HospSysDigest2015

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F INANCIALS
HOSPI TALS
HOSPITALS/SYSTEMS DIGEST 2015 SANOFI / MANAGED CARE DIGEST SERIES® / WHERE INFORMATION BECOMES INTELLIGENCE.™ 20
IP Facility Charges Are Highest for Type 2 Diabetes Patients With Hypoglycemia
• In 2012 and 2013, average annual inpatient (IP)
facility charges for Type 2 diabetes patients, by
complication, were highest for hypoglycemia
($57,506 and $57,606, respectively).
• Between 2012 and 2013, annual IP facility
charges for such patients grew 1.6% for
retinopathy, 1.1% for cardiovascular disease and
fractionally for the other profiled complications.
Data source: IMS Health © 2015
Key Takeaway
Hospitals have higher costs than physician practices because, among other things, they provide
24-hour emergency care and safety-net services, treat more complicated cases and so have
significantly more infrastructure to maintain.3 Hospitals attempt to cover these costs with facility
fees, which can be charged only by hospitals or hospital-owned outpatient facilities. However, the
fees—particularly those associated with outpatient facilities—have come under scrutiny recently,
as lawmakers and health care stakeholders seek ways to reduce overall health care costs.
FACILITY CHARGES PER YEAR FOR TYPE 2 DIABETES PATIENTS, BY REGION1
Hospital Outpatient Hospital Inpatient
REGION 2012 2013 2012 2013
West $12,229 $13,008 $44,767 $47,607
Midwest 10,274 10,185 41,060 39,725
South 11,214 11,825 42,778 43,736
Northeast 15,426 14,688 66,586 67,614
NATION $11,969 $12,278 $46,616 $47,363
INPATIENT FACILITY CHARGES PER YEAR FOR TYPE 2 DIABETES PATIENTS,
BY TYPE OF COMPLICATION1,2
1 Figures reflect the charges generated by the facilities that delivered care. The data also reflect the amounts charged, not the amounts paid.
2 A complication is defined as a patient condition caused by the Type 2 diabetes of the patient. These conditions are a direct result of having
Type 2 diabetes. Complications of Type 2 diabetes include, but are not limited to, cardiovascular disease, neuropathy, nephropathy
and retinopathy.
3
$40,000
$45,000
$50,000
$55,000
$60,000
Average Charges
Cardiovascular
Disease
Hypoglycemia Nephropathy Neuropathy Retinopathy Overall
$52,844 $53,443
$57,506 $57,606
$56,224 $56,577
$54,073 $54,355
$48,623 $49,380
$46,616 $47,363
2012 2013
Facility Charges for Type 2 Diabetes Patients Rise Nationally
CHRONIC DISEASE
• From 2012 to 2013, average annual hospital
outpatient facility charges for Type 2 diabetes
patients rose 2.6% nationally, 6.4% in the
West region and 5.4% in the South region.
• Meanwhile, facility charges for such patients
treated in the inpatient setting increased in
the West (6.3%), South (2.2%) and Northeast
(1.5%), but decreased in the Midwest (3.3%).