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HOSPITALS/SYSTEMS DIGEST 2015
SANOFI / MANAGED CARE DIGEST SERIES
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WHERE INFORMATION BECOMES INTELLIGENCE
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EXECUT IVE SUMMARY
EXECUT IVE SUMMARY
Hospitals
• After growing from 2010 to 2012, the number
of acute-care hospitals operating nationally
dipped 0.4% in 2013, to 5,214 from 5,233 in 2012.
• Outpatient case counts per hospital increased
for 11 of 12 profiled disease states between
2012 and 2013; conversely, the number of
inpatient cases per hospital decreased for nine.
• The ratio of FTE registered nurses per occupied
bed grew across hospitals of all sizes from 2011
to 2013. Those with 50–119 beds recorded the
largest annual percentage growth (19.8%).
• Average inpatient Medicare charges increased
for 11 of 12 disease states in 2013; average
Medicare reimbursement rose for seven.
• From 2011 ($1,304) to 2013 ($1,406), pharmacy
costs per discharge grew by nearly 8% at
hospitals nationally; these costs per staffed bed
rose by 10.6% over the same two-year period.
Multihospital Systems
• The number of hospitals in multihospital systems
(MHSs) edged up 1.9% in 2013, to 3,367 from
3,304 in 2012. The growth lifted the total share of
MHS-owned hospitals to 64.6% from 63.1%.
• From 2011 to 2013, staffing ratios per occupied
bed for five of 10 full-time-equivalent positions
increased more rapidly in MHS-owned hospitals
than in their non-MHS-owned counterparts.
• Non-MHS HMOs recorded an average number
of hospital days per 1,000 members in 2013
(432.5) that was 7.4% greater than that of their
MHS counterparts (402.8). Both rose since 2011.
• From 2012 to 2013, total revenue shrank 1.7%
(to $482.7 million from $491.0 million) at hospitals
in MHSs that owned HMOs, and 0.2% (to
$464.9 million from $465.8 million) at hospitals in
MHSs that did not own HMOs. Inpatient revenue
decreased at both MHS and non-MHS hospitals.
• From 2012 to 2013, pharmacy expenditures as
a percentage of total operating costs rose to
15.0% from 14.7% for non-MHS HMOs and to
13.2% from 13.1% for MHS-owned HMOs. The
overall portion grew to 14.7% from 14.5%.
Integrated Health Systems
• In 2014, the percentage of hospitals tied to
highly integrated systems reached 46.5%,
an increase of nearly five percentage points
from 41.6% in 2010. The total number of such
networks also rose, to 342 from 335 (2.1%).
• From 2010 to 2014, the number of physician
practices owned by or contracted to highly
integrated health systems climbed 18.2%.
• The number of hospitals owned by or
contracted to highly integrated health systems
increased in 28 states, and by 4.5% overall, to
2,426 nationwide in 2014 from 2,321 in 2013.
• Hospital utilization per short-term staffed bed
decreased between 2012 and 2013 for all
profiled measures in system-affiliated hospitals.
• From 2012 to 2013, average lengths of stay at
system-affiliated hospitals fell in 10 of 20 profiled
markets and were unchanged in five others.
Medical Group Practices
• From 2013 to 2014, the shares of eight profiled
specialty medical group practices affiliated
with integrated systems each rose fractionally;
family practice groups had the highest rate of
affiliation (42.4%), by specialty type, in 2014.
• In 2014, 21.1% of medical group practices
reported 750 or more visits per week,
accounting for at least 34,484 physicians.
• For selected specialty medical group
practices, X-ray services were the most
commonly offered imaging modality in 2014,
with shares topping 90% across five specialties.
• Among medical groups that provided
any pharmacy services, those in systems
were more likely overall (25.6%) to offer
full pharmacy services in 2014 than their
nonsystem counterparts (16.5%).
• The shares of practices that provided
full pharmacy services in 2014 were
largest among those with 20 or more
physicians—52.2% of system-affiliated medical
group practices and 49.3% of unaffiliated
medical group practices.