Appendices

1
Appendices
2
(No Transcript)
3
Appendix 1Supplementary Data Tables Trends in
the Overall Health Care Market
4
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.1National Health Expenditures1980 -
2003

• Source Centers for Medicare Medicaid Services,
  Office of the Actuary National Health Statistics
  Group
• (1) Expressed in 1980 dollars adjusted using the
  overall consumer price index for urban consumers
• Data for Charts 1.1, 1.3, and 1.10

A-4
5
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.2Percent Change in National
Expenditures forSelected Health Services and
Supplies1993 - 2003
Source Centers for Medicare and Medicaid
Services, Office of the Actuary Data for Chart
1.7
A-5
6
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.3National Health Expenditures(1)1980 -
2014
Source Centers for Medicare Medicaid Services,
Office of the Actuary (1) Years 2004 2014 are
projections Data for Chart 1.8
A-6
7
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.4Consumer Out-of-Pocket Payments
forNational Health Expenditures1990 - 2003
Source Centers for Medicare Medicaid Services,
Office of the Actuary Data for Chart 1.9
A-7
8
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.5Growth in Total Prescription Drug
Spending as aPercentage of Total Growth in
National Health Expenditures1980 - 2003
Source Centers for Medicare Medicaid Services,
Office of the Actuary Data for Chart 1.11
A-8
9
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.6Consumer Out-of-Pocket Spending vs.
Private Health Insurance Spending for
Prescription Drugs1980 - 2003
Source Centers for Medicare Medicaid Services,
Office of the Actuary Data for Chart 1.12
A-9
10
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.7Number and Percent Uninsured(1)1985 -
2003
Source US Census Bureau (1) 1999 - 2003 data
use population estimates based on Census
2000. Data for Chart 1.15
A-10
11
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.8Average Percent Uninsured by
State2001 - 2003
Source US Census Bureau Data for Chart 1.16
A-11
12
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.9Medicaid Enrollees1990, 1995, 2000 -
2003
Source Centers for Medicare Medicaid Services
2002 data, CBO March 2003 Baseline 2003 data,
CBO March 2004 Baseline Data for Chart 1.18
A-12
13
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.10Percent Change in SCHIP Enrollment by
State FY 2002 FY 2003
Source Center for Medicare and Medicaid
Services Data for Chart 1.20
A-13
14
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.11Percentage of Employees with
Employer-based Coverage Who Can Choose
Conventional, PPO, HMO and POS Plans1988 - 2004
Source The Kaiser Family Foundation and Health
Research and Educational Trust, Survey of
Employer-Sponsored Health Benefits 2002,
2003,2004 KPMG Survey of Employer-Sponsored
Health Benefits 1988, 1993, 1996 (1)
Point-of-service plans not separately
identified Data for Chart 1.21
Table 1.12Percent Distribution of
Employer-sponsored Health Insurance Enrollment by
Type of Plan1988 - 2004
Source The Kaiser Family Foundation and Health
Research and Educational Trust, Survey of
Employer-Sponsored Health Benefits 1999, 2002,
2003,2004 KPMG Survey of Employer-Sponsored
Health Benefits 1988, 1993, 1996 (1)
Point-of-service plans not separately
identified Data for Chart 1.22
A-14
15
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.13Growth in Medicare Spending per
Beneficiary vs. Private Health Insurance Spending
per Enrollee1980 - 2003
Source Centers for Medicare Medicaid Services,
Office of the Actuary Data for Chart 1.24
A-15
16
Supplementary Data Tables - Trends in the Overall
Health Care Market
Table 1.14Percentage of Medicaid Beneficiaries
Enrolled in Medicaid Managed Care by State2002
and 2003
Source Centers for Medicare Medicaid Services,
Office of the Actuary Data for Chart 1.26
A-16
17
Table 1.15Operating Margins of the Top
Insurers2000 - 2003
Source Robinson J. Consolidation and the
transformation of competition in health
insurance. Health Affairs 200423(6)11-24. Data
for Chart 1.29
A-17
18
(No Transcript)
19
Appendix 2Supplementary Data Tables
Organizational Trends
20
Supplementary Data Tables - Organizational Trends
Table 2.1Number of Community Hospitals(1)1980
- 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospitals (1) All
nonfederal, short-term general, and special
hospitals whose facilities and services are
available to the public (2) Hospitals that are
part of a corporate body that may own and/or
manage health provider facilities or
health-related subsidiaries as well as
non-health-related facilities including
freestanding and/or subsidiary corporations Data
collected on health systems before 1999 are not
comparable and are therefore not
presented. Data for Charts 2.1 and 2.4
A-20
21
Supplementary Data Tables - Organizational Trends
Table 2.2Number of Beds and Number of Beds per
1,000 Persons1980 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospitals Data for Chart
2.2
A-21
22
Supplementary Data Tables - Organizational Trends
Table 2.3Beds per 1,000 Personsby State2002
and 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data, 2002 and
2003 for community hospitals and US Census
Bureau State and County QuickFacts, 2003
population estimate data derived from Population
Estimates, 2000 Census of Population and
Housing Data for Chart 2.3
A-22
23
Supplementary Data Tables - Organizational Trends
Table 2.4Percent of Outpatient Surgeries by
Facility Type1981 - 2005
Source Verispans Diagnostic Imaging Center
Profiling Solution, 2004. 2005 values are
estimated based upon current trends. Data for
Chart 2.5
Table 2.5Percentage of Hospitals with Physician
Affiliates(1)by Type of Relationship1994 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1994-2003, for community hospitals (1) A hospital
is considered to have a physician relationship if
the relationship exists as part of the hospital
or a system or network of which the hospital is a
part Data for Chart 2.7
A-23
24
Supplementary Data Tables - Organizational Trends
Table 2.6Percentage of Hospitals with Insurance
Products by Type of Insurance1994 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1994-2003, for community hospitals Data for Chart
2.8
Table 2.7Percentage of Hospitals Offering
Non-hospital Services(1)1995 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1995-2003, for community hospitals (1) Includes
services offered in hospital, health system,
network or joint venture Data for Chart 2.9
A-24
25
Appendix 3Supplementary Data Tables
Utilization and Volume
26
Supplementary Data Tables - Utilization and Volume
Table 3.1Trends in Inpatient Utilizationin
Community Hospitals1980 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospitals and US Census
Bureau State and County QuickFacts, 2003
population estimate data derived from Population
Estimates, 2000 Census of Population and
Housing Data for Charts 3.1, 3.2, 3.3, 3.4, 3.5,
and 3.14
A-26
27
Supplementary Data Tables - Utilization and Volume
Table 3.2Average Length of Stay in Community
Hospitalsby State2002 and 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data, 2002 and
2003, for community hospitals Data for Chart 3.6
A-27
28
Supplementary Data Tables - Utilization and Volume
Table 3.3Emergency Department Visits, Emergency
Department Visits per 1,000, and Number of
Emergency Departments 1990 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1990-2003, for community hospitals and US Census
Bureau State and County QuickFacts, 2003
population estimate data derived from Population
Estimates, 2000 Census of Population and
Housing (1) Defined as hospitals that reported ED
visits Data for Charts 3.7 and 3.8
A-28
29
Supplementary Data Tables - Utilization and Volume
Table 3.4Outpatient Utilization in Community
Hospitals1980 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1990-2003, for community hospitals and US Census
Bureau State and County QuickFacts, 2003
population estimate data derived from Population
Estimates, 2000 Census of Population and
Housing Data for Charts 3.12, 3.13, and 3.14
A-29
30
(No Transcript)
31
Appendix 4Supplementary Data Tables Trends in
Hospital Financing
32
Supplementary Data Tables - Trends in Hospital
Financing
Table 4.1Aggregate Total Hospital Margins(1),
Operating Margins(2), and Patient Margins(3)
Percentage of Hospitals with Negative Total
Margins and Aggregate Non-operating Gains as a
Percentage of Total Net Revenue1980-2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospital (1) Total
Hospital Margin is calculated as the difference
between total net revenue ant total expenses
divided by total net revenue (2) Operating Margin
is calculated as the difference between operating
revenue and total expenses divided by operating
revenue (3) Patient Margin is calculated as the
difference between net patient revenue and total
expenses divided by net patient revenue Data for
Charts 4.1, 4.2, and 4.9
A-32
33
Supplementary Data Tables - Trends in Hospital
Financing
Table 4.2Distribution of Inpatient vs.
Outpatient Revenues1980 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospitals Data for Chart
4.4
A-33
34
Supplementary Data Tables - Trends in Hospital
Financing
Table 4.3Annual Change in Hospital Operating
Revenue and Expensesper Adjusted
Admission(1)1980 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospitals (1) An
aggregate measure of workload reflecting the
number of inpatient admissions, plus an estimate
of the volume of outpatient services, expressed
in units equivalent to an inpatient admission in
terms of level of effort Data for Chart 4.5
A-34
35
Supplementary Data Tables - Trends in Hospital
Financing
Table 4.4Aggregate Hospital Payment-to-Cost
Ratiosfor Private Payers, Medicare and
Medicaid1980 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospitals (1) Includes
Medicaid Disproportionate Share payments Data for
Chart 4.7
A-35
36
Supplementary Data Tables - Trends in Hospital
Financing
Table 4.5Hospital Payment Shortfall Relative to
CostsMedicare, Medicaid, and Other
Government1997 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data, 1997
2003, for community hospitals Data for Chart 4.8
A-36
37
Appendix 5Supplementary Data Tables Workforce
38
Supplementary Data Tables - Workforce
Table 5.1Total Number of Active Physicians per
1,000 Personsby State2001 and 2002
Source CDC, NCHS Health United States, 2003 and
2004 includes active non-federal doctors of
medicine and active doctors of osteopathy Data
for Chart 5.2
A-38
39
Supplementary Data Tables - Workforce
Table 5.2Medical and Dental Residents in
Trainingin Community Hospitals1980 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospitals Data for Chart
5.3
A-39
40
Supplementary Data Tables - Workforce
Table 5.3Total Full-Time Equivalent Employees
Working in Hospitalsand Full-Time Equivalents
per Adjusted Admission(1)1980 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1980-2003, for community hospitals (1) An
aggregate measure of workload reflecting the
number of inpatient admissions, plus an estimate
of the volume of outpatient services, expressed
in units equivalent to an inpatient admission in
terms of level of effort Data for Charts 5.4 and
5.5
A-40
41
Supplementary Data Tables - Workforce
Table 5.4Number of RN Full-Time Equivalent
Employees,RN Full-Time Equivalent Employees per
Adjusted Admission,and RN Full-Time Equivalents
as a Percentage of Total FTEs1986 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1986-2003, for community hospitals Data for
Charts 5.6 and 5.7
Table 5.5Number of Physicians by Age1980,
1990, and 2003
Source American Medical Association, Physician
Characteristics and Distribution in the US, 2005
Edition Data for Chart 5.8
A-41
42
Supplementary Data Tables - Workforce
Table 5.6RN Employment by Type of Provider1980
- 2000
Source Findings from the National Sample Survey
of Registered Nurses, 1980 - 2000 Bureau of
Health Professionals, Division of Nursing Data
for Chart 5.9
Table 5.7Distribution of RN Workforce by Age
Group1980 2020 (projected)
Source Buerhaus, P.I. et al. Implications of an
Aging Registered Nurse Workforce. JAMA
20002832948-2954 Data for Chart 5.10
A-42
43
Supplementary Data Tables - Workforce
Table 5.8National Supply and Demand Projections
for FTE RNs 2005 - 2020
Source National Center For Health Workforce
Analysis, Bureau of Health Professions, Health
Resources and Services Administration, 2002 Data
for Chart 5.12
A-43
44
(No Transcript)
45
Appendix 6Supplementary Data Tables The
Economic Contribution of Hospitals
46
Supplementary Data Tables The Economic
Contribution of Hospitals
Table 6.1Number of Full-Time and Part-Time
Hospital Employees1992 - 2003
Source The Lewin Group analysis of American
Hospital Association Annual Survey data,
1992-2003, for community hospitals Data for Chart
6.2
Table 6.2Hospital Employment vs. Employment in
Other Industries2004(1)
Source Department of Labor, Bureau of Labor
Statistics, Current Employment Statistics Survey
custom data request (1) Data is as of October
2004 Data for Chart 6.4
A-46
47
Supplementary Data Tables The Economic
Contribution of Hospitals
Table 6.3Average Weekly Earnings of Workers,
Hospitals(1) vs. All Service-Providing
industries 1990 - 2003
Source Department of Labor, Bureau of Labor,
Current Employment Statistics Survey (1)
Includes physicians employed by hospitals. Data
for Chart 6.5
A-47
48
(No Transcript)