Consumer health and wellness startups obsess over acquisition cost, activation, and retention. Fewer obsess over the exact moment a customer is ready to pay and quietly disappear instead, because the screen price is higher than they budgeted for, and there’s no good way to spread it out.
That moment, the checkout screen for a dental implant consult, a fertility treatment, a med spa package, a veterinary procedure, is where a meaningful share of a young health company’s revenue is currently leaking out, and most founders aren’t tracking it as closely as they track their funnel above it.
A Familiar Problem, Just Further Downstream
The revenue-leakage problem is well known on the provider side of healthcare, and it’s spawned a wave of well-funded NYC startups. Adonis, which raised a $40M Series C earlier this year, built its entire pitch around the fact that health systems fail to collect up to 15% or more of the revenue they’re actually owed, largely due to denials, fragmented billing, and administrative breakdowns between the claim and the payment.
That’s the back-office version of the problem. The consumer-facing version is less discussed but arguably more direct: it isn’t a denial or a coding error causing the lost revenue, it’s a customer who was ready to buy and simply couldn’t make the number work at checkout.
The Numbers Behind the Abandonment
The scale of what patients now owe out of pocket has grown considerably. According to Kodiak Solutions’ benchmarking analysis of more than 2,300 hospitals and 375,000 physicians, the share of net revenue that falls to insured patients themselves rose from 6.8% in 2024 to 7.3% in 2025, and providers collected less of it, not more, over that same stretch.
For consumer health startups operating largely outside traditional insurance billing, self-pay isn’t a fraction of the business. It’s usually the entire business model.
That means a startup selling directly to consumers is more exposed to sticker shock at checkout than a hospital system with a payer mix to fall back on. If a $3,000 procedure only converts when a customer can pay $3,000 upfront, a founder is voluntarily shrinking their own addressable market to whoever happens to have that much sitting in a checking account.
E-Commerce Already Solved This. Healthcare Is Catching Up.
Retail and e-commerce companies figured this out years ago. Offering an installment option at checkout, a buy now, pay later style, consistently increases conversion and average order value because it reframes a high one-time cost as a manageable monthly cost. Health and wellness startups selling elective, high-ticket services are only now catching up to that same insight.
A handful of point-of-care financing platforms exist specifically to plug into this checkout moment. One breakdown of how customer financing works outlines the mechanics from the merchant side: a patient applies in the same flow where they’re reviewing their treatment plan or invoice, gets a decision in seconds without a hard credit check in most cases, and the provider is typically funded upfront regardless of the payment term the patient chooses.
For a startup, the appeal isn’t just patient goodwill. It’s that the entire cost of financing risk and the collections timeline are shifted off the company’s own balance sheet and onto a partner built to underwrite exactly that kind of consumer credit.
Why This Matters More for Startups Than Incumbents
Larger, established healthcare organizations can absorb some checkout abandonment because they have volume, brand trust, and often insurance reimbursement to cushion the blow.
Early-stage companies don’t have that luxury. Every customer who reaches checkout already represents real marketing spend, sales cycle time, and founder attention. Losing that customer at the very last step, over a financing gap rather than a product or trust problem, is close to the most expensive kind of churn a startup can have, because the acquisition cost was already sunk.
It’s also a fixable problem, unlike most of the issues that show up in a churn report. Adding a financing option at checkout doesn’t require a product rebuild or a new go-to-market motion. For most platforms, it’s closer to adding a payment method than launching a new feature.
The Takeaway for Founders
Health and wellness startups spend enormous effort optimizing the top of the funnel: performance marketing, referral loops, content, and brand. Comparatively little attention goes to the last five feet of that funnel, the actual moment of payment, even though it’s often where the most avoidable revenue loss happens.
For any founder selling a service with a four-figure price tag directly to consumers, the question isn’t just how to get more people to check it out. It’s how many of the people who already got there left empty-handed, and whether a financing option at that exact moment would have kept them.
