State of Recovery: H1 2026 Benchmark Report

The useful benchmarks in this industry sit scattered across a hospital finance study, a Federal Reserve household credit report, a cybersecurity survey, and a trade association’s annual member research. Nobody assembles them in one place, so buyers end up quoting a decade-old statistic from a vendor slide.

Two rules for everything below. Every number names its publishing organization. Where a figure is dated, derived, or single-sourced, we say so instead of laundering it.

Collectability by placement age

The oldest and least controversial data in receivables, and the least acted on.

The Commercial Collection Agencies of America publishes a collectability curve that the Credit Research Foundation republishes. It measures the share of a commercial receivable that remains collectable at each month past due.

Between month 1 and month 6, a receivable gives up about 37 points of value. Between month 1 and month 12, 67 points.

Two figures put that in context. Encore Capital Group deployed $1.408 billion on portfolio purchases in FY2025 against $9.684 billion in estimated remaining collections, which is a market pricing expected recovery rather than face value. And in 2022, half of US hospitals and health systems reported more than $100 million in receivables for claims older than six months, per the American Hospital Association, which is to say half the field carries assets past the midpoint of that curve at close to book value.

Volume, liquidity, and operating conditions

TransUnion’s seventh annual Debt Collection Industry Report: Investing For Impact is the primary industry survey.

That volume-and-liquidity pairing is the single most useful finding in the survey. More accounts arriving, each worth less on arrival.

The question measures use or planned deployment, which is broader than deployment in production. Attribute it that way.

Delinquency transitions by product

The Federal Reserve Bank of New York’s Quarterly Report on Household Debt and Credit for Q1 2026 is the reference series for consumer credit conditions.

The same report puts balances by product at mortgage $13.191 trillion, auto $1.685 trillion, student loan $1.658 trillion, credit card $1.252 trillion, and HELOC $0.446 trillion.

One number cuts the other way. The Federal Reserve Board’s credit card charge-off rate was 3.84% in Q1 2026, down from 4.46% a year earlier and falling for five consecutive quarters. Rising delinquency transitions alongside falling charge-offs generally means issuers are holding and working paper longer before it leaves the balance sheet, which pushes older, harder inventory into third-party placement later.

Denials, appeals, and overturn rates

The healthcare numbers are the best-documented in recovery, because healthcare is the only vertical that agreed on definitions.

Read Kodiak and Premier together and the shape is clear. Payers deny more, providers overturn less of what they contest, and Premier puts the share of initially denied claims that eventually get paid at about 70%. Premier’s hospital population is self-selected, as is the New York external appeal population behind the JAMA reversal rates, and both point the same direction: a large volume of denied claims was payable.

Six states enacted laws in 2026 barring insurers from relying on AI as the sole basis for denying care, per Holland & Knight: Alabama, Indiana, Maryland, Utah, Georgia, and Washington, with effective dates running through 2027. California’s SB 1120 already required a licensed physician to make medical necessity determinations, effective January 2025.

Cost to collect

HFMA’s MAP Key FM-6 defines cost to collect as total revenue cycle cost divided by total patient service cash collected. The numerator includes salaries, vendor fees, outsourced services, software maintenance, IT, and legal.

Two honest caveats. There is no published, standardized cost-to-collect benchmark for utilities, telecom, or higher education comparable to HFMA’s. The APQC measure is the only cross-vertical denominator available, and it covers internal collections process cost rather than total recovery cost. And commonly quoted contingency-rate ranges by placement tier and vertical come from trade sources with no audited rate card behind them, so we’ve left them out. The GAO’s documented 25% federal cap is the sturdiest published anchor available.

Third-party breach share and vendor risk

HHS Office for Civil Rights priced its proposed HIPAA Security Rule overhaul at $9 billion in first-year compliance cost across covered entities and business associates. The proposal makes every implementation specification mandatory and requires business associates to notify covered entities within 24 hours of an emergency.

Litigation, complaints, and regulatory posture

One trade tracker, TCPAWorld, reported 330 TCPA cases filed in April 2026 with 255 of them class actions, up 40% year over year. Single-sourced, so treat it as directional against WebRecon’s annual counts.

Structurally, the federal collections enforcer got quieter while private litigation and state law got louder, and FDCPA exposure is capped where TCPA exposure is not.

Market size and structure

Named RCM transactions in 2025, per KPMG Corporate Finance: Access Healthcare at $2.07 billion, CentralReach at $1.85 billion, Iodine Software at $1.25 billion, AGS Health at $1.2 billion, Elevate Patient Financial Solutions at $565 million, and Knack RCM at $500 million. R1 RCM went private in 2024 at $8.9 billion.

Growing markets, shrinking operator count, rising deal sizes. Market-research sizing figures are commercial estimates rather than audited data, and different firms produce materially different numbers for the same market, so use them for direction and not for precision.

What isn’t benchmarked, and should be

Three gaps are worth naming, because their absence shapes how the industry argues.

Nobody has published research on the performance delta between single-agency and multi-agency placement strategies in ARM. Champion-challenger competition is the standard justification for wide panels, and the liquidation difference has never been measured in public.

Nobody has studied net-back in receivables with a citable methodology. Net-back gets discussed in trade press. The closest published analogue is the federal procurement literature on lowest-price-technically-acceptable source selection, which is specific to federal IT.

And outside healthcare, no vertical has agreed on what collecting costs. HFMA’s MAP Key is the only accepted definition in the field, which is why healthcare CFOs are the only recovery buyers who can see the number they’re optimizing.

How to use this

Pick the three or four figures that describe your own book and check yourself against them. The collectability curve tells you what your placement lag is costing. Kodiak’s initial denial and overturn rates tell you whether your denial performance is drifting with the market or against it. The Verizon and HIPAA Journal numbers tell you what share of your risk now sits outside your own walls.

For the argument underneath these numbers, we’ve published three papers: The model is the commodity, The rate is the smallest number on the page, and The seam is the failure point.

Compiled by TSI, August 2026. Figures are reproduced as published by the named organizations, with publication dates given where the underlying data is older than the report. No TSI performance figure appears in this benchmark. Where sourcing is single-tracked, dated, or derived, we’ve said so in the body.