As healthcare costs continue to climb and out-of-pocket expenses rise1, patients across the country are postponing or declining treatments simply because they cannot afford them2. Providers, meanwhile, are navigating increasing financial risk, unpredictable payment patterns, and the operational complexities of helping patients access financing at the point of care3. In this environment, traditional credit models—long dependent on static scores and limited data—often fall short.
Synchrony, the company behind the widely used CareCredit health and wellness credit card, believes the solution requires reimagining how credit decisions are made. The company’s next-generation underwriting system, Synchrony PRISM, is now at the center of that transformation. Positioned as a breakthrough in modern credit decisioning, PRISM uses dynamic, data-rich insights to responsibly expand access, identify stability, and strengthen confidence for both patients and providers.
“Synchrony’s PRISM is indeed a game-changer in credit underwriting, because it fundamentally redefines how we assess creditworthiness,” says Max Axler, EVP and Chief Credit Officer at Synchrony. And it is already reshaping how individuals pay for care.
Moving Beyond the Limits of Traditional Credit Modeling
Historically, credit decisions have leaned heavily on a single score and limited financial indicators. That static snapshot often excludes millions of people, particularly the 45 million Americans categorized as “credit invisible.”4 These individuals may be financially stable and fully capable of managing credit, but lack deep credit histories and access to financial products.
Synchrony’s PRISM system is specifically built to close that gap.
“PRISM is our next-generation credit decisioning system that looks beyond traditional credit score inputs to identify creditworthy individuals through a holistic and dynamic evaluation of their financial health and history,” Axler explains. Instead of viewing a consumer through one metric, the system analyzes up to 9,000 data attributes, including credit bureau information, alternative financial data, proprietary Synchrony insights, and merchant-specific signals.
This shift turns what used to be a flat snapshot into what Axler describes as “a dynamic, holistic financial profile,” enabling Synchrony to make more equitable and precise decisions. For patients, this often translates into approvals that might never have been possible under conventional methods.
Responsible Inclusion: Expanding Access While Maintaining Stability
Broadening access to credit can only succeed if it is paired with strong risk management. PRISM is designed with that dual objective in mind: identify more creditworthy individuals and prevent overextension.
According to Axler, the technology “provides a more clear, real-time understanding of an applicant’s true financial capacity,” which allows Synchrony to say “yes” more often, responsibly. It has proven especially powerful for consumers with limited credit files, evaluating them based on actual financial behaviors such as rent payments, cash flow patterns, and utility history.
One example of this impact is Synchrony’s partnership with the U.S. Office of the Comptroller of the Currency through Project REACh. Axler notes that “Synchrony has approved more new accounts than all our peers combined, and within just one year, over 60% of REACh participants achieved prime credit scores.” This is not just about access; This is about mobility, stability, and long-term financial empowerment.
At the same time, PRISM plays a protective role. Axler explains that the system “also identifies potential risky behaviors that a traditional ‘high’ credit score might otherwise mask.” That helps prevent consumers from overextending themselves and safeguards providers from downstream payment issues.
The Power of Massive, Multi-Layered Data
Central to PRISM’s accuracy is the extraordinary depth of data Synchrony can bring to each credit decision. The company draws on traditional bureau history, alternative data streams, Synchrony’s own proprietary insights, and merchant-specific signals.
Synchrony’s data footprint is expansive:
- Over 140 million tradelines
- More than one trillion dollars in sales since SYF PRISM began in 2018
- Billions of annual transactions
- One in four U.S. adults holding a Synchrony credit card 5
As Axler notes, “This data provides unparalleled insights into consumer behaviors and has been the most powerful data we have used over the last five years.”
Partner-level data also matters, especially in healthcare. A patient’s relationship with a provider, appointment regularity, engagement history, or tenure, can offer meaningful insight into consistency and reliability.
Combined, these data layers allow PRISM to see a much fuller picture of a person’s financial life than traditional underwriting ever could.
Helping Patients Move Forward With Care
CareCredit has long been one of the most widely recognized financing solutions in healthcare. With PRISM behind it, its reach and impact have grown even stronger.
Synchrony’s mission, Axler emphasizes, is “to help people get the care they want, for themselves and their families.”
PRISM helps achieve that by enabling Synchrony to approve more patients, particularly those who fall into the underserved or overlooked category. This is vital as out-of-pocket costs continue to rise; more than a quarter of Americans have postponed medically recommended procedures because of cost.6
For providers, the value is equally clear. In Synchrony’s 2023 Healthcare Journey Research:7
- 59 percent of providers say alternative payment solutions are critical for patients
- 53 percent say they are essential for practice success
PRISM gives providers more confidence by delivering real-time, accurate credit decisions, appropriate credit limits, and stronger underwriting discipline, all while Synchrony assumes the credit risk.
Addressing Affordability Gaps Through a Multi-Layered Financing Model
Even with expanded approvals, not every patient will qualify for CareCredit. To strengthen access further, Synchrony’s multi-source financing (MSF) approach, pairs applicants with trusted third-party lenders when needed.
Axler explains that an MSF approach“makes it possible for us to quickly and seamlessly source additional trusted lender options for patients,” ensuring continuity of care even when primary credit lines are not an option.
Synchrony also integrates financing directly into provider workflows through its ISV capabilities, eliminating friction and improving the patient experience during financial conversations.
Beyond these structural tools, the organization prioritizes financial literacy, offering calculators, cost estimators, provider locators, and the company’s Fair Financing Principles to encourage informed, responsible decisions.
Real-World Benefits for Healthcare Providers
For practices, the advantages of PRISM reach far beyond approvals.
Synchrony’s data-driven model helps to deliver:
- Faster, smoother transactions at the point of care
- Real-time credit decisions that improve patient flow
- Reduced administrative burden
- Lower financial risk, since Synchrony manages collections
- More stable, predictable revenue
For patients, payment options remains central for personal financial preparedness. “Synchrony offers a diverse set of financing products for consumers to choose between short and long-term installment, or promotional financing…allowing consumers to have the flexibility to manage their cash flow,” Axler says.
Altogether, the model helps ensure that healthcare providers can focus on delivering care, not navigating the complexities of patient financing.
Building Stability in Uncertain Economic Times
Economic uncertainty has heightened the need for resilient credit frameworks.8 PRISM’s sophisticated underwriting helps keep both patients and providers on solid footing by evaluating stability in a far more accurate, dynamic way than traditional credit tools.
Axler explains that PRISM “helps to ensure consistency through an economic cycle, giving needed surety to both patients and providers through advanced risk management and underwriting capabilities.” For patients, this means access without overextension. For providers, it means predictable revenue and less operational complexity.
With more than thirty-five years in healthcare financing, Synchrony has navigated multiple economic cycles, and PRISM strengthens that long-term stability even further.
Shaping the Future of Healthcare Financing Through AI and Predictive Analytics
As AI evolves, Synchrony is preparing for an era where credit decisions can become even more personalized, anticipatory, and efficient.
“We have been using Artificial Intelligence and Machine Learning for decades in our analytics and modeling,” Axler says. But the next wave, driven by agentic commerce and expanded data integration, will push healthcare financing into deeper personalization and broader inclusion.
Synchrony plans to remain at the forefront by continuing to expand the data it can safely and responsibly ingest, anticipating patient needs, and identifying financial challenges before they arise.
“Our goal,” Axler says, “is to help ensure financial considerations don’t stand in the way of having Americans get the health and wellness care they desire.”
For more information, visit carecredit.com.
1. Cox, Cythia. “Health Care Costs and Affordability.” KFF Health. October, 2025. Retrieved from: https://www.kff.org/health-costs/health-policy-101-health-care-costs-and-affordability/?entry=table-of-contents-introduction.
2. Sparks, Grace. “Americans’ Challenges with Health Care Costs.” KFF Health. July, 2025. Retrieved from: https://www.kff.org/health-costs/americans-challenges-with-health-care-costs/.
3. Abelson, Reed. “Health Care Costs for Workers Begin to Climb.” The New York Times. September, 2025. Retrieved from: https://www.nytimes.com/2025/09/04/health/health-care-costs-employers-workers.html#:~:text=Higher%20drug%20costs%2C%20rising%20hospital,even%20after%20changes%20to%20plans.
4. “More than 45 Million Americans are Either Credit Unserved or Underserved; Approximately 20% Migrate to Being Credit Active Every Two Years.” TransUnion. April, 2022. Retrieved from: https://newsroom.transunion.com/more-than-45-million-americans-are-either-credit-unserved-or-underserved—approximately-20-migrate-to-being-credit-active-every-two-years/.
5. Synchrony strives to be essential to people’s everyday lives and to businesses across the country.” Synchrony. April, 2025. Retrieved from: https://www.synchrony.com/s/fact-sheet.html.
6. “Lifetime of Healthcare Costs Research”. Synchrony 2022. Retrieved from: https://www.carecredit.com/sites/pc/pdf/lifetime-of-healthcare-costs.pdf?msockid=1eae37ff700267f52592236471b5665a.
7. “Healthcare Journey Research Consumers and Providers”. Synchrony, 2023. CareCredit is a Synchrony solution.
8. Pathak, Kirtiman. “Amid persistent complexity, bank leadership teams need to urgently revisit their approaches to credit risk management.” McKinsley & Company. April, 2023. Retrieved from: https://www.mckinsey.com/capabilities/risk-and-resilience/our-insights/navigating-economic-uncertainty-new-guidance-for-credit-risk-management.
Daniel Casciato is a seasoned healthcare writer, publisher, and product reviewer with two decades of experience. He founded Healthcare Business Today to deliver timely insights on healthcare trends, technology, and innovation. His bylines have appeared in outlets such as Cleveland Clinic’s Health Essentials, MedEsthetics Magazine, EMS World, Pittsburgh Business Times, Post-Gazette, Providence Journal, Western PA Healthcare News, and he has written for clients like the American Heart Association, Google Earth, and Southwest Airlines. Through Healthcare Business Today, Daniel continues to inform and inspire professionals across the healthcare landscape.
