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Despite Financial Challenges, Essential Hospitals Maintain High Quality, Service


Even with broader access to health insurance under the Affordable Care Act (ACA), hospitals that care for large numbers of vulnerable people continue to face significant financial challenges and high levels of uncompensated care, new data from America’s Essential Hospitals show.

The association’s annual member profile, 2014 Essential Data: Our Hospitals, Our Patients, shows that while the financial picture improved for essential hospitals in 2014, the first year of ACA coverage, the association’s members still posted a slight operating loss, on average. By contrast, other U.S. hospitals had an average positive operating margin of 8.3 percent.

“We’ve made progress under the ACA, especially in states that expanded Medicaid, but we still have a long way to go,” America’s Essential Hospitals President and CEO Bruce Siegel, MD, MPH, said. “Vulnerable patients and their hospitals continue to need strong funding support.”

The association’s members provided $7.8 billion in uncompensated care in 2014, or 18.3 percent of all uncompensated care nationally. America’s Essential Hospitals represents about 275 large, mostly urban hospitals that commit to caring for low-income and other vulnerable people and that provide vital community services, such as level I trauma care and public health.

Essential hospitals also disproportionately train the nation’s medical workforce: In 2014, the average association member trained 270 physicians versus 41 physicians at other U.S. teaching hospitals. More notably, essential hospitals trained an average of 50 physicians above their federal funding cap, compared with 21 at other hospitals.

“Our hospitals take on a significant amount of uncompensated costs to meet their teaching mission and ensure communities have enough medical professionals to meet their needs,” Siegel said. “This is a critical — and often overlooked — role of essential hospitals.”

Other highlights from 2014 Essential Data: Our Hospitals, Our Patients include these:

  • Essential hospitals operated 45 percent of all level I trauma centers, 80 percent of burn care beds, and more than a third of psychiatric care beds in the nation’s 10 largest cities.
  • About half of all inpatient discharges and outpatient visits were for uninsured or Medicaid patients. Commercially insured patients accounted for only 19.2 percent of inpatient visits.
  • Member hospitals delivered more than 233,000 babies in 2014 and Medicaid covered 67 percent of those deliveries.
  • Essential hospitals treated more than 8.2 million patients in their emergency departments, averaging 78,403 visits per hospital.
  • Member acute-care hospitals averaged more than 20,000 inpatient admissions, nearly three times the inpatient volume of other acute-care hospitals nationwide.

Essential hospitals continue to receive high marks from patients. In general, member scores on all 10 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures of patient experience and satisfaction have increased steadily since 2010. Member hospitals also perform well on quality measures, matching or outperforming other hospitals nationally for treating heart failure and heart attacks.

“Essential hospitals use efficiency and innovation to deliver top-quality care and community services — often beyond what their funding supports,” Siegel said.

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About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.

Our roughly 275 members are vital to their communities, providing primary care through trauma care, disaster response, health professional training, research, public health programs, and other services. They innovate and adapt to lead the broader health care community toward more effective and efficient care. Learn more at

Carl Graziano


About the Author

Dedicated staff at America's Essential Hospitals work together to produce high-quality, reliable content. Please view the about section for more details about staff.

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