Indiana Hospitals Owed Over $1 Billion by Insurers, IHA Reports

Unpaid claims and delayed payments create financial strain for healthcare providers across the state.

Apr. 14, 2026 at 8:03pm

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According to the Indiana Hospital Association (IHA), data from 70 hospitals across Indiana shows that they delivered over $717 million in patient care last year that went unpaid by health insurers. IHA estimates the total unpaid care across all hospitals in the state likely exceeds $1.6 billion. This financial strain is causing issues for hospitals, especially rural facilities operating on thin margins.

Why it matters

Underpayments and delayed payments from insurers are creating significant financial challenges for Indiana's hospitals, which could disrupt access to medical care, especially in rural communities. This issue is compounded by rising health insurance premiums that Hoosiers are paying, yet the money does not seem to be reaching the hospitals providing the care.

The details

The IHA says insurers are delaying, denying, or incorrectly processing claims, even for care that is contractually covered. One hospital, Greene County General Hospital, has had to serve Anthem with a breach of notice after months of failed efforts to resolve payment issues. The CEO of Greene County General Hospital said Anthem has acknowledged claims were not handled correctly, but the problem remains unresolved, harming the hospital's operations.

  • In 2025, Indiana hospitals had an operating margin of just 1.9%, below the national median of 2.6%.
  • Last year, Indiana hospitals delivered over $717 million in unpaid patient care.

The players

Indiana Hospital Association (IHA)

The organization representing hospitals across the state of Indiana.

Greene County General Hospital

A rural hospital in Indiana that is taking legal action against Anthem over unpaid claims.

Brenda Reetz

The CEO of Greene County General Hospital.

Scott B. Tittle

The president of the Indiana Hospital Association.

Anthem

A major health insurance provider that Greene County General Hospital is in a dispute with over unpaid claims.

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What they’re saying

“Our data shows hospitals are delivering care but not being reliably paid by insurers, often because claims are delayed, denied, or processed incorrectly even when the care is contractually covered.”

— Scott B. Tittle, President, Indiana Hospital Association

“Anthem has acknowledged that claims were not handled correctly, yet the problem remains unresolved. This has harmed our hospital, likely harmed our patients, and continues to put pressure on our operations.”

— Brenda Reetz, CEO, Greene County General Hospital

“Rural hospitals cannot continue absorbing this kind of payment failure. When reimbursement is suppressed over time, it becomes harder to protect services that our community depends on.”

— Brenda Reetz, CEO, Greene County General Hospital

“Hoosiers are paying more every year for health insurance, so the question is simple: where is that money going?”

— Scott B. Tittle, President, Indiana Hospital Association

“Indiana hospitals are approaching a breaking point.”

— Scott B. Tittle, President, Indiana Hospital Association

What’s next

The IHA and Greene County General Hospital are continuing to push for resolution with insurers over the unpaid claims issue, which could involve further legal action if the problem persists.

The takeaway

This situation highlights the financial strain facing Indiana's hospitals, especially rural facilities, due to insurers not fully reimbursing for provided care. If left unresolved, it could lead to disruptions in access to healthcare services for Hoosiers across the state.