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Hospital Expenses: How Are They Allocated?

How is the average hospital dollar spent? Wages and benefits are the largest expense for hospitals – 59% of total costs. According to an AHA analysis of data from the Centers for Medicare & Medicaid Services, here’s how other hospital expenses are allocated [excluding capital costs]:

Hospital costs by expense type 2012

Source: Chart 6.10: Percent of hospital costs by type of expense, 2012. In: Trendwatch Chartbook 2013. American Hospital Association, Sept. 2013. http://www.aha.org/research/reports/tw/chartbook/2013/chart6-10.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Health Insurance Coverage under the ACA as of June 2014

How has the Affordable Care Act changed insurance coverage for the uninsured? Urban Institute researchers have analyzed changes in the number of uninsured between September 2013 — just before open enrollment in the ACA’s Marketplace started on October 1 — and June 2014. Here’s what they found:

  • The uninsured population dropped by 8 million people, decreasing the American population percentage that’s uninsured from 17.9% to 13.9%.
  • Most of the gain in coverage was among the low and middle income adults targeted by the ACA and in the states that implemented Medicaid expansion.
  • All demographic groups benefited but the biggest gains were for the young, male, and minority adults that typically have had high uninsurance rates.

Who are the remaining uninsured? They were more likely to be low income or in states that did not expand Medicaid coverage. While most had heard about the Marketplaces and the individual mandate, fewer (38%) had knowledge of available subsidies. Financial reasons was the most frequent explanation given for lack of coverage.


Long SK and others. Taking stock at mid-year: health insurance coverage under the ACA as of June 2014. Health Reform Monitoring Survey, Urban Institute Health Policy Center, July 29, 2014. http://hrms.urban.org/briefs/taking-stock-at-mid-year.pdf

Shartzer A and others. Who are the remaining uninsured as of June 2014. Health Reform Monitoring Survey, Urban Institute Health Policy Center, July 29, 2014. http://hrms.urban.org/briefs/who-are-the-remaining-uninsured-as-of-june-2014.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Finding Quality Doctors: What the Public Thinks

What do Americans think about the available information to assist them in finding quality doctors? Here are key finding from a recent survey by the Associated Press and the NORC Center for Public Affairs Research:

  • When it comes to what makes a high or low quality provider,  most consumers focus on doctor-patient interactions or physician personality traits rather than effectiveness of care or their personal health outcomes.
  • Friends and family remain the most trusted source for providing quality information about doctors or other providers
  • About half of the public links higher quality to higher cost.
  • While many Americans are not confident they could locate quality information about doctors, even more have trouble finding health care costs for decision-making.

Source: Finding quality doctors: how Americans evaluate provider quality in the United States. Associated Press; NORC, July 2014. http://www.apnorc.org/PDFs/Finding%20Quality%20Doctors/Finding%20Quality%20Doctors%20Research%20Highlights.pdf

Related Sources:

Lynch W and others. Altarum Institute survey of consumer health care opinions. Altarum Institute, Fall 2013, revised Jan. 8, 2014 [includes information sources used to find a doctor and seeking cost and quality information]. http://altarum.org/sites/default/files/uploaded-related-files/Altarum%20Fall%202013%20Survey%20of%20Consumer%20Opinions.pdf Other Altarum Institute consumer surveys: http://altarum.org/research-centers/center-for-consumer-choice-in-health-care/semi-annual-consumer-survey-results

Fox S and Duggan M. Health online 2013. Pew Research Internet Project, Jan. 13, 2013. http://www.pewinternet.org/2013/01/15/health-online-2013/

Sarasohn-Kahn J. Consumer trust in health care: online information trumps health plans. HealthPopuli.com, May 21, 2012. http://healthpopuli.com/2012/05/21/consumer-trust-in-health-care-online-information-trumps-health-plans/

Deloitte 2012 Survey of U.S. health care consumers. INFOBrief: Information technology, social media and online resources for health care – a slow climb. Deloitte, 2012. http://www.deloitte.com/view/en_US/us/Industries/US-federal-government/center-for-health-solutions/acd4509

Posted by AHA Resource Center (312) 422-2050, rc@aha.org





Achieving Price Transparency for Consumers: a Hospital Toolkit

The American Hospital Association has released a new toolkit to help hospitals address price transparency. After discussing the what and why of price transparency, the toolkit recommends these action steps:

  1. Put yourself in the shoes of the consumer
  2. Train your staff
  3. Make information meaningful
  4. Know how your information compares to others — not just hospitals but other providers — in its accessibility and usefulness
  5. Tap your community for help

A self-assessment checklist is included for further help, followed by case examples from nine providers, sample web-based tools, and additional resources.

Source: Transparency for consumers: a hospital toolkit. American Hospital Association, July 2014. http://www.ahacommunityconnections.org/content/14transparencytoolkit.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

How many physicians have licenses in more than one state?

PHYSICIANS WITH ACTIVE LICENSES (2012): includes MDs and osteopaths

[The following includes some of my calculations based on the original source material.]

  • 684,991 (78%) held just one active license
  • 140,511 (16%) held licenses in two jurisdictions
  •   52,692 (6%) held licenses in three or more jurisdictions
  • 878,194 total (100%) held active license to practice

There were about 300 physicians, many of whom are probably practicing telemedicine, who had active licenses to practice in 25 or more jurisdictions.

Source: Steinbrook, R.  Interstate medical licensure: major reform of licensing to encourage medical practice in multiple states.  JAMA, July 28, 2014.  Click here for access to this article:  http://jama.jamanetwork.com/article.aspx?articleID=1892303&utm_source=Silverchair%20Information%20Systems&utm_medium=email&utm_campaign=JAMA%3AOnlineFirst07%2F28%2F2014   Posted by AHA Resource Center (312) 422-2050, rc@aha.org



Top 10 biggest ACOs (accountable care organizations)

Here are the top 10 largest accountable care organizations according to the number of covered lives, starting with the largest first:

  1. Advocate Health Care (Downers Grove, IL)
  2. Partners HealthCare (Boston, MA)
  3. Allina Health (Minneapolis, MN)
  4. Banner Health Network (Phoenix, AZ)
  5. UnityPoint Health Partners, West Des Moines, IA)
  6. Bellin-ThedaCare Healthcare Partners (Green Bay, WI)
  7. MichCare (Rochester, MI)
  8. OSF HealthCare System (Peoria, IL)
  9. Atlantic Accountable Care Organization (Morristown, NJ)
  10. Physician Organization of Michigan ACO (Ann Arbor, MI)

Source: Ranking of respondent ACOs by covered lives.  Modern Healthcare.  44(28):S2, July 14, 2014.  Click here for access to the article: http://www.veritasmrs.com/pdfs/ModernHealthcare-ACOSurvey-20140714.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Over half of Americans live in an area covered by an ACO

Characteristics of local areas that are served by accountable care organizations (ACOs) were studied based on the 227 ACOs identified as of August 2012.  The findings were that over half (55 percent) of Americans live in an area served by one or more ACOs.  Characteristics of areas that are MORE likely to have attracted the formation of ACOs include:

  • High-cost areas
  • High-performing on quality measures
  • Fewer physician groups in the market
  • Affluent and urban areas

The policy implications of this study stem from the observation that “ACOs may be less likely to form in regions where it may be less difficult to achieve savings or meet quality benchmarks.” (p. 1855).

Source: Lewis, V.A., Colla, C.H., and others.  Accountable care organizations in the United States: market and demographic factors associated with formation.  Health Services Research.  48(6, Part 1):1840-1858, Dec. 2013.  Click here to access publisher’s website:  http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12102/abstract.  Posted by AHA Resource Center (312) 422-2050, rc@aha.org




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