83 hospital benchmarks | 2022

Much has changed amid the COVID-19 pandemic, but hospitals must remain laser-focused on care quality and costs, using benchmarking to determine top priorities for improvement. 

Becker's has collected benchmarks related to some of the most important day-to-day areas hospital executives oversee: finance, patient experience and care quality. 

Finance

Key ratios

Source: Moody's Investors Service, "Not-for-profit and public healthcare – US: Medians" report, September 2020. 

The medians are based on an analysis of audited fiscal 2020 financial statements for 130 freestanding hospitals, single-state health systems and multistate health systems, representing 40 percent of all Moody's-rated nonprofit healthcare entities. Children's hospitals, hospitals for which five years of data are not available and certain specialty hospitals were not eligible for inclusion in the medians.

1. Maintained bed occupancy: 64.5 percent

2. Operating margin: 0.5 percent

3. Excess margin: 3.7 percent

4. Operating cash flow margin: 6.7 percent

5. Return on assets: 2.9 percent

6. Three-year operating revenue CAGR: 5.2 percent

7. Three-year operating expense CAGR: 5.6 percent

8. Cash on hand: 246.9 days

9. Annual operating revenue growth rate: 3 percent

10. Annual operating expense growth rate: 4.7 percent

11. Total debt-to-capitalization: 33.9 percent

12. Total debt-to-operating revenue: 32.3 percent

13. Current ratio: 1.6x

14. Cushion ratio: 27.8x

15. Annual debt service coverage: 4.7x

16. Maximum annual debt service coverage: 4.1x

17. Total debt-to-cash flow: 3.3x

18. Capital spending ratio: 1.19x 

19. Accounts receivable: 44.6 days

20. Average payment period: 99.1 days

21. Average age of plant: 11.9 years

Hospital margins by credit rating group

Source: S&P Global Ratings "U.S. Not-For-Profit Health Care System Median Financial Ratios — 2020 vs. 2019" report, September 2020.

AA+ rating

22. Operating margin: 4.5 percent

23. Operating EBIDA margin: 11.3 percent

24. Excess margin: 5.5 percent

25. EBIDA margin: 12.2 percent

AA rating

26. Operating margin: 3.2 percent

27. Operating EBIDA margin: 8.3 percent

28. Excess margin: 5.8 percent

29. EBIDA margin: 10.7 percent

AA- rating

30. Operating margin: 1.9 percent

31. Operating EBIDA margin: 7.1 percent

32. Excess margin: 4.1 percent

33. EBIDA margin: 9.2 percent

A+ rating

34. Operating margin: 1.6 percent

35. Operating EBIDA margin: 8.1 percent

36. Excess margin: 3.1 percent

37. EBIDA margin: 8.9 percent

A rating

38. Operating margin: 0.7 percent

39. Operating EBIDA margin: 6.6 percent

40. Excess margin: 2.3 percent

41. EBIDA margin: 8 percent

 A- rating

42. Operating margin: 0.6 percent

43. Operating EBIDA margin: 6.7 percent

44. Excess margin: 2.4 percent

45. EBIDA margin: 8 percent

Average adjusted expenses per inpatient day

Source: Kaiser State Health Facts, accessed in 2020 and based on 2019 data. 

Adjusted expenses per inpatient day includes all operating and nonoperating expenses for registered U.S. community hospitals, defined as public, nonfederal, short-term general and other hospitals. The figures are an estimate of the expenses incurred in a day of inpatient care and have been adjusted higher to reflect an estimate of the volume of outpatient services.

46. Nonprofit hospitals: $2,738

47. For-profit hospitals: $2,149

48. State/local government hospitals: $2,372

Patient experience

Source: HCAHPS' Patients' Perspectives of Care Survey, accessed in January 2022 and based on July 2021 data. 

49. Patients who said nurses always communicated well: 80 percent 

50. Patients who said nurses always treated them with respect and courtesy: 86 percent

51. Patients who said nurses always listened carefully: 77 percent

52. Patients who reported that their doctors always communicated well: 81 percent

53. Patients who reported that their doctors always treated them with courtesy and respect: 87 percent

54. Patients who reported that their doctors always listened carefully: 79 percent

55. Patients who reported that they always received helped as soon as they wanted: 67 percent

56. Patients who reported that when given new medications staff always communicated what the medication was for: 76 percent

57. Patients who reported that when given new medications staff always communicated possible side effects: 50 percent

58. Patients who reported that hospital staff gave them information regarding at-home recovery: 86 percent

59. Patients who strongly agreed that they understood their care after leaving a hospital: 52 percent

60. Patients who strongly agree that staff took their preferences into consideration: 45 percent

61. Patients who strongly agree that they understood how to manage their health: 52 percent

Quality and process of care 

Source: Hospital Compare, CMS, Complications and Deaths-National Averages, January 2022, and Timely and Effective Care-National Averages, January 2022.

Data from the first and second quarters of 2020 are excluded because of the effect of the pandemic. Because of the pandemic-related factors, measures were calculated from differing timeframes, as noted below. All data is the latest available for the measures.  

Hospital-acquired conditions 

The following represent the average percentage of patients in the U.S. who experienced the conditions from July 1, 2018, to Dec. 31, 2019. 

62. Collapsed lung due to medical treatment: 0.23 percent

63. A wound that splits open after surgery: 0.86 percent

64. Accidental cuts and tears from medical treatment: 1.2 percent

65. Serious blood clots after surgery: 3.63 percent

66. Serious complications: 1 percent

67. Bloodstream infection after surgery: 4.9 percent

68. Postoperative respiratory failure rate: 5.03 percent

69. Pressure sores: 0.59 percent

70. Broken hip from a fall after surgery: 0.1 percent  

71. Perioperative hemorrhage or hematoma rate: 2.55 percent

Death rates

The following represent average death rates from July 1, 2017, to Dec. 1, 2019. 

72. Death rate for CABG surgery patients: 2.9 percent

73. Death rate for COPD patients: 8.1 percent

74. Death rate for pneumonia patients: 15.3 percent

75. Death rate for stroke patients: 13.5 percent

76. Death rate for heart attack patients: 12.3 percent

77. Death rate for heart failure patients: 11.2 percent

Outpatients with chest pain or possible heart attack

Data was collected from July 1, 2020 to March 31, 2021. 

78. Median time to transfer to another facility for acute coronary intervention: 61 minutes

Lower extremity joint replacement patients 

Data was collected from April 1, 2017, to Oct. 2, 2019.  

79. Rate of complications for hip/knee replacement patients: 2.4 percent 

Flu vaccination

Data was collected from Oct. 1, 2020, to March 31, 2021.  

80. Healthcare workers who received flu vaccination: 86 percent

Pregnancy and delivery care 

Data was collected from July 1, 2020, to March 31, 2021. 

81. Mothers whose deliveries were scheduled one to two weeks early when a scheduled delivery was not medically necessary: 3 percent 

Emergency department care

82. Average time patient spent in the ED before being sent home: 149 minutes  

Data was collected from July 1, 2020, to March 31, 2021. 

83. Percentage of patients who left the ED before being seen: 2 percent  

Data was collected from Jan. 1, 2020, to Dec. 31, 2020.

 

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