by Christine Monahan, Kennah Watts, Julia Burleson, Rachel Swindle, and Ariel Winter
Hospitals present important well being care, so it’s essential they keep monetary viability and may readily serve their communities. On the similar time, spending on hospital companies makes up the largest proportion of complete nationwide well being expenditures, and hospital costs are a key driver of spending. As Individuals more and more wrestle to afford each insurance coverage premiums and out-of-pocket medical payments, it’s ever extra obvious that entry to well being care and the worth of well being care are intently interwoven. Policymakers, their employees, and others collaborating within the policymaking course of want to know the laws, fee applications, and reporting necessities that apply to hospitals with a purpose to craft focused, efficient reforms that scale back spending whereas sustaining entry to high quality care.
To help evidence-based policymaking, our new information helps readers perceive the organizational and monetary variations throughout hospitals in america. Via a group of truth sheets, the information explains:
- Key inquiries to ask a couple of hospital
- Core hospital fee and accounting ideas
- How a hospital’s organizational type, kind of care, location, service of low-income sufferers, instructing standing, and different fee fashions affect operations
- The place to seek out out extra about particular person hospitals
The information permits readers to decide on the extent of element and focus that’s most useful to them: learn the information straight via, or concentrate on sections of biggest curiosity of their most popular order. To assist readers determine the place to start out, under we spotlight what every of the important thing elements provide and the way they match collectively. The total information and particular person sections and truth sheets can be found to learn and obtain right here.
Methods to Use This Information
This doc has 4 core elements, which can be utilized collectively or individually. The information is structured to assist readers simply pinpoint probably the most helpful data, and all through the information, inside hyperlinks information the reader between sections. The sections are additionally shade coded to assist readers distinguish between main thematic areas.
Inquiries to Ask (About) a Hospital
Overview: This part outlines the important thing inquiries to ask a couple of hospital to raised perceive the regulatory scheme below which it operates, the funding streams it might have accessible, and different elements that affect its enterprise practices and monetary standing. These questions correspond to the six hospital classes mentioned in additional element within the “Key Info on Hospitals” part under.
Methods to Use This Element: This part can function a framework or line of questioning for policymakers to be taught extra about particular hospitals. With temporary solutions, these questions cowl the important high-level data to learn about a hospital and provide a fast useful resource for readers with out a lot time.
Hospital Fee and Accounting Explainer
Overview: This part demystifies advanced hospital fee programs and descriptions how hospitals are paid for care. It particulars the important thing phrases and ideas associated to hospital income, in addition to how every main payer kind –– Medicare, Medicaid, and industrial plans –– pays hospitals. It additionally gives an summary of public sources of hospital value and monetary accounting data, and key hospital finance measures.
Methods to Use This Element: This part can function a 101 explainer of hospital fee, in addition to a glossary of key phrases. Readers may refer again to this explainer when studying the important thing details part to attach particular federal insurance policies to fee or to raised perceive information factors on hospital funds.
Key Info About Hospitals
Overview: Via a sequence of quick truth sheets, this part gives readers with data on necessary hospital classifications and explains how these groupings affect hospital operations and funds. These key details are divided into six color-coordinated collections, every related to a technique to categorise hospitals:
- Organizational type (blue)
- Sort of care (inexperienced)
- Geographic location (yellow)
- Service of low-income sufferers (orange)
- Educating standing (purple)
- Participation in different fee fashions (purple)
Our method to grouping hospitals is basically knowledgeable by distinctions drawn in federal regulation and laws, particularly the Medicare program.
Methods to Use This Element: Use this part to dive deep into particular hospital classes. Every assortment begins with a quick overview of how a sure hospital classification influences operations and funds, which expands on the “Inquiries to Ask (About) a Hospital” part of the information. Following the overviews are a number of particular person truth sheets for the precise varieties a hospital might take or applications through which they might take part inside that class. Every assortment –– besides participation in different fee fashions –– concludes with a “By the Numbers” part with related information from Medicare Value Experiences and different data sources, to the extent accessible. Readers may refer again to the Hospital Fee and Accounting Explainer to pair key fee ideas with extra element on fee strategies.
The place to Discover Out Extra
Overview: This part identifies assets for readers who need to apply the data on this information and be taught extra about a person hospital. It contains hyperlinks to extra data on hospital possession; regulatory and fee classifications; and funds, operations, and high quality efficiency.
Methods to Use This Element: This part directs readers to exterior, impartial databases that can enable them to dive deeper into a selected hospital.
Methods to Learn and Obtain This Information
To enhance usability, we offer a number of methods to learn and obtain the information. Readers can flip via the information and see side-by-side pages with the flipbook characteristic on the web site homepage. For readers preferring a PDF or printed model of the information, it’s accessible for obtain right here. For readers preferring to tug out particular sections or singular truth sheets, these items of the information can be found for particular person obtain via the desk of contents on the homepage.