Knowledge sources used for Key Information About Hospitals are listed beneath. Some figures pull from different sources, together with prior KFF analyses and KFF State Well being Information, which embrace further details about the information and methodology. Numbers have been rounded.
American Hospital Affiliation (AHA) Annual Survey. Knowledge from an annual survey of all hospitals in the USA and its related areas. Non-federal psychiatric hospitals had been outlined to incorporate psychiatric hospitals in addition to hospitals that recognized their hospital sort as “substance use dysfunction” or “mental disabilities.”
American Medical Affiliation (AMA) Doctor Follow Benchmark Survey. As described by the AMA, the Doctor Follow Benchmark Survey is a nationally consultant survey of “post-residency physicians who present not less than 20 hours of affected person care per week, are usually not employed by the federal authorities, and observe in one of many 50 states or [DC].”
Census Bureau delineation information. The Census Bureau delineation information map counties and county equivalents to metropolitan areas, micropolitan areas, and different areas. These information had been used to group hospitals into metropolitan, micropolitan, and different areas. A metropolitan space is a county or group of counties that comprises not less than one city space with a inhabitants of fifty,000 or extra folks. A micropolitan space is a county or group of counties that comprises not less than one city space with a inhabitants of not less than 10,000 however lower than 50,000. City and rural areas had been outlined as metropolitan and nonmetropolitan areas, respectively.
Census Bureau inhabitants estimates. We relied on annual inhabitants estimates for the 50 states and DC as of July 1 of a given yr from the Census Bureau’s Inhabitants Estimates Program.
Healthcare Value and Utilization Venture (HCUP) Nationwide Inpatient Pattern (NIS). The NIS is a pattern that features about 20% of all inpatient discharges from U.S. neighborhood hospitals (except for rehabilitation and long-term care hospitals). It’s nationally consultant of non-federal short-term hospitals within the U.S. and is sponsored by the Company for Healthcare Analysis and High quality. Main diagnoses are grouped into medical classes based mostly on Scientific Classifications Software program Refined (CCSR). The classes used for rankings are mutually unique; when a prognosis falls beneath a number of medical classes, the keep is assigned to a single class based mostly on hierarchical pointers.
KFF Well being Care Debt Survey. The KFF Well being Care Debt Survey is a nationally consultant survey of U.S. adults that was performed from February 25 by means of March 20, 2022.
Medical Expenditures Panel Survey (MEPS). MEPS is a nationally consultant survey of the U.S. civilian non-institutionalized inhabitants that features details about well being care expenditures and sources of fee, amongst different issues. The evaluation of out-of-pocket spending relied on the MEPS Family Element (HC).
Nationwide Well being Expenditures. These knowledge are revealed yearly by the Facilities for Medicare & Medicaid Providers and supply estimates of nationwide spending on well being care, by payer and by sort of service.
Producer Worth Index (PPI). These knowledge come from the Bureau of Labor Statistics (BLS). As BLS notes, PPI indices measure “the typical change over time in promoting costs acquired by home producers of products and companies.” The well being care PPIs mirror the reimbursement that suppliers obtain for well being care companies. The Medicare, Medicaid, and personal and different affected person PPIs are mutually unique. The Medicare and Medicaid PPIs take account of personal Medicare and Medicaid plans. The PPI might exclude supplemental funds which can be paid to hospitals as a lump sum.
Quarterly Census of Wages and Employment (QCEW). These knowledge additionally come from BLS. As BLS notes, the QCEW knowledge present a “quarterly rely of employment and wages reported by employers overlaying greater than 95 % of U.S. jobs.” The QCEW consists of staff coated by state unemployment insurance coverage legal guidelines in addition to federal staff coated by the Unemployment Compensation for Federal Staff (UCFE) program. Analyses of hospital and different employment relied on the typical annual employment numbers reported by BLS. Trade subsector rankings had been based mostly on 3-digit NAICS codes. Employment for a given trade subsector and employer sort weren’t included in totals when not disclosed by BLS.
RAND Hospital Knowledge. These knowledge are a cleaned and processed model of annual price reviews that Medicare-certified hospitals are required to undergo the federal authorities. Value reviews embrace details about hospital traits, utilization, and funds. The RAND Hospital Knowledge additionally crosswalk hospitals to well being programs based mostly on the Company for Healthcare Analysis and High quality (AHRQ) Compendium of U.S. Well being Programs.
For charity care analyses, lacking charity care prices had been recoded as $0 if the hospital reported complete unreimbursed and uncompensated care prices. Hospitals had been excluded if that they had lacking or unfavorable working bills or charity care prices, outlier quantities of charity care as a % of working bills (≥18.1%), or reporting intervals lower than or higher than one yr. Value report directions point out that hospitals ought to report quantities associated to each charity care and uninsured reductions as a part of their charity care prices. MedPAC has noted that present HCRIS calculations favor hospitals with greater markups, and it has beneficial revisions that might put hospitals on extra equal footing and scale back reported charity care prices on common.
RAND Worth Transparency Research, Spherical 5.1. These knowledge are based mostly on business claims for employer-sponsored medical health insurance plan enrollees collected from taking part self-insured employers and well being plans in addition to from all-payer claims databases (APCDs) from 12 states. Industrial-to-Medicare value ratios are based mostly on the precise allowed quantity from the claims and an estimate of the allowed quantity had Medicare coated the identical companies. Ratios introduced in key details embrace facility claims for hospital inpatient and outpatient companies however exclude related skilled claims (that are additionally obtainable by means of the RAND examine). Analyses of metropolitan areas exclude hospitals for which RAND didn’t disclose related knowledge whereas state and nationwide analyses embrace all hospitals within the RAND examine.
Survey of Earnings and Program Participation (SIPP). SIPP is a nationally consultant survey of the civilian noninstitutionalized inhabitants. Amongst different questions, SIPP asks people ages 15 and older about their medical debt. The evaluation of medical debt additional restricted the pattern to adults ages 18 and older.
