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10 Concerns and Trends Facing Hospitals Right Now

Becker’s Hospital Review has identified these 10 current trends facing hospitals and briefly explains each:

  1. Growth in high-deductible plans
  2. Accountable care organization growth
  3. Intensity of rivalries
  4. Reduced inpatient procedures
  5. Layoffs
  6. Narrow networks
  7. Shift from fee-for-service to population health/managed care
  8. Hugh growth in health IT spending
  9. Competition for physicians
  10. Staying independent

Source: Becker S and Gamble M. 10 concerns and trends facing hospitals right now. Becker’s Hospital Review, July 17, 2014. http://www.beckershospitalreview.com/leadership-management/10-concerns-and-trends-facing-hospitals-right-now.html

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

Hospitals slowing in physician practice acquisitions?

The deals practice at PricewaterhouseCoopers provides a periodic report on the volume of mergers and acquisitions in the health care sector.  In this report on the First Quarter 2014, PwC notes that the number of hospital mergers and acquisitions is experiencing a short-term slowdown.  This may be related to the large-scale deals in 2013 involving Tenet and Community Health Systems.  PwC states that “our outlook for hospital deal activity in 2014 continues to be optimistic as the impetus for greater alignment and size remains unchanged” (page 3).  Hospitals are said to be endorsing the “bigger is better” philosophy.

PwC also reports interesting comparative statistics related to physician practice acquisitions by hospitals and health systems.

HOSPITAL & HEALTH SYSTEM acquisition of physician practices accounted for:

  • 51% of all practice acquisitions in 2011
  • 14% of all practice acquisitions in 2013

PwC expects this trend of a greater percentage of acquisitions by physician practice management companies to continue.

Source: PricewaterhouseCoopers.  Q1 2014 US Health Services Deals Insights, May 2014.  Click here: http://www.pwc.com/us/en/healthcare/publications/healthcare-m-a-insights.jhtml Posted by AHA Resource Center (312) 422-2050, rc@aha.org


2014 Physician Compensation, Benefits & Recruitment Incentives Report

The Association of Staff Physician Recruiters, represening in-house recruiters in hospitals, physician practices, health plans, or similar organizations, and the MDLinx.com web site collaborated on a physician survey earlier this year focused on learning more about compensation models and recruitment incentives offered by their employers.

The survey yielded benchmarking data related to each of these areas:

  • Incentives, including relocation assistance, signing bonuses, malpractice coverage assistance, requirment to stay in the position for a defined time period, and for residents/fellows, stipend incentives for their final year of training
  • Compensation methodology, covering compensation model and the percent tied to quality measures, supervision of advanced practice providers, payment for on-call coverage, bonus eligibility, bonus structure, and satisfaction with the compensation model
  • Benefits, such as coverage of professional fees, annual provision of CME activities, paid time off for CME, vacation, sick time, and holidays, and if domestic partner benefits are offered
  • Contract, encompassing restrictive or non-compete agreement details
  • Schedule, touching on schedule flexibility, what defines ‘full-time’, and time providedfor administrative activities

Source: 2014 physician compensation, benefits & recruitment incentives report. Association of Staff Physician Recruiters, 2014. https://c.ymcdn.com/sites/aspr.site-ym.com/resource/resmgr/Files/2014_ASPR_PhysComp_Report.pdf

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


U.S. Elder Care Market – Top 50 Nursing Homes & Systems

SK&A has just released an update of its report that lists the top 50 nursing homes in the U.S. based on bed size. It also ranks the top 50 nursing home systems based on the number of nursing homes.

Topping the list of the largest nursing homes are:

  1. Laguna Wood Community – Laguna Woods, CA – 12,736 beds
  2. Rossmoor Walnut Creek — Walnut Creek, CA – 10,000 beds
  3. Fair Acres Geriatric Center – Lima, PA – 908 beds

The largest nursing home systems are:

  1. Genesis Healthcare – 326 nursing homes
  2. Golden Living – 305 nursing homes
  3. HCR Manor-Care – 301 nursing homes

The report also ranks the states by the number of nursing homes and lists the number of nursing home beds in each state. The number of nursing homes are classified by ownership type and by type of care provided, such as skilled nursing, assisted living and 10 other categories.

Source: U.S. elder care market. SK&A, June 2014. http://www.skainfo.com/registration.php [Free registration required]

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

Uncompensated Care for Uninsured in 2013: a Detailed Examination

A new Urban Institute report prepared for the Kaiser Commission on Medicaid and the Uninsured takes a close look at uncompensated care for the uninsured. It examines the cost, the service sites providing uncompensated care, the sources of funding, and cost shifting for unfunded costs of compensated care. Here are the highlights:

  • A patient uninsured the entire year incurred lower medical expenses on average — $2,443 compared to an insured patient’s average annual expense of $4,876.
  • In 2013 the cost of uncompensated care provided to the uninsured was $84.9 billion.
  • To partially offset provider costs for uncompensated care, the federal government paid providers $32.8 billion in 2013, state and local government paid $19.8 billion, and the private sector contributed $0.7 billion — an overall total of $53.3 billion.
  • Hospitals provided 60% of the uncompensated care, while community based clinics and health centers provided 26% and office-based physicians 14%.
  • The authors estimate uncompensated care cost-shifting to private insurers may be in the 2.3%-4.6% range.

While the new health law is designed to reduce both the number of uninsured and the level of funding for uncompensated care, it is still unclear what the outcome will be for providers and uncompensated care costs.

Source: Couglin TA and others, Urban Institute. Uncompensated care for uninsured in 2013: a detailed examination. Kaiser Commission on Medicaid and the Uninsured. May 30. 2014. http://kff.org/uninsured/report/uncompensated-care-for-the-uninsured-in-2013-a-detailed-examination/

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

Diversity and Disparities: a Benchmark Study of U.S. Hospitals in 2013

Three key ways hospitals and health systems can address disparities in health care are:

  1. Increase the collection and use of race, ethnicity and language preference [REAL] data to identify where disparities exist
  2. Increase cultural competency training to ensure caregivers and other staff have a deeper understanding of diverse patients and their individual needs
  3. Increase leadership and governance diversity

A new survey report looks at what hospitals are doing on these 3 fronts, learning more about the strategies used and providing benchmarks for gauging hospital progress.

Top line survey results found:

  • Most hospitals are actively collecting patient demographic data — 97% collect data on race, 94% on ethnicity, and 95% on primary language.
  • 86% of hospitals provide cultural competency training to clinical staff, while nearly 65% require all employees to attend diversity training.
  • Minorities comprise 14% of hospital trustees, 12% of executive leadership, and 17% of first- and mid-management positions.
  • Nearly a third of patients are from a minority group.

Meanwhile, a new report from the Robert Wood Johnson Foundation and the Urban Institute compares how the U.S. and European Union approach eliminating health disparities. One key difference: the U.S. has focused primarily on racial/ethnic disparities rather than economic inequities, although they are often intertwined.


Diversity and disparities: a benchmark study of U.S. hospitals in 2013. Institute for Diversity in Health Management; Health Research & Educational Trust, 2014. http://www.equityofcare.org/about/resources/diversity_disparities_Benchmark_study_hospitals_2013.pdf

Docteur E; Berenson RA. In pursuit of health equity: comparing U.S. and EU approaches to eliminating disparities. Robert Wood Johnson Foundation; Urban Institute, June 2014. http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2014/rwjf414060

Related sources:

Earlier benchmarking surveys: 2011 2009

Equity of Care web site, a collaboration of the American College of Healthcare Executives, American Hospital Association, Association of American Medical Colleges, Catholic Health Association of the United States, and America’s Essential Hospitals. Accessed June 25 at http://www.equityofcare.org/

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

New Overview of ER Visits in the US

A new Agency for Healthcare Research and Quality report analyzing emergency department visits during 2011 includes these highlights:

  • For every 100 people in the population, there were 42.1 visits to the ED, and 6.2 of these visits resulted in a hospital admission.
  • Women had a 20% higher rate of ED visits than men.
  • For infants and children, respiratory issues were the most common reason an ED visit resulted in a hospital admission.
  • Mood disorders were the most frequent reason for younger adults to be admitted to the hospital through the ED, while septicemia was the top reason for older adults.
  • Rural hospitals had a higher rate of ED visits resulting in an ED discharge than their urban counterparts.
  • Private insurance was the expected primary payer for 29% of ED visits, Medicaid for 27%, and Medicare for 22%. Uninsured visits represented 16%.

Source: Weiss AJ and others. Overview of emergency department visits in the United States, 2011. HCUP [Healthcare Cost and Utilization Project] Statistical Brief, #174, June 2014. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb174-Emergency-Department-Visits-Overview.pdf

Related post: http://aharesourcecenter.wordpress.com/2014/02/25/fast-stats-on-emergency-department-visits/

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


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