Sahni Nikhil R, Istvan Brooke, Bello Thornhill Heather, Joynt-Maddox Karen E, Cutler David, Emanuel Ezekiel J
Economics Department, Harvard University, Cambridge, MA 02138, United States.
Center for US Healthcare Improvement, McKinsey & Company, Boston, MA 02110, United States.
Health Aff Sch. 2025 May 22;3(5):qxaf069. doi: 10.1093/haschl/qxaf069. eCollection 2025 May.
Health care spending continues to rise, and opportunities to decrease costs without negatively impacting patient care are a priority. Addressing administrative spending, approximately 25% of US health care spending, is an opportunity. To identify savings, hospitals and policymakers need data to quantify administrative expense categories and establish benchmarks for comparisons. However, it is unknown whether the Medicare Cost Reports-the only universal, public source for US hospital financials-accurately capture administrative expenses. We found that, at the national level, administrative expenses for 5639 hospitals were $166.1 billion, or 17.0% of total hospital expenses. A total of 4417 (78.3%) hospitals reported only a single overall "administrative and general" expense, averaging 18.9% (SD: 5.8%) of total hospital expenses, while 1222 (21.7%) provided detailed data on administrative expenses averaging 17.1% (SD: 5.0%) in sum. For those reporting subcategories, "other administrative and general" represented $37.6 billion (66.1%). Of the 3971 subcategories reported, 31.2% appeared mislabeled. In summary, hospitals report widely variable administrative expenses (7.0 percentage points between the 25th and 75th percentile), with few detailed, and often mislabeled, data to guide the identification of savings opportunities. As structured today, the Medicare Cost Reports are not a consistent, reliable, or actionable dataset to aid hospitals or policymakers in quantifying and addressing excess administrative spending.
医疗保健支出持续上升,在不负面影响患者护理的情况下降低成本的机会成为当务之急。解决约占美国医疗保健支出25%的行政支出问题是一个契机。为了确定节省开支的方法,医院和政策制定者需要数据来量化行政费用类别并建立比较基准。然而,尚不清楚医疗保险成本报告(美国医院财务唯一通用的公共来源)是否准确反映行政费用。我们发现,在国家层面,5639家医院的行政费用为1661亿美元,占医院总费用的17.0%。共有4417家(78.3%)医院仅报告了一项总体“行政及一般”费用,平均占医院总费用的18.9%(标准差:5.8%),而1222家(21.7%)医院提供了行政费用的详细数据,总计平均为17.1%(标准差:5.0%)。对于那些报告子类别的医院,“其他行政及一般”费用为376亿美元(66.1%)。在报告的3971个子类别中,31.2%似乎标签有误。总之,医院报告的行政费用差异很大(第25百分位数和第75百分位数之间相差7.0个百分点),几乎没有详细且常常标签有误的数据来指导节省开支机会的识别。按照目前的结构,医疗保险成本报告并非一个一致、可靠或可操作的数据集来帮助医院或政策制定者量化和解决过多的行政支出。