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HOSPITALS/SYSTEMS DIGEST 2013
SANOFI / MANAGED CARE DIGEST SERIES
®
/ WHERE INFORMATION BECOMES INTELLIGENCE.
™
Execut ive Summary
Hospitals
• The total number of short-term, acute-care,
nonfederal hospitals in the nation rebounded
in 2011, to 5,211, following a modest 1.0%
drop to 5,181 facilities in 2010.
• Inpatient case counts rose for all 12 disease
states tracked between 2010 and 2011, with
inpatient breast (10.5%) and prostate cancer
(8.6%) case counts growing at the highest rates.
• From 2010 to 2011, the number of outpatient
cases per hospital rose for all 12 of the disease
states highlighted, while inpatient cases per
hospital declined for seven of those diseases.
• In 2011, hospitals overall reported increased
total costs per admission, to $21,427 from
$20,844 in 2010. This 2.8% growth was the
lowest increase of the past six years.
• For each of the 12 disease states profiled,
inpatient Medicare charges per case grew
by at least 4% between 2010 and 2011.
Medicare reimbursements likewise expanded
over this time, but did not keep pace.
Multihospital Systems
• The number of hospitals in multihospital
systems (MHSs) has grown annually since 2004
and climbed 8.5% from 2010 (2,944) to 2011
(3,195)—the highest rate in more than 10 years.
• For MHS hospitals and non‑MHS hospitals alike,
growth in total costs per occupied bed topped
3% in 2011. This cost exceeded $1.7 million
at MHS hospitals but remained higher at
non-MHS counterparts.
• On average, non-MHS facilities recorded fewer
inpatient cases in 2011 than in 2010 for 12
common disease states; for all but one of these
diseases, this average dropped at least 20%.
• In 2011, hospitals in MHSs that owned HMOs
staffed more full-time equivalent registered
nurses per occupied bed (2.62) than hospitals
in MHSs not owning HMOs (2.42).
• Total revenue for hospitals in MHSs owning
HMOs slipped 5.4% between 2010 and 2011,
but an increasing percentage of that
revenue (43.4%, up from 42.5%) came from
outpatient cases.
Integrated Health Systems
• In 2012, the total number of hospitals in
highly integrated systems edged up to
2,240 from 2,234 in 2011, the fifth consecutive
annual increase.
• Between 2011 and 2012, the total number of
provider units either contracted to or owned
by highly integrated systems climbed 5.6%,
with physician offices accounting for the
greatest such increase, by facility type, at 8.7%.
• Outpatient case counts for 12 common disease
states rose at U.S. hospitals, regardless of system
affiliation, but system-tied hospitals had higher
growth rates than nonsystem hospitals for the
majority of these diseases.
• For the fifth consecutive year, hospitals
affiliated with highly integrated health systems
in 2011 reported more admissions, patient-days,
outpatient visits and total surgical operations
than their nonsystem counterparts.
• By most measures, pharmacy utilization
was lower at in-system HMOs than at
their nonsystem peers in 2011. These gaps in
utilization between system and nonsystem HMOs
widened for most metrics in 2011.
Medical Group Practices
• Of the nation’s nearly 13,000 medical group
practices with five or more physicians, nearly
28% (3,594) belonged to integrated systems in
2012. Since 2001 (2,014), the number of system-
affiliated practices has jumped by nearly 80%.
• The total number of medical group practices
with 20 or more full-time equivalent (FTE)
physicians increased by 3.5% between 2011
(1,493) and 2012 (1,545).
• More than 43% of family practice groups—the
specialty most likely to integrate—were part of
an integrated health system in 2012. Meanwhile,
the share of general surgery groups in systems
rose 4.2 percentage points in 2012.
• Although the percentage of system-affiliated
medical group practices with full pharmacy
services declined between 2011 (25.3%) and
2012 (22.8%), it still exceeded the corresponding
share for nonsystem groups in 2012 (16.8%).
EXECUT IVE SUMMARY
I,II,1,2,3 5,6,7,8,9,10,11,12,13,14,...IV