Eliminating Medicare bad debt payments: are critical access and rural hospitals at risk?

ABSTRACT:

Introduction

While Medicare Allowable Bad Debt (MBD), defined as unpaid patient financial obligations Medicare partially reimburses to hospitals, represents only 0.12% of patient revenue, policymakers and executives should note the $1.7 billion reimbursed in 2022 affects hospitals of different types in various ways (see Appendix 1). The recent passage of the One Big Beautiful Bill Act did not eliminate MBD, but elimination has been proposed, supporting a need to understand what elimination could do to hospitals.

Methods

Using Medicare Cost Reports, we conducted a retrospective, longitudinal analysis of short-term general acute-care hospitals in 2022.Total margin was evaluated with and without MBD by Critical Access Hospital (CAH), rurality, state, and Hospital Referral Regio

SUBMITTER: Williams D 

PROVIDER: S-EPMC12661523 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature