Uncompensated Care

Healthcare services provided to patients who are unable to pay and have no insurance or whose insurance does not fully cover the cost of care. Uncompensated care includes both charity care (provided with no expectation of payment) and bad debt (billed but unpaid). It represents a major financial burden for rural CCBHCs, community paramedicine programs, and doula services, all of which receive dedicated RHTP funding to address this cost.

Uncompensated care is a structural subsidy embedded in the rural health system — providers absorb costs that the payment system does not cover, creating perpetual financial fragility. The RHTP's targeted uncompensated care funds for community paramedicine and doula services are designed to bridge this gap while new billing pathways are established through SPAs and Medicaid policy changes. For telehealth infrastructure broadly, reducing uncompensated care through expanded Medicaid coverage and new billable service codes is essential to making the rural health system financially sustainable. Portal deployments are most viable in communities where telehealth services are billable through Medicaid, Medicare, or private insurance, ensuring a revenue stream that can support ongoing operations.