Emergency department visits rose in June and uncompensated care climbed across most of the country, according to Kaufman Hall’s latest “National Hospital Flash Report.”
ED visits were up 4% year over year and 7% from May, the report found. Year to date, they are up 2% from 2025 and 9% from 2023. The report, published Aug. 18, draws on data from more than 1,300 hospitals compiled by Kaufman Hall, a Vizient company.
Kaufman Hall tied the rising volume to “broader payer landscape shifts,” warning that more patients “may rely on EDs for care” as coverage changes take hold — a dynamic that tends to route more uninsured and underinsured patients through the one door hospitals cannot legally close.
That pressure is already in the financial ledgers. Bad debt and charity care rose 23% year over year per calendar day in June and are up 25% year to date, the sharpest run-up in any category the report tracks. Bad debt and charity care per calendar day rose 16% year over year in May and is up 16% year to date compared with the same period in 2025.
Even as volume climbed, hospitals moved patients through faster. Average length of stay fell 3% year over year, while discharges per calendar day rose 5% and equivalent patient days climbed 9%. Observation stays also grew as a share of total patient days, up 2% from a year ago.
Taken together, the figures point to hospitals absorbing heavier — and often lower-paying — demand while leaning harder on discharge planning and care coordination to keep beds turning.
Some systems are moving to get ahead of the shift by expanding federally qualified health center partnerships, patient navigation services and same-day access to keep newly uninsured patients from defaulting to the ED.
The strain is uneven across the country. ED visits rose 12% year to date in the Great Plains, the steepest climb of any of the five regions into which Kaufman Hall separates the nation, while volumes were flat in the South. Rural and critical access hospitals with 25 or fewer beds were the exception: ED visits there fell 1.8% year to date even as their uncompensated care rose 14.4%.
Kaufman Hall said hospital performance continues to vary in 2026, with smaller and rural facilities facing the greatest strain on already thin cash reserves.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
