Nationally, the gap is $7.23B a year.

By state

Tap any state for its full rankings. Some states have very few filers — Utah has 4, Wyoming 5 — so their medians move on a single hospital and should be read with that in mind. A hospital system appears in every state where it operates a facility — so these do not sum to the national figure. See the note below.

Read this before you quote the number

• Two different universes. The national figure counts each filer once (1,794 filers). The state table counts a filer in every state where it operates a hospital, which is how a patient would ask the question — so multi-state systems appear more than once and the state rows sum to more than the national total. Ohio’s $584.9M here is the same figure published on our launch counter, to the dollar.
• Mixed fiscal years. Each filer at its own latest filed year (FY2019–FY2025, mostly FY2023–24).
• Demographics matter. A hospital in a wealthy, fully insured area legitimately has fewer patients to forgive. That is why we publish bad debt, trend, and eligibility beside charity, and why the methodology page lists five real weaknesses of this percentage.
• Not claimable dollars. This is a benchmark-relative aggregate. It implies no individual entitlement and no specific patient is owed anything by it.
• The benchmark has a seam. The 2.3% standard comes from published literature drawing partly on Medicare cost reports. Measured with our own ruler — same filings, same parser — the sector median is about 1.0%. We show both.

States where most filers sit above the average — Texas, Tennessee, Georgia, Mississippi, Florida — have small gaps here. That is a real finding, not a data error: those states’ hospitals report much higher charity care, often because of state-level charity care requirements or larger uninsured populations.