10 Interesting Hospital and Health Plan Expense Stats and Trends

Here are 10 stats and trends relating to hospital and health plan expenses from data gathered and references by the American Hospital Association.

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1. From 2001-2006, 62 percent of community hospital cost growth was attributable to costs of goods and services purchased, 30 percent to change in number of services provided and 8 percent to intensity and other factors.

2. Forty-one percent of the 62 percent relating to costs of goods and services purchased which attributed to community hospital cost growth was attributable to wages and salaries, and employee benefits; 4 percent was prescription drugs; 3 percent was professional fees; 2 percent was professional liability insurance; and 12 percent fell into an “other” category.

3. Seventeen percent of the 30 percent relating to change in number of services provided which attributed to community hospital cost growth was attributable to use rates, with the remaining 13 percent to population growth.

4. Citing research published in 2005, hospitals spend about 20.9 percent of their revenue on administration, with a high estimate of 10.8 percent on billing and insurance-related costs (and a lowest estimate of 6.6 percent). Physician groups spend 26.7 percent of their revenue on administration and 13.9 percent on billing and insurance-related costs.

5. According to data from 1999, for-profit HMOs spend 19 percent of their revenue on administrative costs. Non-profit HMOs spend 13 percent and Medicare spends 3 percent.

6. According to data gathered from 1996-2000, commercial insurance attributes 9.9 percent of its health plan costs to administrative functions. Medicaid attributes 11.6 percent and Medicare attributes 4.5 percent.

7. According 2001 data, for every hour spent on patient care in an emergency department, an hour is spent on paperwork. In surgery and inpatient acute care, for every hour spent on patient care, 0.6 hours are spent on paperwork.

8. According to 2007 data:

  • 34 percent of workers with HMOs must pay a copayment (a fixed dollar amount required by a health insurer to be paid by the insured at the time a service is rendered) only for hospital admission; 14 percent pay coinsurance (a set percentage of the charge or fee for services to be paid for by the insured) only; 4 percent pay both copay and coinsurance and 7 percent have a charge per day.
  • 37 percent of workers with a point-of-service plan pay copyament only; 23 percent pay coinsurance only; 7 percent pay both and 8 percent have a charge per day.
  • 13 percent of workers with a PPO pay copyament only; 56 percent pay coinsurance only; 9 percent pay both and 3 percent have a charge per day.
  • 3 percent of workers with a high-deductible health plan (with savings options) pay copyament only; 64 percent pay coinsurance only; 1 percent pay both and 2 percent have a charge per day.

These payments are in addition to any deductible.

9. In 1981, the average length of stay in a community hospital was 7.6 days. In 1986, it was 7.1 days. In 1991, it was 7.2 days. In 1996, it was 6.2 days. In 2001 it was 5.7 days. In 2006, it was 5.6 days.

10. According to 2006 data, patients averaged a length of stay in community hospitals equal to or greater than eight days in Montana, Wyoming, North Dakota and South Dakota. On the lower end of the scale, patients averaged a length of stay between 4 and 4.9 days in Washington, Oregon, Idaho, Utah, Arizona, New Mexico and Maryland.

Source: American Hospital Association.

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