustbemetbeforetheirhealthplanpaysforservices.Inrecentyears,growthofdeductiblesseemtobereachingaplateauintrajectorybutamountsaremuchhigherthanadecadeago.

Morethan70%

ofbusinessleadersdonotexpectarecessionin2025.3

59%

ofhealthcareexecutiveshadapositiveindustryoutlookforthecomingyear,

comparedto52%ayearago.4

69%

ofhealthcareexecutives

anticipatearevenueincrease.5

71%

ofhealthcareexecutives

expectprofitabilitywillimprove.6

133%

increaseinproviderswhoidentified

patientcollectionsastheirprimaryrevenuecycleconcernfrom2011to2024.7

87%

ofcoveredworkerswithsinglecoveragehaveageneralannualdeductible.8

$1,787

istheaverageannualdeductible.9

Deductiblesare47%

higherthanaverageannualdeductiblestenyearsago.10

7TrendsinHealthcarePayments2024

HowDeepIstheConsumerDisconnectinHealthcare?

Understandingconsumersentimentinhealthcareseemsratherclear

cut.Consumersareunhappyandtheyarelettingtheirdissatisfaction

knownonline,reachingafeverpitchinlate2024.11Tothispointmorebroadly,consumerswithpositiveratingsofhealthcareareatthelowestpointsince2001.12

Healthcaremayfinallybetakingnoticeofthisconsumerdisconnectandmakingchange,asatleastonemajorhealthinsureristying

compensationtocustomersatisfaction.13

Consumerdissatisfactionisveryevidentinthehealthcarepaymentsexperience,includingmostnotably,consumerloyalty.Infact,halfofconsumersarewillingtoswitchprovidersforpaymentexperiences,

includingunderstandingcostsupfrontandmakingpaymentshowtheywant.Foryoungergenerations,thiswillingnesstoswitchincreases

significantly.

Thisshouldcomeasnosurpriseasthemajorityofconsumersareconfusedbytheirmedicalbills.Since2020,therateofconfusedconsumershasbeenabove70%orhigher.

33.S.adults

saythequalityofhealthcareisgood,

down10percentagepointssince2020.14

54%

ofU.S.adultssaythequalityofhealthcareisfairorpoor.15

50%

ofconsumerswouldswitchproviders,oralreadyhave,forabetterhealthcarepaymentsexperience.16

72%

ofconsumersundertheageof35wouldswitchproviders,oralreadyhave,forabetterhealthcarepaymentsexperience.17

67%

ofconsumersareconfusedbytheirmedicalbills.18

8TrendsinHealthcarePayments2024

PriceTransparencyandBadDebtFuelingConsumerDissatisfaction

Whileconsumerconfusionisnotanewtrend,pricetransparencyhas

emergedasarealconsumerdemandinhealthcare.Themajorityof

consumersthinkknowinghowmuchisowedbeforeavisitisimportant.

However,veryfewactuallyknowtheamountthatwillbedue.This

doesnotseemtobeapriorityforprovidersaslessthanaquarteroforganizationsareprioritizingpricetransparency.

Withincreasingpaymentresponsibility,consumersreceivinglargemedicalbillshavealsorisen.Halfofconsumersreportedreceivingamedicalbillformorethan$400.Themajorityofprovidersarealsoseeingincreasesinlargepatientbalances.

Theseincreasesinlargebillsareonlyexacerbatedbythelackofpricetransparencyandgeneralconsumerconfusion.Thiscouldbewhya

significantnumberofprovidersarechallengedbyunpaidbalances.

87%

ofconsumersthinkitisimportantto

knowhowmuchisowedforamedicalbillbeforeaprovidervisit.19

22%

ofconsumersalwaysknowhowmuchtheyoweforaprovidervisit.20

24%

ofproviderssaidincreasingpricetransparencyisapriorityfortheirorganization.21

50%

ofconsumershavereceivedamedicalbillwithanamountduefor$400+.22

%

63

ofproviderswerechallengedbylargepatientbalances.23

43%

ofproviderswerechallengedbybad

debtfromuncollectedpatientbalances.24

9TrendsinHealthcarePayments2024

SOURCES

1KFF,OverviewofPresidentTrump’sExecutiveActionsonGlobalHealth,February2025

2KFF,HowhasU.S.spendingonhealthcarechangedovertime?,December2024

3J.P.MorganChase,2025U.S.BusinessLeadersOutlook,January2025

4Deloitte,2025UShealthcareoutlook,December20245-6Ibid

7InstaMedProviderHealthcarePaymentsSurvey

8KFF,2024EmployerHealthBenefitsSurvey,October20249-10Ibid

11CBS,AsangeratUnitedHealthcareboilsover,Americanspaymorethaneverforhealthinsurance,December2024

12Gallup,ViewofU.S.HealthcareQualityDeclinesto24-YearLow,December2024

13HealthcareDive,Cignatotieexecutivecompensationtocustomersatisfaction,February2025

14Gallup,ViewofU.S.HealthcareQualityDeclinesto24-YearLow,December2024

15Ibid

16InstaMedConsumerHealthcarePaymentsSurvey17-18Ibid

19InstaMedConsumerHealthcarePaymentsSurvey

20Ibid

21InstaMedProviderHealthcarePaymentsSurvey

22InstaMedConsumerHealthcarePaymentsSurvey

23InstaMedProviderHealthcarePaymentsSurvey

24Ibid

HealthcareNavigates

EvolvingPaymentsLandscape

Inthelastyear,providersfinallyfeltasenseoffinancialrecoveryafteryearsofnavigatingseveralnegativefinancialtrends

includingtroublingstaffingshortagesandskyrocketingoperatingcosts.Thoughtheoutlookispositivegenerally,manyprovider

organizationswerehithardbyalargescalecyberattackthat

impactedpayments.Thisattackisareminderofhowexpensiveanddestructivecyberattackscanbeforhealthcareorganizations.

Thepromisesofinnovationinhealthcareseemtobelimitless,if

theheadlinesaretobebelieved.Yet,innovationadoptionamong

organizationsremainslowfortechnologythatcouldsavesignificantamountsofmoneyintheindustry.Ultimately,consumersand

providerswouldallbenefitfromanychangesthatremovesomefriction,costsandtimefromhealthcarepayments.

10TrendsinHealthcarePayments2024

11TrendsinHealthcarePayments2024

ProviderFinancialOutlookTrendingPositive,YetThreatsLoomLarge

Afteryearsofoperatinginthered,theoverallfinancialoutlookfor

hospitalsandhealthsystemsexperiencedsignificantimprovementin

thelastyear.25Thispositiveoutlookisattributedtoseveralkeyfactors,includingincreasedpatientvolumes,wideroperatingmarginsandmorefavorablefinancialmarkets.26Despitethisupwardtrendoverall,alargescalecyberattackhittheindustryandmanyprovidersfinancially.

Theimpactsofthatlargecyberattackwillnotsoonbeforgotten

andmayserveasawakeupcallfortheveryrealandever-presentthreatsfacinghealthcare.Whenhealthcarecyberattacksdohappen,thefinancialtollissubstantialwiththecostofasingledatabreachpotentiallyskyrocketingtonearly10milliondollars.

Beyondthemonetaryimpact,thedisruptiontohealthcareservicescanbeprofoundafteracyberattack.Nearlyallprovidersrecognizedthatcybersecuritymustbeahighpriorityattheirorganization.

Largecyberattacksexposedthedataof190millionpeople27

94%

ofhospitalsreportedfinancialimpactfromthiscyberattack,morethan

halfreportedasignificantorseriousimpact.28

36%

ofphysicianspracticessawasuspensionofclaimpayments.29

$9.8million

istheaveragecostforadatabreachinhealthcare.30

Ofproviderswhoexperiencedacyberattack

53%

saidsystemsweredownforaperiodoftime.31

%

24

saidsignificantresourceswerededicatedtorecovery.32

18%

saidsignificantamountsofdataandfundswerelostandneverrecovered.33

92%

ofproviderssaidcybersecurityisahighpriorityattheirorganization.34

12TrendsinHealthcarePayments2024

TheDireNeedfortheUntappedPotentialofHealthcareInnovation

Thepromisesofinnovation,andmorespecificallyAI,aresetto

transformthefutureofthehealthcareindustry.LeveragingAIfor

automationandanalyticscouldsavetheindustry$360billioninannualhealthcarespending.35

However,theonlywaytotrulycapturethefullpotentialofany

innovativebreakthrough,includingAI,woulddependonwidespread

adoption.Accordingtosomeproviders,adoptingandusingAIisnotontheradar.

Theneedforinnovativetechnologyisapparentinthepatient

collectionsprocesses.Forthemajorityofproviders,patientcollectionsareaslowandcostlyordeal.Infact,aboutaquarterofproviders

werechallengedbyadministrativecostsduetopatientcollections.Themajorityofproviderstakemorethanamonthandtwoormorestatementstocollectafterapatientvisit.Forasignificantportionofproviders,thetimetocollectismorethantwomonths.

$360billion

inannualhealthcarespending

couldbesavedbythewidespreadadoptionofAIforhealthcare

automationandanalytics.36

47%

ofproviderswerenotawareofAIbeingusedbytheirorganization.37

23%

ofproviderssaidAIwasnotbeingusedandtherewerenoplansforitsuse.38

24%

ofproviderssayadministrativecostsassociatedwithpatient

collectionsisatopchallengefortheirorganization.39

71%

ofproviderssayittakesmorethan30daystocollectafterapatient

encounter.40

33%

saidittakesmorethan60daystocollectafterapatientencounter.41

79%

ofproviderssayittakestwo

ormorestatementstocollectapatientbalanceinfull.42

38%

sayittakethreeormore

statementstocollectapatientbalanceinfull.43

13TrendsinHealthcarePayments2024

PatientRefundsProveHealthcareMust

91%

RethinkStatusQuo

ofprovidersissuerefundstopatientsforoverpaymentofmedicalbills.44

Patientrefundsaretheprimeexampleofwhypatientcollectionsare

22%

inneedofachange.First,theissueispervasiveasnearlyallprovidersissuerefundstopatientsforoverpaymentofmedicalbills.Asignificant

ofproviderssaytheyissuerefundsoften.45

portionofprovidersissuetheserefundsoften.

54%

Thesedatapointssuggestthatprovidersarecollectingthewrong

amountsfrompatientsataconcerningrate.Further,theissue

compoundswhenlookingathowthoserefundsarepaidout.Morethan

ofprovidersissuerefundsviapapercheck.46

48%

halfofprovidersusepaperchecksforrefunds.

Itmaycomeasnosurprisethatthepatientrefundprocessonlyadds

ofconsumerssaidtheslowprocesswasthemostfrustratingpartof

providerrefunds.47

frictiontotheconsumerpaymentsexperienceinhealthcare.Nearlyhalf

Only6consumers

ofconsumerswerefrustratedbytheslowprocessofproviderrefunds.Paperchecksarealikelyculpritfortheslowrefundsthatconsumers

prefertopaytheirmedicalbillswithmailedpaperchecks.48

experience.

34%

Fewconsumersprefermailedpaperchecksformedicalbills.Whileconsumersdonotpreferpaperchecks,thereishopethatprovidersmaybeembracingchangeasathirdofprovidersareprioritizingtheneedtoreducepaper-basedpayments.

ofprovidersaresignificantlyreducingcash,paper-based

paymentsacrossalllocations.49

14TrendsinHealthcarePayments2024

SOURCES

25KaufmanHall,NationalHospitalFlashReport:December2024Data,February2025

26Advisory,Whattoexpectfromhealthcareprovidersandretailersthisyear,January2025

27AmericanHospitalAssociation,Reports:ChangeHealthcarecyberattackexposeddataof190millionpeople,January2025

28AmericanHospitalAssociation,AHASurvey:ChangeHealthcareCyberattackSignificantlyDisruptsPatientCare,Hospitals’Finances,March2024

29AmericanMedicalAssociation,ChangeHealthcarecyberattackimpact:KeytakeawaysfrominformalAMAsurvey,April2024

30IBM,CostofaDataBreachReport2024,July2024

31InstaMedProviderHealthcarePaymentsSurvey32-34Ibid

35McKinsey,SettingtherevenuecycleupforsuccessinautomationandAI,July2023

36Ibid

37InstaMedProviderHealthcarePaymentsSurvey38-43Ibid

44InstaMedProviderHealthcarePaymentsSurvey45-46Ibid

47InstaMedConsumerHealthcarePaymentsSurvey

48Ibid

49InstaMedProviderHealthcarePaymentsSurvey

LeadingtheFuture

ofHealthcarePayments

Thefutureofhealthcareispoisedfordisruptionwith$265trillioninpotentialsavingsannuallythroughinterventionsthatimprove

efficiency.50Paymentinnovationwillbeattheforefrontofthis

transformationbyreducingwidespreadfrictionanddissatisfaction,whileenhancingthehealthcareexperienceforallstakeholders.

Asconsumersincreasinglydemanduser-friendlyexperiences,

digitalsolutionswillbeessentialinhealthcarepayments.Online

payments,electronicstatementsandautomatedpaymenttoolsaregainingtraction,empoweringconsumerstomanagetheirpaymentsproactively.However,totrulymovetheneedle,payersmustactivelyengageondrivingadoptioninthehealthcareindustry.

15TrendsinHealthcarePayments2024

16TrendsinHealthcarePayments2024

DrivingPaymentInnovationto

$20billion

EliminateFrictionandWaste

potentialannualcostsavings

withfullyelectronicadministrativeworkflows.53

Inhealthcarepayments,embracingelectronicworkflowscan

significantlyreducefrictionandwaste.Withafullyelectronicworkflow,

70minutes

thehealthcareindustrycanrealizethesavingspotentialof$20billionannually.51Thereisalsoasubstantialtime-savingspotentialforboth

savedonaverage,perpatientvisitwithfullyelectronicadministrativeworkflows.54

providersandpatients.Onaverage,afullyelectronicworkflowcan

saveoveranhourperpatientvisit.52Thisshiftcouldnotonlyeliminatewastedresourcesbutalsoenhancetheoveralleffectivenessof

healthcareorganizationsandimprovetheconsumerexperience.

Only17

payregularhouseholdbillsviamailedpayments,likepaperchecks.55

78%

Consumershavealreadydemonstratedastrongpreferencefor

electronicpaymentchannelsinotherareasoftheirlives,including

payinghouseholdbillsandmanagingsubscriptions.Thistrendseemstoindicateagrowingexpectationforsimilarconvenienceandefficiencyin

ofconsumershaveregularand

activesubscriptionspaidforwith

automaticpaymentsalreadysetup.56

62%

healthcarepayments.

Patientsareincreasinglyseekingtheabilitytopaymedicalbillsthroughdigitalplatforms,reflectingabroadershifttowardstechnology-driveninteractionsinallaspectsofdailylife.

ofconsumersprefertopaytheirmedicalbillsonline.57

17TrendsinHealthcarePayments2024

HarnessPaymentInnovationforHealthcare’sTopChallenges

Thehealthcareindustryismiredinmailandpaperprocessesthataddstotheoverwhelmingadministrativecomplexity.However,theindustrycouldbeonthecuspofatransformativeshift.Byembracingpaymentinnovation,healthcareorganizationscanpavethewayforamore

efficientandconsumer-friendlyexperience.

Thejourneytowardsthistransformationhasalreadybegunwiththemodernizationofhealthcarepayments.Automation,integrationanddigitaladoptionareattheforefrontofthisrevolution,offeringa

glimpseintohowprogressandinnovationcanbeachieved.

Thedatatellsacompellingstory:whenpaymentstoolsempower

consumerstomanagehealthcarepaymentswithdigitalandself-servicechannels,theresultsareremarkable.Forinstance,givingconsumers

theoptiontopaytheirmedicalbillsonlinehasgrownsignificantly,asshownbyInstaMedNetworkdata.59ThegrowthofeStatementsandcardssavedonfilefurtherunderscoresconsumerdemandforbetterpayments.

Theseinnovativepaymentoptionsnotonlyimprovethepaymentexperienceforconsumers,butalsohelptoensurecashflowfor

healthcareorganizationswithmoreefficientandautomatedtools.

243%

increaseinproviderswhouseeStatementsastheprimary

methodforpatientcollectionsfrom2016to2024.58

From

2021to2024

onlinepatientpaymenttransactions

tothesamesetofprovidersonthe

InstaMedNetworkincreasedby38%,growingby11%onaverageeachyear.59

thenumberofeStatement

transactionsincreasedby123%,

growingby31%onaverageeachyear.60

thenumberofcardssavedonfile

increasedby567%,growingby78%onaverageeachyear.61

18TrendsinHealthcarePayments2024

ThePathwaytoAcceleratingPaymentDisruption

Torealizethefutureofhealthcarepayments,theroleofpayersandhealthplanswillbeacriticalfactor.Thisistrueinmanyaspectsofhealthcare,especiallythepaymentsecosystem.Despitethegrowingpreferenceforelectronicpayments,themajorityofpayersstill

relyonpapercheckstocompensateproviders.Thisisalsotrueforreimbursementstomembers.However,providerspreferelectronicfundstransfer(EFT)forpaymentsfrompayers.

Whenpayersandhealthplansembracepaymentinnovation,there

isadominoeffectfortheentireindustry.Fortheadministrative

transactionsbetweenpayersandproviders,theindustrysaved$222

billiononadministrativetaskswithautomation,whichisa15%

increasefromthepreviousyear.65Forfuturesavings,adoptionamongproviderslikelywillnotproveahugechallengeforpayersasproviderspreferencesforpaymentoptionsindicates.

68%

ofpayersreimburseproviderswithpaperchecks.62

52%

ofpayerssaytheyreimbursememberswithpaperchecks.63

%

84

ofproviderssayEFTforfreeistheirpreferredpaymentfrompayers.64

22%

ofpayerssayERA/EFTadoptionamongprovidernetworksisatopchallenge.66

savedonadministrativetasks

$222billion

withautomation,a15%increasefromtheprioryear.67

19TrendsinHealthcarePayments2024

SOURCES

50McKinsey,Administrativesimplification:Howtosaveaquarter-trilliondollarsinUShealthcare,October2021

51CAQH,TheCAQHIndexReport,February202552-54Ibid

55InstaMedConsumerHealthcarePaymentsSurvey56-57Ibid

58InstaMedProviderHealthcarePaymentsSurvey

59-61InstaMedNetworkData

62InstaMedPayerHealthcarePaymentsSurvey

63Ibid

64InstaMedProviderHealthcarePaymentsSurvey

65CAQH,TheCAQHIndexReport,February2025

66InstaMedPayerHealthcarePaymentsSurvey

67CAQH,TheCAQHIndexReport,February2025

20TrendsinHealthcarePayments2024

ConsumerSentiment

J.P.MorganHealthcarePaymentscommissionedtheConsumerHealthcarePaymentsSurvey2024tobetterunderstandthe

experiencesofconsumersintheindustry.Thisnationwide

surveyconsistedofconsumerswhoarearepresentative

sampleoftheUnitedStatespopulation,madeahealthcare

paymentandhadhealthinsurancein2024