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AmericanCollege ofHealthcareExecutivesfor lenders who care Key Industry Facts: 2010
We are pleased to provide you with "Key Industry Facts," prepared by ACHE'S Division of Research. The insert is publishedeach year in Healthcare Executive, providing annual updates on healthcare spending and other vital information.3 We hope
-you find it a valuable resource. The facts were gathered from a variety of sources, including the American HospitalAssociation, the Centers for Medicare & Medicaid Services and the National Center for Health Statistics. A complete list ofreferences is included on the last page of the insert.
ECONOMIC INDICATORSREFERENCE NO. PAGE/TABLE
*
Gross Domestic Product (billions)$ 5,801 1990 1
9,952 2000 114,441 2008 1
National Health Expenditures (billions)$ 714.2 1990 1
1,352.9 2000 12,338.7 2008 1
Healffi Expenditures as Percentage of GDP12.3 1990 113.6 2000 116.2 2008 1
Amount per Capita$ 2,814 1990 1
4,789 2000 17,681 2008 1
Table 1Table 1Table 1
Table 1Table 1Table 1
Table 1Table 1Table 1
Table 1Table 1Table 1
SOURCE OF FUNDS—WHERE THE MONEY CAME FROM
REFERENCE NO. PAGE/TABLE
National Health Expenditures Total (billions)1'$ 714.2 1990 1
1,352.9 2000 12,338.7 2008 1
Private (percentage)59.8 1990 155.9 2000 152.7 2008 1
Public (percentage)40.2 1990 144.1 2000 1^473, 2008 1
A. Federal (percentage of total public)27.2 1990 130.9 2000 134.9 2008 1
B. State and Local (percentage of total)13.0 1990 113.2 2000 112.4 2008 1
Table 2Table 2Table 2
Table 1Table 1Table 1
Table 1Table 1Table 1
Table 1Table 1Table 1
Table 1Table 1Table 1
SOURCE OF FUNDS— ]WHERE THE MONEY CAME FROM continued
REFERENCE NO
Personal HealthcareTotal
$ 607.61,139.21,952.3
I. Out of Pocket$
II
$
$
$
$
PAGE/TABLE
Expenditures (billions) ^T^yW^^i
199020002008
136.1 ^1990192.6 /y %2000277.8 2008
. Third PartyA. Private Health Insurance
204.7 /I990402.8 "3/ &2000691.2 ' 2008
B. Other Private Funds30.557.075.5
C. Public FundsFederal
199020002008
Unfo172.8 1990369.8 2000718.0 2008
State and Local63.4117.1
189.8
199020002008
111
111
111
111
111
111
Table 6Table 6Table 6
Table 6Table 6Table 6
Table 6Table 6Table 6
Table 6Table 6Table 6
Table 6Table 6Table 6
Table 6Table 6Table 6
* figures for 1990 and 2000 may not correspond to ACHE'S Key Industry farts Sept/Ocf report from 2009, as tnese figures have since been updated by the referencedsources.
b National health expenditures amounted to $2.2 trillion in 2007 and include itemsother than personal healthcare expenditures such as construction and research.
Healthcare Executive Sept/Oct2010
Key Industry Facts: 2010 AmericanCollege ofHealthcareExecutives
OBJECT OF EXPENDITURES— BWHERE THE MONEY WENT •
REFERENCE NO. PAGE/TABLE
National Health Expenditures Total (billions)$
1.$
$
$
$
$
$
$
$
$
$
$
$
t
714.2 1990 11,352.9 2000 12,338.7 2008 1
Health Services and Supplies (breakdown
Table 1Table 1Table 1below)
666.8 1990 1 Table 21,264.1 2000 1 Table 22,181.3 2008 1 Table 2
A. Personal Healthcare (breakdown below)607.6 1990
1,139.2 20001,952.3 2008Hospital Care
251.6 1990416.9 2000718.4 2008
Physician and Clinical Services157.5 1990288.6 2000496.2 2008
Other Professional Services18.2 199039.1 200065.7 2008
Dental Services31.5 199062.0 2000
101.2 2008Other Personal Healthcare
9.6 199037.1 200068.1 2008
Home Healthcare12.6 199030.5 200064.7 2008
Nursing Home Care52.6 199095.3 2000
138.4 2008Prescription Drugs
40.3 1990120.6 2000234.1 2008
Other Durable or Nondurable
111
111
11
111
111
111
111
111
111Medical
Table 2Table 2Table 2
Table 2Table 2Table 2
Table 2Table 2Table 2
Table 2Table 2Table 2
Table 2Table 2Table 2
Table 2Table 2Table 2
Table 2Table 2Table 2
Table 2Table 2Table 2
Table 2Table 2Table 2
Products33.7 1990 1 Table 249.2 2000 1 Table 265.5 2008 1 Table 2
B. Government Administration and Net Cost ofPrivate Health Insurance
39.3 1990 181.8 2000 1
159.6 2008 1C. Government Public Health Activities
;
20.0 199043.0 200069.4 2008
1
Table 2Table 2Table 2
Table 2Table 2Table 2
1 OBJECT OF EXPENDITURES— 1WHERE THE MONEY WENT continued 1
REFERENCE NO.
II. Investment Total (breakdown below)$ 47.3 1990 1
88.8 2000 1157.5 2008 1
A. Research$ 12.7 1990 1
25.6 2000 143.6 2008 1
B. Structures and Equipment$ 34.7 1990 1
63.2 2000 1113.9 2008 1
• INSURANCEREFERENCE NO.
Enrollment in HMOs (millions)'133.0 1990 280.9 2000 264.5 2008 3
Number of HMOs572 1990 2568 2000 2577 2008 4
Sources of Insurance Coverage (millions)Total Nonelderly Population
220.6 1990 5244.8 2000 6262.8 2008 6
Total With Private Health Insurance"164.7 1990 5183.5 2000 6177.3 2008 6
Employer Coverage
PAGE/TABLE
Table 2Table 2Table 2
Table 2Table 2Table 2
Table 2Table 2Table 2
1PAGE/TABLE
Table 137Table 137See ref.
Table 137Table 137See ref.
Figure 1Figure 1Figure 1
Figure 1Figure 1Figure 1
149.6 1990 5 Figure 1167.5 2000 6 Figure 1160.6 2008 6 Figure 1
Other Private Coverage (individually purchased)15.1 1990 516.0 2000 616.7 2008 6
Total With Public Health Insurance32.2 1990 535.8 2000 651.0 2008 6
Medicare3.5 1990 S5.4 2000 67.7 2008 6
Medicaid
Figure 1Figure 1Figure 1
Figure 1Figure 1Figure 1
Figure 1Figure 1Figure 1
22.7 1990 5 Figure 126.2 2000 6 Figure 139.2 2008 6 Figure 1
c Starting with 2006 data all managed health plans offering Medicaid products,whether licensed as HMOs or not, are included in these data. Starting with 2006data, enrollment data for Medicare HMOs are limited to Medicare Advantage HMOplans. Previously, some other types of Medicare plans were included in the enroll-ment data for certain plans.
Includes employment-based coverage and individually purchased coverage.
Healthcare Executive Sept/Oct 2010
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Key Industry Facts: 2010•̂ MMT AmericanCollege of^^•^ HealthcareExecutives
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^^^^H INSURANCE continuedREFERENCE NO.
Tricare/CHAMPVA'7.9 1990 56.8 2000 67.8 2008 6
Uninsured
mmmPAGE/TABLE
Figure 1Figure 1Figure 1
32.9 1990 5 Figure 138.2 2000 6 Figure 145.7 2008 6 Figure 1
Sources of Insurance Coverage for Elderly (millions)Total Elderly Population
30.1 1990 733.6 2000 837.8 2008 8
Total With Private Health Insurance20.6 1990 721.0 2000 822.3 2008 8
Employer Coverage10.0 1990 711.5 2000 813.2 2008 8
Direct Purchase(N/A) 1990 7
10.7 2000 810.1 2008 8
Total With Public Health Insurance28.9 1990 732.4 2000 835 4 2008 8
Medicare28.8 1990 732.3 2000 835.3 2008 8
Medicaid2.6 1990 73.3 2000 83.4 2008 8
Military Healthcare*1.2 1990 71.4 2000 82.8 2008 8
Total Uninsured (thousands)276 1990 7251 2000 8646 2008 8
Table C-2Table C-3Table C-3
Table C-2Table C-3Table C-3
Table C-2Table C-3Table C-3
Table C-2Table C-3
Table C-2Table C-3Table C-3
Table C-2Table C-3Table C-3
Table C-2Table C-3Table C-3
Table C-2Table C-3Table C-3
Table C-2Table C-3Table C-3
• HOSPITALS ^^HREFERENCE NO. PAGE/TABLE
Number of Hospitals6,649 1990 9 Table 15,810 2000 9 Table 15,815 2008 9 Table 2
Number of Community Hospitals9
5,420 1990 9 Table 14,934 2000 9 Table 15,026 2008 9 Table 1
Number of Beds (Community Hospitals) (thousands)929 1990 9 Table 1825 2000 9 Table 1810 2008 9 Table 1
Average Length of Stay (Community Hospitals) (days)7.3 1990 9 Table 15.8 2000 9 Table 15.5 2008 9 Table 1
Average Occupancy (Community Hospitals)11 (percentage)69.6 1990 9 Table 166.1 2000 9 Table 168.2 2008 9 Table 1
Total Net Margin (Community Hospitals)1 (percentage)4.6 2000 10 Table 32.6 2008 9 Table 3
Net Patient Margin (Community Hospitals)1 (percentage)-4.2 2000 10 Table3-2.6 2008 9 Table 3
• PHYSICIANS AND NURSES ^^HREFERENCE NO. PAGE/TABLE
Number of Physicians (thousands)615 1990 11 Table 5.1814 2000 11 Table 5.1954 2008 12 Mini-Table 11
Number of Nurses (Active Registered) (thousands)1,790 1990 13 Page 1222,190 2000 14 See ref.2,543 2008 15 See ref.
e Tricare (formerly known as CHAMPUS) is a program administered by theDepartment of Defense for military retirees as well as families of active duty, retiredand deceased service members. CHAMPVA, the Civilian Health and MedicalProgram for the Department of Veterans Affairs, is a healthcare benefits programfor disabled dependents of veterans and certain survivors of veterans.
f Military healthcare includes CHAMPUS/Tricare and CHAMPVA as well as care pro-vided by the Health and Medical Program of the Department of Veterans Affairsand care provided by the Department of Veterans Affairs and the military.
9 Community hospitals are nonfederal short-term general and other special hospitals,e.g., obstetrics and gynecology; eye, ear, nose and throat; rehabilitation; orthope-dic; and other individually described specialty services available to the general pub-lic. Short-term general and special children's hospitals are also considered to becommunity hospitals.
Calculated as follows: Average daily census/beds.
Definitions for Total Net Margin and Net Patient Margin are as follows: Total NetMargin is defined as (Total Net Revenue-Total Expenses)/Total Net Revenue. NetPatient Margin is defined as (Total Net Patient Revenue-Total Expenses)/Total NetPatient Revenue.
Healthcare Executive Sept/Oct 2010
Key Industry Facts: 2010AmericanCollege ofHealthcareExecutives
LONG-TERM CAREREFERENCE NO. PAGE/TABIE
Number of Nursing Homes15,23615,37115,094
199720002008
161718
Page 25Page 16Page 41
Number of Beds in Nursing Homes (thousands)1,6781,7171,658
199720002008
161718
LIFE EXPECTANCY
Males (years)
Page 25Page 16Page 42
REFERENCE NO. PAGE/TABLE
71.8 1990 19 Tables74.3 2000 19 Table 875.3 2007 20 Table 6
LIFE EXPECTANCY continued \E NO.PAGE/TABLE
Females (years)78.8 199079.7 200080.4 2007
19
19
20
Table 8Table 8Table 6
INFANT MORTALITYREFERENCE NO. PAGE/TABLE
Rate per 1,000 Live Births9.2 19906.9 20006.7 2006
International Ranking of U.S.'24 199027 200028 2006
21
2323
212223
Table 25Table 22Table 22
Table 25Table 25Table 22
Most recent data from the National Center for Health Statistics.
REFERENCES
1 . Centers for Medicare & Medicaid Services, Office of theActuary, National Health Statistics Group; U.S. Department ofCommerce, Bureau of Economic Analysis; and U.S. Bureau ofthe Census. NHE Web Tables 1, 2, 6. http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf
2. National Center for Health Statistics. "Health, United States,2005 With Chartbook on Trends in the Health of Americans."Hyattsville, MD: 2005.
3. The Henry J. Kaiser Family Foundation, statehealthfacts.org.Data Source: Healthleaders, Inc., Special Data Request, March2009. "Total HMO Enrollment, July 2008."http://www.statehealthfacts.org/cornparemaptable.jsp?ind=348&cat=7&print=1
4. The Henry J. Kaiser Family Foundation, statehealthfacts.org.Data Source: Healthleaders, Inc., Special Data Request, March2009. "Number of HMOs, July 2008."http://www.statehealthfacts.org/comparemaptable.jsp?ind=347&cat=7&print=1
5. Fronstin, P. "Sources of Health Insurance and Characteristics ofthe Uninsured: Analysis of the March 2002 Current PopulationSurvey." Employee Benefit Research Institute: December 2002.http://www.ebri.org/pdf/briefspdf/1202ib.pdf
6. Fronstin, P. "Sources of Health Insurance and Characteristics ofthe Uninsured: Analysis of the March 2009 Current PopulationSurvey." Employee Benefit Research Institute: September 2009.http://www.ebri.org/pdf/briefspdf/EBRIJB_9-2009_No334_Hl-Cvgl.pdf
7. DeNavas-Walt, Carmen, Bernadette D. Proctor, and Cheryl HillLee. U.S. Census Bureau, Current Population Reports, P60-231,Income, Poverty, and Health Insurance Coverage in the UnitedStates: 2005. U.S. Government Printing Office, Washington, DC,2006. http://www.census.gov/prod/2006pubs/p60-231 .pdf
8.
9.
DeNavas-Walt, Carmen, Bernadette D. Proctor, and Jessica C.Smith, U.S. Census Bureau, Current Population Reports,P60-236, Income, Poverty, and Health Insurance Coverage inthe United States: 2008. U.S. Government Printing Office,Washington, DC, 2009. http://www.census.gov/prod/2009pubs/p60-236.pdf
American Hospital Association, "AHA Hospital Statistics," 2010Edition, Chicago: Health Forum LLC, 2009.
10. American Hospital Association, "AHA Hospital Statistics," 2006Edition, Chicago: Health Forum LLC, 2006.
11. American Medical Association, "Physician Characteristics andDistribution in the U.S.," 2007 Edition, Chicago: AMA, 2007.
12. American Medical Association, "Physician Characteristics andDistribution in the U.S.," 2010 Edition, Chicago: AMA, 2010.
13. U.S. Census Bureau. "Statistical Abstract of the United States:2000." Washington, DC: 2000.
14. U.S. Department of Labor, Bureau of Labor Statistics."2000 National Occupational Employment and WageEstimates: Healthcare Practitioners and Technical Occupations."http://www.bls.gov/oes/2000/oes_29He.htm
15. U.S. Department of Labor, Bureau of Labor Statistics."Occupational Employment and Wages, May 2008, 29-1111Registered Nurses." http://www.bls.gov/oes/2008/may/oes291111.htm
16. Aventis. "Managed Care Digest Series 1999." Bridgewater, NJ:Aventis Pharmaceuticals, 1999.
17. Aventis. "Managed Care Digest Series 2001." Bridgewater, NJ:Aventis Pharmaceuticals, 2001.
18. sanofi-aventis U.S. LLC. "Managed Care Digest Series Public PayerDigest 2009." Bridgewater, NJ: sanofi-aventis U.S. LLC, 2009.
19. Kung HC, Hoyert DL, Xu JQ, Murphy SL. Deaths: Final data for2005. National vital statistics reports; vol. 56, no. 10.Hyattsville, MD: National Center for Health Statistics. 2008.http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf
20. Xu J, Kochanek KD, Tejada-Vera B. Deaths: Preliminary data for2007. National vital statistics reports; vol. 58, no. 1. Hyattsville,MD: National Center for Health Statistics. 2009. http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_01.pdf
21. National Center for Health Statistics. "Health, United States,1993." Hyattsville, MD: Public Health Service. 1994. http://www.cdc.gov/nchs/data/hus/hus93.pdf
22. National Center for Health Statistics. "Health, United States,2004 With Chartbook on Trends in the Health of Americans."Hyattsville, MD: 2004. http://www.cdc.gov/nchs/data/hus/hus04.pdf
23. National Center for Health-Statistics. "Health, United States,2009: With Special Feature on Medical Technology." Hyattsville,MD: 2010. http://www.cdc.gov/nchs/data/hus/hus09.pdf
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