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Health Care Collection Statistics

Facts and statistics about health care debt and collections

Average Recovery Rates

  • Hospitals – 15.3 percent. (Source: ACA International’s Top Collection Markets Survey*, Jan. 1 – Dec. 31, 2013.)
  • Non-hospitals – 21.8 percent. (Source: ACA International’s Top Collection Markets Survey, Jan. 1 – Dec. 31, 2013.)

Uncompensated Care/Bad Debt

  • U.S. hospitals provided $45.9 billion in uncompensated care in 2012, representing 6.1 percent of annual hospital expenses.(Source: American Hospital Association, “Uncompensated Hospital Care Cost Fact Sheet,” January 2014.)
  • U.S. hospitals reported that 5.32 percent of their total fourth quarter gross revenue was written off as charity care or bad debt, compared to 5.44 percent in the third quarter of 2014. Of the 5.32 percent written off as uncollectible, 3.26 percent was for bad debt and 2.06 percent was for charity care expenses. The Southeast region of the U.S. had the highest percentage of total uncollectable accounts at 8.32 percent. (Source: The Hospital Accounts Report Analysis on Fourth Quarter 2013.)


  • The percentage of people without health insurance declined from 15.7 percent in 2011 to 15.4 percent in 2012. The total number of uninsured decreased only slightly from 48.6 million in 2011 to 48.0 million in 2012. (Source: The U.S. Census Bureau, “Income, Poverty and Health Insurance Coverage in the United States: 2012.”)
  • The number of people with health insurance increased to 263.2 million in 2012 from 260.2 million in 2011, as did the percentage of people with health insurance (84.6 percent in 2012, 84.3 percent in 2011.) (Source: The U.S. Census Bureau, "Income, Poverty, and Health Insurance Coverage in the United States: 2012.)
  • The proportion of the foreign-born population without health insurance in 2012 was about two-and-a-half times that of the native-born population. The uninsured rate declined for the foreign-born population between 2011 and 2012, while the 2012 rate was not statistically different from the 2011 rate for naturalized citizens and noncitizens. (Source: The U.S. Census Bureau, “Income, Poverty and Health Insurance Coverage in the United States: 2012.”)
  • As of 2012, 75 million people reported problems paying their medical bills or were paying off medical debt, up from 73 million in 2010 and 58 million in 2005. An estimated 48 million people were paying off medical debt in 2012, up from 44 million in 2010 and 37 million in 2006 (Source: Press Release, The Commonwealth Fund.)
  • The number of Americans under age 65 who did not have insurance at the time of interview in 2013 was 44.8 million, 39.6 million for ages 18-64 and 4.8 million for children under age 18. (Source: Centers for Disease Control and Prevention Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-June 2013.)  


  • In 2013, annual premiums for families covered by employer-sponsored health insurance were $16,351 and $5,884 for individuals. Family premiums rose 4 percent since 2012. Over the last 10 years, the average premium for family coverage has increased 80 percent. (Source: the 2013 Employer Health Benefits survey, the Kaiser Family Foundation and the Health Research and Educational Trust (HRET), January-May 2013.)


  • The percentage of covered workers enrolled in a plan with a general annual deductible increased to 78 percent in 2013.  More than half (58 percent) of covered workers at small firms with 3 to 199 employees now have a deductible of $1,000 or more. (Source: the 2013 Employer Health Benefits survey, the Kaiser Family Foundation and the Health Research and Educational Trust (HRET), January-May 2013.)

Cost of Care

  • In 2012, 41 percent of adults (ages 19-64) reported that they had medical debt or trouble paying medical bills. Of those who reported difficulties paying medical bills or paying off medical debt, 42 percent (32 million people) said they received a lower credit rating as result of unpaid medical bills. (Source: The Commonwealth Fund Biennial Health Insurance Survey 2012, April 2013.)
  • For individuals with greater levels of obesity, lifetime medical costs are higher, ranging from $15,000 to $29,000 more than for normal weight individuals. (Source: RTI International and Merck & Co., May 29, 2008.)

Electronic Medical Records

  • Although U.S. primary care doctors’ use of electonic medical records increased from 46 percent in 2009 to 69 percent in 2012, the U.S. lags far behind other leading countries, where more than 90 percent of doctors use electronic records. (Source: Press Release, The Commonwealth Fund, November 15, 2012.)

Access to Care

  • In 2012, 43 percent of adults, or 80 million people, said they had skipped or delayed getting needed health care or filling prescriptions because of the cost. This is an increase from 75 million people who reported such problems in 2010, and 64 million in 2005. More than a quarter (28 percent) of adults with a chronic health condition said they had skipped doses or not filled a prescription for their health condition because of the cost. (Source: The Commonwealth Fund Biennial Health Insurance Survey 2012, April 2013.)

Enrollment in Health Plans

  • Enrollment in consumer-directed health plans rose 15 percent in 2013 to 45 million covered workers, up from 39 million workers in 2012. (Source: American Association of Preferred Provider Organizations Survey of Consumer-Directed Health Plans 2013, June 10, 2014.)
  • Fifty-seven percent of covered workers are enrolled in PPO plans, which are the most common type. Twenty percent of covered workers are enrolled in an HDHP/SO plan, 14 percent have an HMO and 9 percent are enrolled in a POS plan. Enrollment in HDHP/SOs increased significantly between 2009 and 2011, from 8 percent to 17 percent of covered workers, but has plateaued since then. Enrollment distribution varies by firm size, for example, PPOs are relatively more popular for covered workers at large firms (200 or more workers) than smaller firms (62 percent vs. 47 percent)  and POS plans are relatively more popular among smaller firms than large firms (16 percent vs. 5 percent). (Source: The 2013 Employer Health Benefits Survey, the Kaiser Family Foundation and the Health Research and Educational Trust (HRET), August 2013.)

Health Care Spending

  • Health care spending in the United States grew 3.7 percent in 2012, to $2.8 trillion, or $8,915 per person. 2012 marked the fourth consecutive year of slow growth in health care spending. The share of the economy devoted to health spending decreased from 17.3 percent in 2011 to 17.2 percent in 2012, as the Gross Domestic Product increased nearly one
    percentage point faster than health care spending at 4.6 percent. (Source: Centers for Medicare and Medicaid Services, National Health Expenditures 2012 Highlights.)

*To purchase the 2013 Top Collection Markets results, please contact ACA’s Member Services Department at (952) 926-6547. You can also visit our online store.



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