Table 1.
Characteristics of 1331 nonprofit US hospitals in a study of community health needs assessment, 2013a
| Characteristic | Study Sampleb (n = 1331) |
|---|---|
| Institutional characteristics | |
| No. of beds, median (IQR) | 129 (52-256) |
| Case mix index,c mean (SD) | 1.44 (0.21) |
| Profitabilityd | |
| High profit margin | 713 (54) |
| Normal profit margin | 267 (20) |
| Negative profit margin | 351 (26) |
| System affiliatione | |
| Yes | 709 (53) |
| No | 622 (47) |
| Network affiliationf | |
| Yes | 488 (37) |
| No | 843 (63) |
| Teaching hospitalg | |
| Yes | 84 (6) |
| No | 1247 (94) |
| Contract-managed hospitalh | |
| Yes | 120 (9) |
| No | 1211 (91) |
| Church-affiliated hospitali | |
| Yes | 188 (14) |
| No | 1143 (86) |
| Sole community providerj | |
| Yes | 86 (6) |
| No | 1245 (94) |
| Member of an ACOk | |
| Yes | 305 (23) |
| No | 1026 (77) |
| Community and market characteristics | |
| Market competition,l median (IQR) | 0.52 (0.27-1.00) |
| Wage index,m median (IQR) | 1.04 (0.90-1.41) |
| % of hospital beds in the county operated by for-profit hospitals, median (IQR) | 0.0 (0.0-5.2) |
| % of hospital beds in the county operated by government hospitals, median (IQR) | 0.0 (0.0-0.0) |
| Locationn | |
| Urban | 784 (59) |
| Rural | 547 (41) |
Abbreviations: ACO, accountable care organization; IQR, interquartile range.
aSources: Internal Revenue Service 2013 Form 990 Schedule H13; County Health Rankings & Roadmaps project14; American Hospital Association Annual Survey (unpublished); Centers for Medicare & Medicaid Services15; 2013 Area Health Resource File16; and proprietary ACO data from government documents, a database from a consulting firm that tracks such data (Leavitt Partners), and the authors’ own primary data collection.
bAll values are No. (%) unless otherwise indicated. Percentages are for categorical variables; medians and IQRs are for continuous variables.
cCase mix index is the average diagnosis-related group weight for a hospital’s Medicare patients. Hospitals with case mix values >1 have patients whose diagnoses are relatively more resource intensive than the national average. Hospitals with index values <1 have patients whose diagnoses are relatively less resource intensive than the national average (a value of 1).
dProfit margin was computed by subtracting a hospital’s operating costs from its operating revenue and dividing the result by the operating revenue: margins >3% = high profit, normal profit is between 0% and 3%, and margins ≤0% = negative profit margins.
eSystem affiliation refers to hospitals that were members of a corporate entity that owns 2 or more hospitals (ie, multihospital system).
fNetwork affiliation refers to hospitals that participated in a strategic alliance or joint venture with 1 or more hospitals. These arrangements do not entail common ownership of the participating hospitals.
gHospitals were classified as teaching if they were members of the Council of Teaching Hospitals.
hContract managed refers to a hospital that contracted with an outside company to manage its operations.
iChurch affiliation refers to hospitals that were owned and operated by a religious organization.
jSole community provider is a designation under the Medicare program for hospitals that meet at least 1 of several criteria (eg, located at least 35 miles from other like hospitals).
kACO participation was defined as participation by a hospital in the Medicare Shared Savings Program or Pioneer ACO initiative.
lMarket competition was measured in accordance with the Herfindahl-Hirschman Index (HHI),18,19 which was computed by summing the squared values of each hospital’s proportion of total hospital patients admitted to general, acute-care hospitals within its market (defined as county). The theoretical range for the HHI is 0 to 1, where 1 indicates a monopoly (ie, 1 firm in the market). For example, if there are 2 hospitals in a market, 1 with .25 share of total admissions and the other with .75 share of the admissions, the HHI would be .625 (.252 + .752).
mThe Medicare wage index reflects geographic differences in hospital wage levels. A hospital’s index value reflects the wage level for its geographic area compared with the national average.
nHospitals classified as urban were located within a metropolitan statistical area.