The 2019 Hospitals And Health Systems Market Report analyzes the major market trends impacting the industry; consolidation, employment, and reimbursement shifts.
- Hospitals are estimated to reach 33% ($1.3 trillion) of U.S. healthcare expenditures in 2019
- Hospital Medicare margins remain negative, but Medicare’s share of the hospital payer mix is projected to increase by 4% by 2028
- 44% of U.S. physicians were employed by hospitals in 2018
Market-At-A-Glance
In 2019, hospitals are expected to account for the largest share of healthcare expenditures at 33% ($1.3 trillion). From 2018 to 2019, hospital expenditures grew 5.1%, driven largely by increased Medicare and Medicaid spending. By 2027, U.S. spend on hospitals is expected to reach $2 trillion. As of 2019, there were an estimated 6,210 hospitals nationwide.
Many Hospitals Struggle To Remain Profitable
In 2018, median for-profit hospital operating margins were estimated at 1.8%, lower than the 2.5% that investors consider healthy. Much of this is attributed to continued erosion of the payer mix. In 2019, Medicare and private health insurance are estimated to reach 25% and 39% of the payer mix respectively. By 2028, Medicare’s share of the payer mix is expected to increase to 29% while private payers’ share is projected to decline to 37%.
This could potentially challenge hospitals as Medicare is increasingly subject to regulatory demands, many of which, such as the Hospital-Acquired Conditions Reduction Program, come with financial penalties. In 2017, hospital Medicare margins averaged -9.9%, down from -9.7% the year prior. As of 2019, one-fifth of U.S. hospitals were considered to be at high financial risk and were considered likely to close unless their situations improved.
2019 Outlook For Nonprofit Hospitals Negative
Revenues for nonprofit hospitals are expected to grow 3-4% in 2019 while expenses are projected to increase 4-5%. While growth in expenses is slower than in prior years, revenues continue to lag.
Contributors to the negative outlook include:
- Low Medicare reimbursement rates
- Increases in the number of Medicare patients as the population ages
- Nursing shortages
- Rising wages
- Specialty drug costs
- New technology costs
Hospitals Continue To Pursue Physician Employment
In 2016, 155,000 (41.7%) of physicians were employed by hospitals. This figure has steadily increased from 26% in 2012. Estimates for 2018 reinforce the trend, with 169,000 (44%) of physicians employed by hospitals.
Table of Contents
- Executive Summary
- US Spending On Hospital Services Projected To Reach $2 Trillion By 2027
- Hospitals Reach One-Third Of National Health Expenditures In 2019
- National Health Expenditures Projected To Reach $60 Trillion By 2027
- Spending Growth On Hospital Services Slows
- Slower Growth In Providers’ Costs To Treat Patients
- US Hospitals By The Numbers, 2019
- Hospitals And Health Systems Say Reducing Operating Costs Is Critical To Success
- One-Fifth Of Rural Hospitals Face High Financial Risk
- Nonprofit Hospitals Face Negative Outlook In 2019
- Majority Of Hospital, Health System Executives Report Supply Budget Increases
- Medical Supplies Expected To Pass Labor As The Number One Hospital Expense By 2020
- Hospital Medicare Margins Remain Negative
- Payer Mix Erosion Projected To Affect Hospitals
- Health System Margins Drop 39% From 2015–2017
- Health System Margins Vary By Geographical Region
- Inpatient Admissions To Remain Flat Through 2028
- Outpatient Visits Increase, Inpatient Discharges Decrease For Medicare Patients
- Endovascular Surgeries Had The Largest Inpatient Volume Growth 2008-2018
- Outpatient Volume Growth Projected
- Volume Growth Estimated To Occur In Outpatient Setting
- Outpatient Revenues Make Up Nearly Half Of Hospital Earnings
- Aging Population Chief Contributor To Outpatient Volume Growth
- Observational Care, Drug Costs Had The Largest Outpatient Medicare Spending Increases From 2012–2017
- Diagnostics Services Top List Of Hospital Outpatient Procedures By Volume
- Knee Replacement Surgery Had Largest Outpatient Volume Growth 2008-2018
- ER Accounts For 25% Of Hospital Revenues, But Growth Is Slowing
- Hospitals Employ Nearly Half Of Healthcare Workers
- Hospitals Nurses Earn More Than The Industry Average Nurse Salary
- Average Turnover For Nurses Is Lower Than That Of Other Employees
- Hospital Nurse Vacancies Are On The Rise
- Turnover Highest Among ER Nurses
- 44% Of Physicians Were Employed By Hospitals In 2018
- Hospitals Embrace Mobile Technologies
- Hospitals Uncover New Technology Challenges
- 10% Of Hospitals Report Medical Device Cybersecurity Incident In 2018
- Health Systems Struggle To Standardize Supply Chain
- Acute Providers Look For Services, Convenience When Selecting A Distributor
- Hospitals And Health Systems Say Cost Reduction, Order Fulfillment Important In Supply Chain Partnership
- Hospital M&A, Construction Appear To Slow
- Physician Offices Remain The Leading Target For Acquisition
- 800 Hospitals Penalized Under Hospital-Acquired Conditions Reduction Program In FY 2019
- Hospital Readmissions Reduction Program Largely Successful In Achieving Goals
- Health Systems Slow To Adopt Payment Models Tied To Outcomes
- GHX Reports $275 Billion In Hospital Sales Through Distribution In 2018
- GHX Lists Top Hospital Products Sold Through Distribution
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