Blog, Inbox Health Labs

Report: Boomers don’t like opening the mail either

January 04, 2021

3 minute read

It is a common myth in the medical billing community that sending patient statements digitally is not necessary or at least not urgent because a large percentage of patients, especially for certain practices, are older and not particularly tech-savvy.

The assumption goes that patients are comfortable with the traditional way of doing things – with a series of mailed paper statements sent over a period of months that will inevitably reach the patient, who will pay on their own time (with little billers can do to accelerate the process or induce them to pay at all).

Inbox Health Labs examined two years of data on patient payment activity to test the assumption that adopting a digital-first or digital-native payment system might be intimidating or alienating to older patients while providing only limited benefit to a younger client base. The data from our analysis reveals these fears to be at best out of date, and at worst entirely out of touch with the way patients are engaging when given the choice. 

Our research assessed changes in statement composition over time (paper vs. email vs. SMS, or paper vs. digital overall) across different generations (Silents, Baby Boomers, Gen X, Millennials, and Gen Z). The primary finding was that, although older age cohorts did rely on paper more than younger age cohorts, the difference was not as significant as some might assume, and the primary trend was towards greater adoption of email over time across all age groups.

If anything, there was a slight tendency for older generations (Silents, Boomers, Gen X) to “catch up” to younger generations by adopting digital statements (SMS and email) at a slightly higher rate over time relative to their baseline. Though the data does reflect lower rates of digital statement adoption among older patients earlier on, it suggests it is with older patients that the most opportunities reside to implement and make use of innovative digital technology to drive greater patient engagement, improved patient billing experiences, and lower patient billing costs in the years to come. 

It is necessary to update previous assumptions that older patients are not ready for the digital revolution or that patients are still best reached through traditional (and more expensive) paper means of notification. Billers might want to consider whether, if they don’t adopt digital technology to keep up with the times, then patients may rapidly outpace them in terms of the level and ease of digital communication they will be expecting. 

To access the full Inbox Health Labs report on how statement composition is changing over time as a function of generational age cohort, click here.


Inbox Health’s rapidly growing proprietary data set of over 30 million unique patient bill payment interactions provides a trove of potential insights. Inbox Health Labs strives to provide valuable research to the medical biller community by analyzing the data to discover key findings that are topical to prevailing and emerging trends in the industry as well as changes that are the consequences of the major events of the day.