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September 2019
Expense
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Expense by Region *
All regions saw unfavorable year-over-year performance in Total Expense per Adjusted Discharge. The South saw the greatest increases, up more than 7 percent year over year, but -0.6 to budget, while the Midwest had the lowest at up 1.42 percent year over year, and 2.3 percent compared to budget. Total Expense per Adjusted Discharge for the Great Plains was up 2 percent year over year, but was significantly below budget expectations at -17.1 percent.
Supply Expense per Adjusted Discharge was the other area where all regions saw uniformly unfavorable year-over-year performance. The South again saw the biggest jump, up 5.6 percent year over year but -2.3 percent to budget. The Northeast/Mid-Atlantic saw the least increase, with Supply Expense per Adjusted Discharge up just 0.6 percent year over year, and about 1.4 percent above budget.
Non-Labor Expense per Adjusted Discharge rose for most regions year over year, except for the West, which was flat compared to the same period in 2018. The Great Plains had the most significant budget variance for Non-Labor Expense per Adjusted Discharge, at -16.5 percent below budget. Labor Expense per Adjusted Discharge was up year over year for hospitals in the South, West, and Northeast/Mid-Atlantic, but declined for hospitals in the Great Plains and Midwest.
Labor
Non-Labor
Supply
Drug
Purchased Service
FTE/AOB
Labor Expense
Non-Labor Expense
Supply Expense
Drug Expense
Purchased Service Expense
FTE per AOB
National Expense Observations
Hospitals nationwide experienced another month of mixed performance in August relative to expenses. Most indicators were down slightly month over month, but up year over year. Total Expense per Adjusted Discharge rose 4.0 percent year over year for its fourth consecutive month of increases, but decreased slightly -0.4 percent month over month, performing -0.5 percent below budget.
Much of the year-over-year increases can be attributed to non-labor expenses. Non-Labor Expenses per Adjusted Discharge rose 3.5 percent year over year in August. Contributing factors include a 1.9 percent increase in Drug Expense per Adjusted Discharge, a 3.6 percent increase in Supply Expense per Adjusted Discharge, and a 6.1 percent increase in Purchased Service Expense per Adjusted Discharge, all year over year. Labor Expense per Adjusted Discharge rose 2.4 percent year over year, although Full Time Equivalents per Adjusted Occupied Bed (AOB) were down -0.3 percent year over year.
Most expense metrics were down slightly compared to July performance and to budget. Non-Labor Expense per Adjusted Discharge was one exception, performing at budget and essentially flat—up just 0.1 percent—month over month. Purchased Service Expense per Adjusted Discharge was the other exception, rising 1.6 percent month over month, and 0.5 percent above budget.
Unless noted, figures are Actuals and Medians
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Total Expense per Adj. Discharge
(0.5%)
(0.4%)
4.0%
Total_Exp_Per_Adj_Discharge.svg
Labor Expense per Adj. Discharge
(1.0%)
(0.8%)
2.4%
Labor_Exp_Per_Adj_Discharge.svg
FTEs per AOB
(3.6%)
(1.1%)
(0.3%)
FTEs_Per_AOB.svg
Non-Labor Exp per Adj. Discharge
0.0%
0.1%
3.5%
Non_Labor_Exp_Per_Adj_Discharge.svg
Supply Expense per Adj. Discharge
(0.3%)
(1.0%)
3.6%
Supply_Exp_Per_Adj_Discharge.svg
Drug Expense per Adj. Discharge
(0.8%)
(1.2%)
1.9%
Drug_Exp_Per_Adj_Discharge.svg
Purchased Service Exp per Adj. Discharge
0.5%
1.6%
6.1%
Purchased_Service_Exp_Per_Adj_Discharge.svg
By Region
By Bed Size
National Observations
Expense by Bed Size
Hospitals of all sizes saw unfavorable year-over-year performance in August for Total Expense per Adjusted Discharge, Labor Expense per Adjusted Discharge, and Non-Labor Expense per Adjusted Discharge. Hospitals of 26-99 beds showed the biggest increase in Total Expense per Adjusted Discharge at 6.6 percent. The nation’s smallest hospitals of 0-25 beds had the greatest variance to budget, however, with Total Expense per Adjusted Discharge at -6.4 percent to budget for the month.
Most bed-size cohorts also experienced year-over-year increases in Supply Expense per Adjusted Discharge, with 26-99 bed hospitals rising the most at 9.5 percent compared to the same period last year. The only cohort that did not see year-over-year increases in Supply Expense per Adjusted Discharge was the nation’s largest hospitals of 500 beds or more, which had a -0.2 percent decrease for this metric, but significant budget variance at about 5.5 percent.
Purchased Service Expense per Adjusted Discharge also saw year-over-year increases for most bed-size cohorts, except for 300-499 bed organizations, which were essentially flat compared to the same period in 2018.
Labor
Non-Labor
Supply
Drug
Purchased Service
FTE/AOB
Labor Expense
Non-Labor Expense
Supply Expense
Drug Expense
Purchased Service Expense
FTE per AOB
By Region
By Bed Size
National Observations
©2019 Kaufman, Hall & Associates, LLC
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