Urban Institute: Medical Debt Landscape

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Details medical debt in collections estimates
Topics medical debt in collections, hospital market concentration, hospital closures and mergers
Source Urban Institute
Years Available 2011-2023
Geographies County, State
Public Edition or Subscriber-only Public Edition
Download Available yes
For more information https://apps.urban.org/features/medical-debt-over-time/
Last updated on PolicyMap September 2025

Description:

This dataset provides national, state, and county-level information on medical debt in collections, along with related measures such as hospital market concentration, hospital closures and mergers, uninsured population, disabled adults, and average household income. Medical debt estimates come from the Urban Institute Credit Bureau Panel, which includes a 2% random sample of consumers from 2011-2019 (over 5 million individuals per year) and a 4% sample from 2020-2023 (over 10 million per year). Hospital market concentration is derived from the American Hospital Association Annual Survey Database, closures and mergers from the CMS Provider of Services File, and demographic data—including uninsured rates, disabled adults, household income, and racial composition—from the U.S. Census Bureau’s American Community Survey (ACS). One-year ACS estimates are used for national and state statistics, while five-year estimates are used for counties and ZIP Code Tabulation Areas (ZCTAs).

Since the credit bureau data do not include race or ethnicity, measures for white communities and communities of color are assigned based on the racial composition of ZCTAs. White community values represent areas where at least 50% of residents are non-Hispanic white, and communities of color represent areas where at least 50% of residents are Black, Hispanic, Asian or Pacific Islander, American Indian or Alaska Native, multiracial, or other non-white groups. Values may be suppressed (“Insufficient Data”) if fewer than 50 individuals are represented or if no majority-race ZCTAs exist in a geographic area.

Notes: Starting in 2022, paid medical collections, collections less than a year old, and collections under $500 are excluded from credit reports. The median medical debt indicator appears to spike in 2023; this increase largely reflects these reporting changes, as only larger debts remain in the dataset. Additionally, as of August 2023, Colorado excludes all medical debt from credit reports.

Citation: Fredric Blavin, Breno Braga, Noah Johnson, Apueela Wekulom. 2024. The Changing Medical Debt Landscape in the United States. Accessible from https://datacatalog.urban.org/dataset/changing-medical-debt-landscape-united-states.

Available Data Layers & Indicators (102)
Estimated hospital market concentration (HHI) in 2011.
Estimated hospital market concentration (HHI) in 2012.
Estimated hospital market concentration (HHI) in 2013.
Estimated hospital market concentration (HHI) in 2014.
Estimated hospital market concentration (HHI) in 2015.
Estimated hospital market concentration (HHI) in 2016.
Estimated hospital market concentration (HHI) in 2017.
Estimated hospital market concentration (HHI) in 2018.
Estimated hospital market concentration (HHI) in 2019.
Estimated hospital market concentration (HHI) in 2020.
Estimated hospital market concentration (HHI) in 2021.
Estimated hospital market concentration (HHI) in 2022.
Estimated median amount of medical debt in collections in 2011.
Estimated median amount of medical debt in collections in 2012.
Estimated median amount of medical debt in collections in 2013.
Estimated median amount of medical debt in collections in 2014.
Estimated median amount of medical debt in collections in 2015.
Estimated median amount of medical debt in collections in 2016.
Estimated median amount of medical debt in collections in 2017.
Estimated median amount of medical debt in collections in 2018.
Estimated median amount of medical debt in collections in 2019.
Estimated median amount of medical debt in collections in 2020.
Estimated median amount of medical debt in collections in 2021.
Estimated median amount of medical debt in collections in 2022.
Estimated median amount of medical debt in collections in 2023.
Estimated median amount of medical debt in collections in communities of color in 2011.
Estimated median amount of medical debt in collections in communities of color in 2012.
Estimated median amount of medical debt in collections in communities of color in 2013.
Estimated median amount of medical debt in collections in communities of color in 2014.
Estimated median amount of medical debt in collections in communities of color in 2015.
Estimated median amount of medical debt in collections in communities of color in 2016.
Estimated median amount of medical debt in collections in communities of color in 2017.
Estimated median amount of medical debt in collections in communities of color in 2018.
Estimated median amount of medical debt in collections in communities of color in 2019.
Estimated median amount of medical debt in collections in communities of color in 2020.
Estimated median amount of medical debt in collections in communities of color in 2021.
Estimated median amount of medical debt in collections in communities of color in 2022.
Estimated median amount of medical debt in collections in communities of color in 2023.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2011.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2012.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2013.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2014.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2015.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2016.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2017.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2018.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2019.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2020.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2021.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2022.
Estimated median amount of medical debt in collections in majority White, non-Hispanic communities in 2023.
Estimated number of hospital closures or mergers in 2011.
Estimated number of hospital closures or mergers in 2012.
Estimated number of hospital closures or mergers in 2013.
Estimated number of hospital closures or mergers in 2014.
Estimated number of hospital closures or mergers in 2015.
Estimated number of hospital closures or mergers in 2016.
Estimated number of hospital closures or mergers in 2017.
Estimated number of hospital closures or mergers in 2018.
Estimated number of hospital closures or mergers in 2019.
Estimated number of hospital closures or mergers in 2020.
Estimated number of hospital closures or mergers in 2021.
Estimated number of hospital closures or mergers in 2022.
Estimated percent of adults with medical debt in collections in 2011.
Estimated percent of adults with medical debt in collections in 2012.
Estimated percent of adults with medical debt in collections in 2013.
Estimated percent of adults with medical debt in collections in 2014.
Estimated percent of adults with medical debt in collections in 2015.
Estimated percent of adults with medical debt in collections in 2016.
Estimated percent of adults with medical debt in collections in 2017.
Estimated percent of adults with medical debt in collections in 2018.
Estimated percent of adults with medical debt in collections in 2019.
Estimated percent of adults with medical debt in collections in 2020.
Estimated percent of adults with medical debt in collections in 2021.
Estimated percent of adults with medical debt in collections in 2022.
Estimated percent of adults with medical debt in collections in 2023.
Estimated percent of adults with medical debt in collections in communities of color in 2011.
Estimated percent of adults with medical debt in collections in communities of color in 2012.
Estimated percent of adults with medical debt in collections in communities of color in 2013.
Estimated percent of adults with medical debt in collections in communities of color in 2014.
Estimated percent of adults with medical debt in collections in communities of color in 2015.
Estimated percent of adults with medical debt in collections in communities of color in 2016.
Estimated percent of adults with medical debt in collections in communities of color in 2017.
Estimated percent of adults with medical debt in collections in communities of color in 2018.
Estimated percent of adults with medical debt in collections in communities of color in 2019.
Estimated percent of adults with medical debt in collections in communities of color in 2020.
Estimated percent of adults with medical debt in collections in communities of color in 2021.
Estimated percent of adults with medical debt in collections in communities of color in 2022.
Estimated percent of adults with medical debt in collections in communities of color in 2023.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2011.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2012.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2013.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2014.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2015.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2016.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2017.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2018.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2019.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2020.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2021.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2022.
Estimated percent of adults with medical debt in collections in majority White, non-Hispanic communities in 2023.