The healthcare payments system is beginning to break down due to increased patient responsibility and the lack of Payment Assurance for healthcare providers. In recent years, payers and employers have consistently driven benefits towards higher member/patient responsibility as a way to influence member behavior and to keep medical cost ratios in check. The increased member responsibility trend is only partially a result of consumer-directed healthcare (CDH) plans, which add alternative payment sources to the mix. Although this trend appears to have the desired effect on member behavior, it is forcing providers to absorb additional administrative and financial challenges.