TABLE OF CONTENTS

CHAPTER 2.0: Organizational Trends

Chart 2.1: Number of Community Hospitals, 1987 – 2007

Chart 2.2: Number of Beds and Number of Beds per 1,000 Persons, 1987 – 2007

Chart 2.3: Beds per 1,000 by State, 2007

Chart 2.4: Number of Hospitals in Health Systems, 2000 – 2007

Chart 2.5: Percent of Outpatient Surgeries by Facility Type, 1981 – 2005

Chart 2.6: Number of Outpatient Surgery Centers, 2003 – 2008

Chart 2.7: Percentage of Hospitals with Physician Affiliates by Type of Relationship, 1997 – 2007

Chart 2.8: Percentage of Hospitals with Insurance Products by Type of Insurance, 1997 – 2007

Chart 2.9: Percentage of Hospitals Offering “Non-hospital” Services, 1997 – 2007

Chart 2.10: Announced Hospital Mergers and Acquisitions, 1998 – 2007

Chart 2.1: Number of Community Hospitals,(1) 1987 – 2007

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.(1) All nonfederal, short-term general, and specialty hospitals whose facilities and services are available

to the public.(2) Data on the number of urban and rural hospitals in 2004 and beyond were collected using coding different from

previous years to reflect new Centers for Medicare & Medicaid Services wage area designations.

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07

Hos

pita

ls

(2)

All Hospitals

Urban Hospitals

Rural Hospitals

Chart 2.2: Number of Beds and Number of Beds per 1,000 Persons, 1987 – 2007

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07

Bed

s

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

Bed

s pe

r T

hous

and

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.

Number of Beds

Number of Beds per 1,000

Chart 2.3: Beds per 1,000 by State, 2007

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. US Census Bureau: National and State Population Estimates, July 1, 2007. Link: http://www.census.gov/popest/states/tables/NST-EST2007-01.xls.

RI 2.32DE 2.65DC 5.81

3 – 3.99

2 – 2.99

<2

4 – 4.99

> 5

Chart 2.4: Number of Hospitals in Health Systems,(1) 2000 – 2007

2,400

2,500

2,600

2,700

2,800

2000 2001 2002 2003 2004 2005 2006 2007

Hos

pita

ls

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. (1) Hospitals that are part of a corporate body that may own and/or manage health provider facilities or

health-related subsidiaries as well as non-health-related facilities including freestanding and/or subsidiary corporations.

Chart 2.5: Percent of Outpatient Surgeries by Facility Type, 1981 – 2005

Source: Verispan, Diagnostic Imaging Center Profiling Solution, 2004.(1) 2005 values are estimated based upon current trends.

(1)

Chart 2.6: Number of Outpatient Surgery Centers, 2003 – 2008

3,6053,957

4,9545,349

5,673 5,876

0

1,500

3,000

4,500

6,000

2003 2004 2005 2006 2007 2008

Am

bula

tory

Car

e S

urge

ry C

ente

rs

Source: SDI. (2008). 2008 Outpatient Surgery Center Market Report.

Chart 2.7: Percentage of Hospitals with Physician Affiliates(1)

by Type of Relationship, 1997 – 2007

0%

5%

10%

15%

20%

25%

30%

35%

97 98 99 00 01 02 03 04 05 06 07

Per

cent

age

of H

ospi

tals

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. (1) A hospital is considered to have a physician relationship if the relationship exists as part of the hospital or a

system or network of which the hospital is a part.

Group Practice without Walls

Management Service Organization

IPA

Physician Hospital Organization

Chart 2.8: Percentage of Hospitals with Insurance Products by Type of Insurance, 1997 – 2007

Health Maintenance Organization

Preferred Provider Organization

Indemnity Fee for Service

0%

5%

10%

15%

20%

25%

30%

35%

97 98 99 00 01 02 03 04 05 06 07

Per

cent

age

of H

ospi

tals

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals.

Chart 2.9: Percentage of Hospitals Offering “Non-hospital” Services,(1)

1997 – 2007

Home Health Service

Skilled Nursing Facility

Other Long Term Care

Assisted Living

Hospice

Meals on Wheels

0%

10%

20%

30%

40%

50%

60%

70%

80%

97 98 99 00 01 02 03 04 05 06 07

Per

cent

age

of H

ospi

tals

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. (1) Includes services offered in hospital, health system, network or joint venture.

Chart 2.10: Announced Hospital Mergers and Acquisitions, 1998 – 2007

Source: Irving Levin Associates, Inc., The Health Care Acquisition Report, Thirteenth Edition, 2008. (1) In 2006, the privatization of HCA, Inc. affected 176 acute-care hospitals. The acquisition was the largest health care

transaction ever announced.

86 8358

3859 51 57 58

287

175

132118

101

56

236

88

249

149139

110

0

50

100

150

200

250

300

350

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Number of Deals Number of Hospitals

(1)