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Medicare and Medicaid underpaid U.S. hospitals by $76.8 billion in 2017, according to the latest data from the AHA's Annual Survey of Hospitals. Underpayment occurs when the payment received is less than the costs of providing care, that is, the amount paid by hospitals for the personnel, technology and other goods and services required to provide hospital care. Medicare underpayments in 2017 totaled $53.9 billion and Medicaid underpayments $22.9 billion.
 
In addition, hospitals in 2017 provided $38.4 billion in uncompensated care meaning care for which no payment was received from the patient or insurer. Uncompensated care is the sum of a hospital's bad debt and the financial assistance it provides, but does not include other unfunded costs of care, such as underpayment from Medicare and Medicaid. It also does not account for other services and programs that hospitals provide to meet identified community needs.