COVID-19 Affected Rural and Urban Hospital Uncompensated Care


Uncompensated care consists of services provided that are never reimbursed, including charity care and unanticipated bad debt. High uncompensated care burden is a concern because it may contribute to smaller operating margins and rural hospital closures. This infographic uses Medicare Cost Report data for all acute care hospitals from the Healthcare Cost Report Information System (excluding Indian Health Services hospitals for which data are unavailable). The analysis includes a balanced panel of hospitals with cost reports for fiscal periods ending on or before 12/31/2021 (n=3,274).

Key Findings:

During COVID-19, compared to urban hospitals:

  • Rural hospitals had smaller reductions in uncompensated care.
  • Rural hospitals had a larger increase in operating expenses.
North Carolina Rural Health Research and Policy Analysis Center
Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink