It’s no secret that while some U.S. hospitals are thriving, others are struggling under the weight of decreasing reimbursement, rising expenses and pressures relative to integrated care.

One source of pressure that hits hospitals particularly dependent on Medicare/Medicaid reimbursement was highlighted in a recent AHA study (pdf).

According to data from the AHA’s Annual Survey of Hospitals, AHA determined that for Medicare, hospitals on average received payment of only 86 cents for every dollar they spent caring for Medicare patients in 2012, while for Medicaid, hospitals on average received payment of only 89 cents for every dollar they spent caring for Medicaid patients in 2012.

Combined underpayments were $56 billion in 2012 (shortfalls of $42.3 billion for Medicare and $13.7 billion for Medicaid).