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MEDICARE: CMS fast facts provides US national statistics

This is a nice two-page summary of current statistics related to the Medicare and Medicaid programs. It provides official federal government counts of people and money – the number of beneficiaries and persons served and a recap of national health expenditures.  But WAIT!  There’s more!  I am excited to let you know of a count of the total number of providers by type in the U.S.  How many total hospitals?  How many hospitals of different types?  How many skilled nursing facilities?  Ambulatory surgery centers?  Labs?  And other types of providers.  These are useful totals for business planners who are sizing the market for a new product, for example.


U.S. Centers for Medicare & Medicaid Services. (2016, July 7). Fast Facts.  Click here for free full text: https://www.cms.gov/fastfacts/

For more indepth information: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMS-Fast-Facts/  Posted by AHA Resource Center (312) 422-2050, rc@aha.org


An All-Payer View of Hospital Discharge to Postacute Care

How many hospital patients are discharged to post acute care? According to a new report from the Agency for Healthcare Research and Quality, nearly 8 million hospital inpatients — 22.3% of all hospital discharges in 2013 — required continued post acute care, such as skilled nursing, rehabilitation, home care, or palliative care. Home health agencies accounted for 50% of the discharges to post acute care, while another 40% were for skilled nursing.

Medicare patients had the highest rate of hospital discharges going to post acute care — 41.7%. Total hip/knee replacement was the most common condition/procedure for post acute care [PAC]. Over 70% of all total hip/knee replacement patients went to PAC, and they accounted for nearly 10% of all discharges to PAC.

Hospital stays were nearly twice as long and costly for discharges to post acute care when compared to routine discharges.

Source: Tian W. An all-payer view of hospital discharge to postacute care, 2013. HCUP [Healthcare Cost and Utilization Project] Statistical Brief #205, May 2016. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb205-Hospital-Discharge-Postacute-Care.pdf

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

Role of Post-Acute Care in New Care Delivery Models

With new models for the delivery of health care, post-acute care provides — long-term care hospitals, skilled nursing  and rehabilitation facilities, and home health agencies — have an important role to play. They can help reduce hospital readmissions, improve care coordination and care setting transitions, and participate in the development of bundled payment approaches.

A new Trendwatch report from the American Hospital Association looks at the factors driving changes in post-acute care and highlights innovative examples of how leading post-acute care providers and health systems are adjusting and creating new business models to improve patient care.

A separate addendum report provides more background on Medicare spending by sectors within post-acute care and their patient characteristics. Medicare’s current fee-for-service system by post-acute care venue is also summarized.

Source: Role of post-acute care in new care delivery models. Trendwatch, American Hospital Association, Dec. 2015. http://www.aha.org/research/reports/tw/15dec-tw-postacute.pdf  Addendum: Background On Post-Acute Care. http://www.aha.org/research/reports/tw/15dec-tw-postacute-adden.pdf

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

CARE COORDINATION: Hospital leases beds at skilled nursing facilities and cuts 30-day readmission rate

UCLA Health (Los Angeles), which operates Ronald Reagan UCLA Health, and Santa Monica UCLA Health, is collaborating with local skilled nursing facilities (SNFs) through a bed leasing program.  The academic medical center pays a negotiated daily fee to hold SNF beds open so that patients ready for discharge but who have been hard to place have a postacute facility to go to.  Despite the bed lease cost, the advantages of being able to move patients out of the acute care setting and decrease the 30-day readmission rate have resulted in the program being a financial success.

Source: Bed leasing program helps hospitals discharge hard-to-place patients. (2015, Dec.). Hospital Case Management, 23(12), 158, 163.  Retrieved from http://www.ahcmedia.com/articles/136601-bed-leasing-program-helps-hospitals-discharge-hard-to-place-patients Posted by AHA Resource Center (312) 422-2050, rc@aha.org

TRENDS: Outpatient utilization metrics have been going up

Health, United States, 2015 is available.  This is the latest in an annual compendium of statistics published by the federal government which is drawn from both government and nongovernment sources, including the American Hospital Association.  It’s a good place to start to look for historical trend statistics (usually at the national level) on topics related to health status and health care delivery.

Below are data from one table in this massive report.  The data below are authoritative national estimates, based on a sample survey, that were produced by the National Center for Health Statistics.

Why are utilization metrics expressed as “per 100 persons” or “per 1000 persons” interesting?  Because if you a health planner, you can take a geographical service area with a known population size and calculate the approximate number of physician office visits or hospital outpatient visits or emergency department visits that can be expected from that population in a twelve month period.  Doing a demand analysis would then go on to take into account the local competition and other factors, but national utilization estimates like this can be a helpful way to start.

PHYSICIAN OFFICE VISITS per 100 persons per year (age adjusted)

  • 271  1995
  • 304  2000
  • 325  2010
  • [not available] 2011

Note that this is consistently about 3 physician office visits per person per year.  Does that seem intuitively pleasing to you?  Did you go to see doctors three times last year?  Remember, too, that the above includes children and seniors.

HOSPITAL OUTPATIENT DEPARTMENT VISITS per 100 persons per year (age adjusted)

  • 26  1995
  • 31  2000
  • 33  2010
  • 40  2011

HOSPITAL EMERGENCY DEPARTMENT VISITS per 100 persons per year (age adjusted)

  • 37  1995
  • 40  2000
  • 43  2010
  • 45  2011

Source: Table 82, Visits to physician offices, hospital outpatient departments, and hospital emergency departments, by age, sex, and race: United States, selected years 1995-2011.  In U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (2015). Health, United States, 2015. Retrieved from http://www.cdc.gov/nchs/hus.htm  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

2014 Private Equity Acquisitions in Health Care Sector

Irving Levin & Associates has released 2014 statistics on the number of private equity acquisitions in the health care sector.  It reports 144 deals in 2014, with 95 of them involving health services and another 49 in health technology. On the health services side, long term care saw the most activity, with 38 deals involving $4.14 billion. There were 4 hospital deals valued at $545 million.

Source: Where private equity spent its healthcare dollars in 2014. Health Care Deal News [Irving Levin & Associates], Feb. 23, 2015. http://www.levinassociates.com/healthcare/health-care-deal-news-150223

Related source [update]: Williams KB. Ventas to acquire Ardent Medical Services for $1.75B. Healthcaredive.com, Apr. 6, 2015. http://www.healthcaredive.com/news/ventas-to-acquire-ardent-medical-services-for-175b/383273/

See also earlier post: https://aharesourcecenter.wordpress.com/2013/03/29/private-equity-and-non-profit-hospitals-strange-bedfellows-or-saving-grace/

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

Active Shooter Incident Planning for Health Facility Emergency Preparedness

A sign of the times, unfortunately. The Departments of Health and Human Services; Homeland Security; and Justice have jointly issued a new planning guide for dealing with active shooters in health care facilities. It’s recommended that active shooter planning be included as part of a facility’s overall emergency preparedness operations covering everything from fires to floods to infectious disease pandemics.

As in other preparedness planning, the guide addresses prevention, protection, mitigation, response, and recovery issues as they relate to active shooter emergencies within health care settings.

Source: Incorporating active shooter incident planning into health care facility emergency operation plans. U.S. Dept. of Health and Human Services, Assistant Secretary for Preparedness and Response, 2014. http://www.phe.gov/Preparedness/planning/Documents/active-shooter-planning-eop2014.pdf


Chu E. How to survive a hospital shooting. MedPage Today, May 2014 [republished Jan. 20, 2015]. http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/45535

Diamond D. When patients kill doctors: the horrifying murder of Michael Davidson. Forbes, Jan. 21, 2015. http://www.forbes.com/sites/dandiamond/2015/01/21/when-patients-kill-doctors-the-horrifying-murder-of-michael-davidson/

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