Bai Ge, Anderson Gerard F
Ge Bai (
Gerard F. Anderson is a professor in the Department of Health Policy and Management and director of the Center for Hospital Finance and Management at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.
Health Aff (Millwood). 2016 May 1;35(5):889-97. doi: 10.1377/hlthaff.2015.1193.
To identify the characteristics of the most profitable US hospitals, we examined the profitability of acute care hospitals in fiscal year 2013, measured as net income from patient care services per adjusted discharge. Based on Medicare Cost Reports and Final Rule Data, the median hospital lost $82 for each such discharge. Forty-five percent of hospitals were profitable, with 2.5 percent earning more than $2,475 per adjusted discharge. The ten most profitable hospitals, seven of which were nonprofit, each earned more than $163 million in total profits from patient care services. Hospitals with for-profit status, higher markups, system affiliation, or regional power, as well as those located in states with price regulation, tended to be more profitable than other hospitals. Hospitals that treated a higher proportion of Medicare patients, had higher expenditures per adjusted discharge, were located in counties with a high proportion of uninsured patients, or were located in states with a dominant insurer or greater health maintenance organization (HMO) penetration had lower profitability than hospitals that did not have these characteristics. These findings can inform policy reforms, while providing a baseline against which to measure the impact of any subsequent reforms.
为了确定美国最盈利医院的特征，我们研究了2013财年急症医院的盈利能力，以每次调整后出院的患者护理服务净收入来衡量。根据医疗保险成本报告和最终规则数据，每家此类出院的医院中位数亏损82美元。45%的医院盈利，其中2.5%的医院每次调整后出院盈利超过2475美元。最盈利的十家医院，其中七家是非营利性医院，每家从患者护理服务中获得的总利润超过1.63亿美元。具有营利性地位、更高加价、系统附属关系或地区影响力的医院，以及位于有价格监管的州的医院，往往比其他医院更盈利。治疗医疗保险患者比例较高、每次调整后出院支出较高、位于未参保患者比例较高的县，或位于有主导保险公司或健康维护组织（HMO）渗透率较高的州的医院，其盈利能力低于没有这些特征的医院。这些发现可为政策改革提供参考，同时提供一个基线，用以衡量任何后续改革的影响。
