Hospitals across the country are navigating an industry-wide financial crisis with no clear end in sight. According to the American Hospital Association, since 2000, they have delivered nearly $745 billion in uncompensated care, driven by a growing uninsured population, higher out-of-pocket costs for insured patients, and deep Medicaid cuts — approaching a trillion dollars¹ — alongside redetermination challenges.

The strain doesn’t stop there. Administrative costs are climbing due to burdensome commercial payer practices, shifting regulations, inflation, chronic staffing shortages, and persistent supply chain disruptions. Add in economic uncertainty, including tariffs, and hospitals are facing a perfect storm that threatens their ability to sustain operations and deliver high-quality patient care.

Investigation Reveals Pathways to Compensation

Uncompensated care is a deceptive, catch-all term that belies the range of underlying causes for non-payment, from indigence to claim denials. In the latter case, a significant portion of injury-related claims can and should be reimbursed through third-party liability coverage; the trick is to find it.

Identifying third-party medical coverage (also known as subrogation) instead of or in addition to primary health insurance is time-consuming. It requires countless phone calls, manual research, and making sense of incomplete patient questionnaires. Patients may not provide or even know whether they have coverage.

Even the most diligent billing teams may find themselves grasping at straws and troubleshooting errors. Indeed, according to Intellivo, only 59% of motor vehicle accidents, the most common type of subrogation event, are billed to the appropriate payer. Failure to identify the proper payer leads to claim denials and misclassification of patients as self-pay. Over time, these errors erode operating margins, potentially triggering staff and service reductions or eliminations.

Hospitals must capture every possible dollar of revenue for services rendered if they hope to bridge funding gaps and push toward profitability.

^{1American Hospital Association website, February 2022, https://www.aha.org/fact-sheets/2020-01-06-fact-sheet-uncompensated-hospital-care-cost. Accessed 17 Sept. 2025.}