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The stock price of R1 RCM tanked by roughly 50% this week after the large medical billing and collections company reported an unexpected $30 million loss in the third quarter.

R1’s revenue fell in part because health insurers have taken longer to pay claims to R1’s hospital and physician clients, and because it’s been more difficult to collect on patient bills. R1 also has stumbled with taking over the billing operations of a couple large physician groups. Those factors, among others, ultimately sapped the company’s profit, lowered expectations for next year’s profit, and resulted in Wall Street erasing $3 billion of its market value.

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