ZBA: The Most Overlooked Lever in Hospital Margin Improvement

Apr 19, 2026

Zero balance accounts are often treated as “done.” But what if they’re not?

In this conversation, VP of Provider Operations David Gaffey explores why 0.5%–1.5% of net patient revenue can remain hidden in accounts that providers assume are fully resolved—and why most organizations lack the operational structure to go back and find it.

This discussion unpacks:

  • Why revenue cycle teams are built to move forward, not look back
  • How payers continue validating after payment (and providers typically don’t)
  • The financial impact of ZBA recoveries hitting directly to the bottom line
  • The key questions CFOs and revenue leaders should be asking today
  • Why ZBA isn’t just recovery, it’s a diagnostic tool for systemic breakdowns

The takeaway is simple: zero balance doesn’t mean zero value. And for organizations operating on thin margins, even a 50–100 basis point lift can be a game changer.