7
SANOFI / MANAGED CARE DIGEST SERIES
®
/ WHERE INFORMATION BECOMES INTELLIGENCE.
™
HOSPITALS/SYSTEMS DIGEST 2013
HOSPI TALS
Not-for-Profit Hospital Count Gains, but Lags 2009 Mark
• After declining fractionally between 2009 (3,123)
and 2010 (3,099), the number of not-for-profit
hospitals rebounded in 2011, to 3,114, not
enough to recover ground lost the prior year.
• Over the same period, the percentage of
hospitals with a case mix index (CMI) of 1.5 or
higher rose more than four percentage points,
to 24.4% in 2011 from 20.3% two years before.
• Between 2006 and 2011, the not-for-profit
percentages of all U.S. acute-care hospitals
decreased even as the total number of hospitals
increased. The for-profit share (not shown), rose
and fell in concert with the hospital count.
• For example, between 2006 and 2009 the
not-for-profit share of hospitals dropped nearly
two percentage points, to 59.7% from 61.5%,
while the total number of hospitals
increased by 6.5%, to 5,232 from 4,911.
DEMOGRAPHICS
Data source: IMS Health © 2013
Key Takeaway
If the Affordable Care Act’s individual mandate reduces the population of uninsured Americans
as expected, the portion hospitals spend on charity care—a factor used in determining tax
exemption status—may likewise fall. Not-for-profit hospitals whose charity care expense ratios
dip below minimum thresholds (which vary by state) may no longer qualify for this tax status as a
consequence, reducing, in turn, the number of not-for-profit hospitals nationally.
Hospital demographics
1
2009
2010
2011
Ownership type
# of Hospitals % of Hospitals # of Hospitals % of Hospitals # of Hospitals % of Hospitals
Not-for-Profit
3,123
59.7%
3,099
59.8%
3,114
59.8%
For-Profit
885
16.9
872
16.8
883
16.9
Government
1,224
23.4
1,210
23.4
1,214
23.3
SEVERITY
2
CMI <1
871
16.6%
895
17.3%
893
17.1%
CMI 1 to <1.2
1,293
24.7
1,099
21.2
1,099
21.1
CMI 1.2 to <1.5
1,562
29.9
1,496
28.9
1,493
28.7
CMI 1.5+
1,062
20.3
1,274
24.6
1,269
24.4
Severity Unknown
444
8.5
417
8.0
457
8.8
Total
5,232
100.0%
5,181
100.0% 5,211
100.0%
1
Hospital data are based on all short-term, acute-care, nonfederal hospitals and are effective as of end-of-year 2011. Psychiatric, rehabilitation
and children’s hospitals are excluded.
2
Severity is approximated by the case mix index (CMI), which is a statistical measure of the average amount of resources consumed per Medicare
inpatient case at a hospital. Hospitals that tend to treat more resource-intensive (i.e., severe) cases will have a higher calculated CMI.
Not-for-Profit Portion of Hospitals Declines Over the Long-Term
LONG-TERM TREND
TOTAL NUMBER OF HOSPITALS and Not-FOR-PROFIT share of hospitals, 2006–2011
58%
59%
60%
61%
62%
Percentage of Hospitals
4,700
4,850
5,000
5,150
5,300
Number of Hospitals
2006
2007
2008
2009
2010
2011
4,911
5,035
5,148
5,232
5,181
5,211
61.5%
61.2%
60.2%
59.7%
59.8%
59.8%
Total Number of Hospitals
Not-for-Profit Hospital Percentage
I,II,1,2,3,4,5,6 8,9,10,11,12,13,14,15,16,17,...IV