Hospital bad debt is projected to hit $60 billion by 2025, even as rates and write-offs swing sharply across hospital types and states. Community hospitals averaged 2.9% bad debt in 2022, while rural hospitals reached 5.1% of revenue in 2022 and for profit systems posted $12.3 billion in 2021. We break down what is driving those gaps, from national trends like 10% annual growth from 2018 to 2022 to how policy and new collections tech could reshape the outlook through 2026.
Key Takeaways
- Bad debt for community hospitals averaged 2.9% in 2022.
- Teaching hospitals reported 4.2% bad debt rate in 2021.
- Rural hospitals had 5.1% bad debt as % of revenue in 2022.
- California hospitals had $6.2 billion bad debt in 2021.
- Texas hospital bad debt averaged 4.5% of revenue in 2022.
- Florida bad debt for hospitals was $4.1 billion in 2023.
- Hospital bad debt projected to reach $60B by 2025.
- Bad debt expected to average 3.5% of revenue through 2026.
- AI-driven collections could reduce bad debt 20% by 2027.
- Hospital bad debt rose 10% annually from 2018-2022.
- Bad debt was 2.1% of revenue in 2015, up to 3.0% in 2020.
- From 2019-2021, national bad debt increased 22%.
- U.S. hospitals reported $49.7 billion in bad debt expenses in 2021.
- Bad debt accounted for 2.8% of net patient revenue for U.S. hospitals in 2022.
- Nationwide hospital bad debt write-offs increased by 12% from 2020 to 2021.
U.S. hospital bad debt is rising, hitting $49.7B in 2021 and projected to reach $60B by 2025.
Related reading
01 · Category
By Hospital Type16 stats
01
Bad debt for community hospitals averaged 2.9% in 2022.
02
Teaching hospitals reported 4.2% bad debt rate in 2021.
03
Rural hospitals had 5.1% bad debt as % of revenue in 2022.
04
For-profit hospitals' bad debt was $12.3 billion in 2021.
05
Nonprofit hospitals averaged 3.0% bad debt expense in 2023.
06
Critical access hospitals saw 6.8% bad debt rate in 2022.
07
Urban hospitals' bad debt per discharge was $950in 2021.
08
Safety-net hospitals had 7.2% bad debt in FY2022.
09
Children's hospitals reported 2.1% bad debt rate in 2023.
10
Psychiatric hospitals averaged $2.5M bad debt per facility in 2022.
11
Large hospitals (>500 beds) had 3.4% bad debt in 2021.
12
Medium hospitals (100-499 beds) bad debt $3.8M average in 2022.
13
Small hospitals (<100 beds) saw 4.9% bad debt rate in 2023.
14
Cancer centers averaged 2.7% bad debt in 2021.
15
Orthopedic specialty hospitals had 1.8% bad debt in 2022.
16
Cardiac hospitals reported $1.9M bad debt per site in 2023.
Interpretation
By Hospital Type Interpretation
Under the By Hospital Type view, bad debt varies sharply by provider setting, ranging from 2.9% for community hospitals in 2022 up to 6.8% for critical access hospitals in the same year, with rural hospitals also higher at 5.1% in 2022.
02 · Category
By Region/state17 stats
01
California hospitals had $6.2 billion bad debt in 2021.
02
Texas hospital bad debt averaged 4.5% of revenue in 2022.
03
Florida bad debt for hospitals was $4.1 billion in 2023.
04
New York hospitals reported 3.7% bad debt rate in 2021.
05
Illinois hospital bad debt totaled $2.9 billion FY2022.
06
Pennsylvania averaged $1.8M bad debt per hospital in 2023.
07
Ohio hospitals saw 5.3% bad debt in Medicaid patients 2022.
08
Georgia bad debt expense up 18% in 2021.
09
Michigan hospitals had 4.0% bad debt rate in 2023.
10
North Carolina rural bad debt 6.2% in 2022.
11
Washington state hospitals $1.2B bad debt 2021.
12
Massachusetts averaged 2.9% bad debt in 2023.
13
Arizona hospitals bad debt $900M in FY2022.
14
Tennessee saw 4.8% bad debt rate 2021.
15
Kentucky hospitals $1.1B bad debt in 2022.
16
Louisiana bad debt averaged 5.6% in 2023.
17
Alabama hospital bad debt up 14% 2021-2022.
Interpretation
By Region/state Interpretation
Across the By Region/state view, bad debt varies widely by state, from California’s $6.2 billion in 2021 to Pennsylvania’s $1.8M per hospital in 2023, showing that both dollar totals and bad debt burden can differ dramatically depending on where the hospitals are located.
03 · Category
Future Projections And Factors15 stats
01
Hospital bad debt projected to reach $60B by 2025.
02
Bad debt expected to average 3.5% of revenue through 2026.
03
AI-driven collections could reduce bad debt 20% by 2027.
04
Medicaid expansion to cut bad debt 15% by 2025.
05
Inflation to drive bad debt up 7% annually to 2028.
06
Self-pay bad debt projected at 45% of total by 2026.
07
Rural hospital closures to increase bad debt 25% by 2025.
08
Tech investments to recover 25% more bad debt by 2027.
09
Uninsured rate drop to lower bad debt $10B by 2026.
10
Commercial denial rates to boost bad debt 10% by 2025.
11
Patient financial engagement to cut bad debt 18% post-2024.
12
Bad debt per discharge expected $1,500by 2028.
13
75% of hospitals predict bad debt rise in 2025 survey.
14
Regulatory changes to reduce bad debt 12% by 2026.
15
Economic recession to add $15B bad debt by 2027.
Interpretation
Future Projections And Factors Interpretation
Under Future Projections And Factors, hospital bad debt is expected to grow to $60B by 2025 and average 3.5% of revenue through 2026, but AI-driven collections could cut it 20% by 2027 while inflation pushes it up 7% annually to 2028 and self-pay could reach 45% of the total by 2026.
More related reading
04 · Category
Historical Trends14 stats
01
Hospital bad debt rose 10% annually from 2018-2022.
02
Bad debt was 2.1% of revenue in 2015, up to 3.0% in 2020.
03
From 2019-2021, national bad debt increased 22%.
04
Pre-COVID bad debt averaged 2.5% (2017-2019).
05
2016 hospital bad debt totaled $38 billion nationally.
06
Bad debt growth slowed to 5% from 2015-2018.
07
In 2014, average recovery rate was 18%.
08
2020 saw 28% spike in bad debt due to pandemic.
09
From 2012-2019, bad debt per hospital doubled.
10
2013 national bad debt $35.2 billion.
11
Bad debt as % revenue stable at 2.9% 2016-2018.
12
2017 rural bad debt rose 11% YoY.
13
Pre-ACA bad debt averaged 4.5% in 2010.
14
2019 bad debt recovery improved to 16%.
Interpretation
Historical Trends Interpretation
Under the Historical Trends lens, hospital bad debt climbed steadily from 2015 to 2022, rising from 2.1% of revenue in 2015 to 3.0% in 2020 and then growing 10% annually from 2018 to 2022, with slower growth at 5% from 2015 to 2018 showing the acceleration that followed.
05 · Category
Us National Averages29 stats
01
U.S. hospitals reported $49.7 billion in bad debt expenses in 2021.
02
Bad debt accounted for 2.8% of net patient revenue for U.S. hospitals in 2022.
03
Nationwide hospital bad debt write-offs increased by 12% from 2020 to 2021.
04
Average bad debt per U.S. hospital was $4.2 million in 2020.
05
65% of U.S. hospitals saw bad debt rise post-COVID in 2022.
06
National bad debt recovery rate for hospitals averaged 15% in 2023.
07
U.S. hospital bad debt totaled 3.1% of gross revenue in FY2022.
08
Bad debt expense grew 8% year-over-year nationally in 2021.
09
72% of U.S. hospitals reported bad debt over 2% of revenue in 2022.
10
National average days in A/R for bad debt was 120 days in 2023.
11
U.S. hospitals' bad debt as % of collections was 4.1% in 2020.
12
Bad debt provisions reached $54 billion across U.S. hospitals in 2022.
13
55% of national bad debt linked to commercial payers in 2021.
14
Average bad debt per inpatient stay nationally was $1,200in 2022.
15
U.S. bad debt rate hit 5.2% for uninsured patients in 2023.
16
National hospital bad debt expense per bed was $280,000in 2021.
17
68% of U.S. hospitals collect less than 20% of bad debt in 2022.
18
Bad debt from self-pay patients averaged 40% of total in 2021 nationally.
19
U.S. average bad debt reserve was 3.5% of revenue in FY2023.
20
National bad debt growth was 15% from 2019-2022.
21
U.S. hospitals reported $49.7 billion in bad debt expenses in 2021.
22
Bad debt accounted for 2.8% of net patient revenue for U.S. hospitals in 2022.
23
Nationwide hospital bad debt write-offs increased by 12% from 2020 to 2021.
24
Average bad debt per U.S. hospital was $4.2 million in 2020.
25
65% of U.S. hospitals saw bad debt rise post-COVID in 2022.
26
National bad debt recovery rate for hospitals averaged 15% in 2023.
27
U.S. hospital bad debt totaled 3.1% of gross revenue in FY2022.
28
Bad debt expense grew 8% year-over-year nationally in 2021.
29
72% of U.S. hospitals reported bad debt over 2% of revenue in 2022.
Interpretation
Us National Averages Interpretation
Across US national averages, hospital bad debt remains a meaningful and worsening burden, with write-offs up 12% from 2020 to 2021 and bad debt rising for 65% of hospitals in 2022, while only an average 15% recovery rate was seen in 2023.
report visual · Key figures
Bad debt rate varies by hospital type
Different hospital types show meaningfully different bad debt rates (as a share of revenue) across recent years.
2.9%
Bad debt for community hospitals averaged 2.9% in 2022.
4.2%
Teaching hospitals reported 4.2% bad debt rate in 2021.
5.1%
Rural hospitals had 5.1% bad debt as % of revenue in 2022.
6.8%
Critical access hospitals saw 6.8% bad debt rate in 2022.
7.2%
Safety-net hospitals had 7.2% bad debt in FY2022.
4.9%
Small hospitals (<100 beds) saw 4.9% bad debt rate in 2023.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Helena Kowalczyk. (2026, February 13). Hospital Bad Debt Statistics. Gitnux. https://gitnux.org/hospital-bad-debt-statistics
MLA
Helena Kowalczyk. "Hospital Bad Debt Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/hospital-bad-debt-statistics.
Chicago
Helena Kowalczyk. 2026. "Hospital Bad Debt Statistics." Gitnux. https://gitnux.org/hospital-bad-debt-statistics.
Sources & references
47 datasets cited across this report