Becker's Hospital Review

12 Sign up for the COMPLIMENTARY Becker's Hospital Review CEO Report & CFO Report E-Weeklies at www.BeckersHospitalReview.com or call (800) 417-2035 (Richmond, Va.) — 812; North Shore Medical Center (Miami) — 775 and CJW Medical Center – Chippenham Campus (Richmond, Va.) — 762.6 gical techniques as well as advanced anesthesia techniques that allow patients to recover more quickly from surgical procedures.8 14. Hospitals vary greatly is size, from small rural facilities with just a few key service lines to large, tertiary care facilities. Here is a breakout of U.S. hospitals by bed count in 2009, the latest year for which data is publicly available.7 16. The average length of stay for an acute-care hospital admission is 4.8 days.9 6-24 beds — 402 17. The average cost per inpatient day is $2,025 at nonprofit hospitals and $1,629 at for-profit hospitals.10 18. There was an average of 2,105.6 outpatient visits per 1,000 people in 2011, up from an average of 1,273.4 visits in 1991, further supporting the trend of inpatient surgeries moving to the outpatient setting.8 25-29 beds — 1,164 50-99 bed — 991 100-199 beds — 1,063 200-299 beds — 582 300-399 beds — 348 400-499 beds — 192 500 beds or more — 266 15. There was an average of 111.8 inpatient hospitals admissions per 1,000 people in 2011, down from an average of 123.2 admissions in 1991. This data suggests on ongoing shift from inpatient to outpatient care, which has been driven largely by advances in minimally invasive sur- 19. Emergency departments are critical units within hospitals as they account for the majority of inpatient admissions. In 2010, there were 42.8 ED visits per 100 persons in the U.S., according to the CDC's National Hospital Ambulatory Medical Care Survey. The number of ED visits resulting in hospital admission was 17.2 million, and number of ED visits resulting in admission to a critical care unit was 2.1 million. 20. EDs at half of all urban hospitals and 51 percent of all teaching hospitals are "at capacity" or "overcapacity," according to a 2010 survey by the AHA.11 21. The American Hospital Association is the leading association representing U.S. hospitals. It is led by President and CEO Richard (Rich) Umbdenstock. 22. The Federation of American Hospitals represents for-profit, investor-owned hospitals. It was founded in 1966 and is led by President and CEO Charles (Chip) Kahn. 23. America's Essential Hospitals represents safety-net hospitals, including many large, urban facilities. It is led by President and CEO Bruce Siegel, MD, MPH. 24. A variety of factors have pressured hospital finances over the last several years, and these forces are unlikely to let up. In addition to the volume shift from inpatient to outpatient visits, the recession and growth in high-deductible heath plans and other health insurance benefit design elements that increase costs for consumers has resulted in some patients delaying or withholding medical care. For 2012, the latest data available, the average operating margin for a nonprofit hospital was 2.5 percent, according to Moody's Investors Service. 25. In 2012, the average nonprofit hospital had 165 days cash on hand and a cash-to-debt ratio of 117.7 percent. However, cash-to-debt ratios vary widely in the industry: • edian cash-to-debt ratio for "Aa2"-rated M hospitals: 214.5 percent • edian cash-to-debt ratio for "Aa3"-rated M hospitals: 185.8 percent • edian cash-to-debt ratio for "A1"-rated M hospitals: 146.9 percent • edian cash-to-debt ratio for "A2"-rated M hospitals: 143 percent • edian cash-to-debt ratio for "A3"-rated M hospitals: 104 percent The Yale School of Management's MBA for Executives brings together experienced professionals to study the complexities of the $2.7 trillion healthcare industry. This unique program develops critical leadership and management skills through a rigorous, integrated curriculum with an emphasis on the most relevant business issues of healthcare. • edian cash-to-debt ratio for "Baa1"-ratM ed hospitals: 91.6 percent • edian cash-to-debt ratio for "Baa2"-ratM ed hospitals: 74.6 percent • edian cash-to-debt ratio for "Baa3"-ratM ed hospitals: 93 percent • edian cash-to-debt ratio for hospitals M with ratings below "Baa": 107 percent12 Join entrepreneurs, health practitioners, executives, and other professionals from across healthcare sectors in learning critical new business skills while continuing to advance in your career. learn more at mbae.som.yale.edu e d u c at i n g l e a d e r s f o r b u s i n e s s a n d s o c i e t y 26. The payment a hospital receives for the service it provides varies based on the payer. Governmental payers, including Medicare and Medicaid, set rates, and nearly every hospital chooses to accept them in order to have access to these patients. With commercial payers, hospitals can negotiate rates based on expected volume and other factors; however many commercial rates are set based on a percent of Medicare or some

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