Category: Hospitals

Dobson DaVanzo, a leading consulting firm, has produced a report for the Federation of American Hospitals, the trade association for for-profit hospitals. The report notes that the rate of change of health spending has slowed down. Indeed, the report concludes that spending is set to shrink this year by over one percent. This introduces a “paradox”:

However, paradoxically, consumers perceive that their health care spending is increasing more than usual. This perception is largely a result of spending on their health care increasing faster than personal income combined with a continuing redesign of their health insurance benefits, which shifts more of the cost burden onto consumers:

• Almost 60% of Americans think that health care costs have been growing faster than usual in recent years, and more than 70% of consumers attribute responsibility for their perceived high and rising costs to health insurance companies.
• Total premiums have increased substantially over the past decade, from 14.9% to 21.6% of median household income between 2003 and 2012.
• Employee contributions to premiums and out-of-pocket spending have risen 23% faster than employee costs since 2009 (32% in cumulative growth vs. 26%) (See Exhibit 2).

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Although the Bureau of Labor Statistics latest employment report shows that health care continues to add jobs at about the same rate as the rest of the economy, the shift of jobs to out of hospitals continues.

From March to April, hospitals barely added two thousand new workers. Physicians’ offices, on the other hand, added six thousand, while providers other than hospitals added jobs at a faster rate than hospitals. This is a trend that has persisted for months.

Hopefully, it portends a change in practice to lower cost settings. Nevertheless, hospitals are still adding workers. The hospital lobby often complains that reduced government reimbursement is causing cutbacks. The data do not confirm this.

Further, the unemployment rate in the education and health services sectors is just 3.7 percent (only government workers, with an unemployment rate of 2.7 percent, are doing better). Were the hospitals to actually reduce their workforce somewhat, we could plausibly anticipate that many of those workers would quickly be picked up by physicians’ offices and other health-services providers.

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Tickets started at $500. Food and beverages totaling $258 were budgeted for each person. A lucky reveler went home with a $125,000 Lexus Luxury Hybrid Sedan, donated for the occasion. It was the November 8, 2011, nonprofit Cedars-Sinai Medical Center’s annual Board of Governors Gala at the Beverly Hilton Hotel.

Of the hospital’s $2.8 billion total revenue that year, the lavish party netted the hospital $780,000 — barely a quarter of the C.E.O.’s salary.

Most galas, says [Charles Rehberg, a former hospital C.F.O], “are part of a carefully crafted strategy to promote their ‘charitable’ image in the community and engage the community leaders in their market. Look at the board of the foundation. It is generally the community business leaders, politicians and thought leaders in the community. It is very difficult to serve on such a board and also criticize the hospital for their high costs, charitable conduct, etc. By engaging these leaders in their ‘mission,’ they buy their support.

Rita Healey, 100Reporters. HT: Ron Shinkman, FierceHealthFinance.

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The study found that high-price hospitals averaged 474 staffed beds — more than double the average number of beds in the low-price hospitals — and had market shares about three times as large as those of low-price hospitals. The high-price hospitals were almost three times as likely to be teaching hospitals, were much more likely to offer specialized facilities and services, and received significantly higher revenues from sources other than patient care. In national rankings of hospitals’ reputations, high-price hospitals scored higher, but clinical outcomes measures were mixed. High-price hospitals performed better on one measure of mortality (for patients with heart failure), but performed worse than the low-price hospitals on measures of excess readmissions and on patient-safety indicators, including postsurgical deaths and complications.

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