What's at Stake

Providing the best health care possible in a safe, compassionate environment is a commitment every hospital makes to it's community.  Hospitals are open 24 hours a day, seven days a week and are often the only source of health care for millions of Americans.  We must keep our hospitals strong.

AMERICA’S HOSPITALS: PREPARED TO CARE

SERVICES

  • Over 35 million people are admitted to the hospital each year.
  • Hospitals treat nearly 118 million people in their emergency departments (EDs) and provide care to 481 million other outpatients each year.
  • Hospitals deliver over 4 million babies each year.
  • In 2006, hospitals provided care to people in need at a cost of over $31 billion for which no payment was received.
  • Hospitals screen and, if an emergent condition is found, stabilize every patient who comes through the ED.

CONTRIBUTION TO THE ECONOMY

  • Hospitals employ more than 5 million people.
  • Behind restaurants, hospitals are the second largest private sector employer.
  • When also accounting for hospital purchases of goods and services from other businesses, hospitals support one of every 10 jobs in the U.S and $1.9 trillion dollars of economic activity.

FINANCES

  • One-third of hospitals lose money on operations.
  • Hospital operating margins were 4.0% in 2006, down from 4.6% in 1996 just prior to the Balanced Budget Act of 1997.

PAYMENT FOR MEDICARE AND MEDICAID SERVICES

  • Together Medicare and Medicaid represent 55% of care provided by hospitals.
  • Medicare payment falls short of the cost of caring for Medicare patients.

ü      Medicare pays only 91 cents for each dollar spent caring for Medicare patients.

ü      64% of hospitals are paid less than the costs of services provided to Medicare patients.

ü      The Medicare funding shortfall for hospital care exceeds $18 billion dollars.

  • Medicaid payment falls short of the cost of caring for Medicaid patients.

ü      Hospitals receive an average of 86 cents for each dollar spent caring for Medicaid patients.

ü      76% of hospitals are paid less than the costs of services to Medicaid patients.

ü      The Medicaid funding shortfall for hospital care exceeds $11 billion dollars.

 

IMPACT OF MEDICARE AND MEDICAID CUTS ON PRIVATELY INSURED (COST SHIFTING)

  • When Medicare and Medicaid fail to cover their share of hospital costs, hospitals are forced to make cutbacks that affect the whole community and/or look to the privately insured to make up the difference.

ü     The actuarial firm Milliman Inc. found that Medicare and Medicaid shortfalls in hospital payment add $490 to the annual cost of the family coverage in Washington state.

ü     RAND found that growing Medicare and Medicaid shortfalls accounted for 12% of the increase in rates paid to hospitals by private insurers in California between 1997 and 2001.

 

CAPACITY CONSTRAINTS

  • 65% of urban hospitals and 47% of all hospitals reported that their EDs were at or over capacity in 2007.
  • 56% of urban hospital EDs report time on “diversion” – when the hospital cannot accept additional patients by ambulance.
  • Hospitals have an estimated 116,000 registered nurse vacancies.
  • By 2020, the U.S. will face a projected shortage of 1 million registered nurses.

 

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