Healthcare Provider Organizations Saw Net Revenue Losses From Final Denials and Bad Debt Grow by 25% in 2025, According to Kodiak Solutions’ Proprietary Data

Revenue cycle efficiencies drove cash flow improvements for the 2,300 hospitals and 375,000 physicians covered by Kodiak’s quarterly revenue cycle benchmarking analysis

INDIANAPOLIS--(BUSINESS WIRE)--The more than 2,300 hospitals on the Kodiak platform lost more than $48 billon in net revenue in 2025 to final denials from payors and uncollected amounts owed by patients, up from $38.6 billion in 2024, according to the latest Kodiak Solutions Revenue Cycle Analytics benchmarking analysis.

The 25% increase in net revenue leakage was driven by increases in the median final denial rate, from 2.5% in 2024 to 2.7% in 2025, and the median bad debt rate, from 1.1% in 2024 to 1.3% in 2025.

Clinical denial rates—covering denials for lack of precertifications or prior authorizations and for medical necessity—accounted for virtually all of the increase in denial rates, according to Kodiak’s analysis.

At the same time, hospitals, health systems and medical providers on the Kodiak platform recorded significant improvements on revenue cycle metrics related to cash flow. The average time to insurance payment, median days for claims in accounts receivable and median accounts receivable greater than 90 days all declined from 2024 to 2025, Kodiak data show.

“Payor behavior led to denial increases and a slight decline in the rate of overturning initial denials, with both driving the large overall increase in net revenue leakage from 2024 to 2025,” said Matt Szaflarski, Vice President, Revenue Cycle Intelligence for Kodiak. “The positive news on cash flow shows that revenue cycle teams can mitigate headwinds with strong performance on the things they can control.”

Kodiak’s data analysis comparing 2025 with 2024 also found:

• The patient responsibility share of net revenue increased from 6.8% in 2024 to 7.3% in 2025.
• Health systems collected less of that patient share, with the rate declining from 45.1% of net revenue in 2024 to 42.4% in 2025.
• Both initial and final claims denials were highly variable by payor category, with Medicaid leading in both categories, although commercial denials contributed more to revenue leakage because commercial health plans pay higher rates.
• Medicare Advantage plans had initial and final denial rates more than double the rates for traditional Medicare.

“In comparing 2024 to 2025, we highlighted five revenue cycle trends, and four of them were negative for financial performance,” Szaflarski said. “In our work with the top performers on the Kodiak platform, however, we identified three best practices that revenue cycle leaders can focus on in 2026: practice tight accounts receivable discipline, focus limited denials resources on preventing clinical denials, and maintain rigor on front-end patient pay processes.”

More data from Kodiak’s “State of the healthcare revenue cycle” analysis and additional detail on these revenue cycle best practices can be found in the quarterly Kodiak RCA Benchmarking Analysis.

About Kodiak Solutions

Kodiak Solutions is a leading technology and tech-enabled services company that simplifies complex business problems for healthcare provider organizations. Over the past two decades, our team created and developed our proprietary net revenue reporting solution, Revenue Cycle Analytics. Kodiak also provides a broad suite of software and services in support of CFOs looking for solutions in financial reporting, reimbursement, revenue cycle, risk and compliance, and unclaimed property. Kodiak’s 450 employees engage with more than 2,300 hospitals and 375,000 practice-based physicians, across all 50 states, and serve as the unclaimed property outsourcing provider of choice for more than 2,000 companies. To learn more, visit Kodiak’s website.