Payor mix at top hospitals

[nimbus]

Overall excellent. Most are 40-50%+ commercial. No wonder they can have nice lobbies and no wonder why they care about USNWR.

Payer mix in the nation's top 20 hospitals - Becker's Payer Issues | Payer News

Becker's calculated the payer mix within the nation's top ranked hospitals to determine the share of their patients covered under commercial plans, Medicare, Medicaid, Medicare Advantage, uninsured/bad debt, and charity care.

www.beckerspayer.com

Payer mix in the nation's top 20 hospitals​

Jakob Emerson, Molly Gamble - 3 hours ago Print |Email


Becker's calculated the payer mix within the nation's top ranked hospitals to determine the share of their patients covered under commercial plans, Medicare, Medicaid, Medicare Advantage, uninsured/bad debt and charity care.
The 2019 data released April 5 is from the coverage, cost and value team at the National Academy for State Health Policy in collaboration with Houston-based Rice University's Baker Institute for Public Policy.
Payer mix in the nation's top 20 hospitals:
(1) Mayo Clinic Hospital — Rochester, Minn.
Commercial: 50 percent
Medicare: 33 percent
Medicare Advantage: 9 percent
Medicaid: 7 percent
Charity care: 1 percent
Uninsured / Bad debt: 0 percent

(2) Cleveland Clinic Hospital
Commercial: 45 percent
Medicare: 24 percent
Medicare Advantage: 17 percent
Medicaid: 12 percent
Charity care: 1 percent
Uninsured / Bad debt: 1 percent

(3) Ronald Reagan UC Los Angeles Medical Center
Commercial: 45 percent
Medicare: 27 percent
Medicaid: 18 percent
Medicare Advantage: 8 percent
Charity care: 0 percent
Uninsured / Bad debt: 0 percent

(4) Johns Hopkins Hospital — Baltimore
Commercial: 46 percent
Medicare: 28 percent
Medicaid: 22
Medicare Advantage: 2 percent
Uninsured / Bad debt: 2 percent
Charity Care: 1 percent

(5) Massachusetts General Hospital — Boston
Commercial: 48 percent
Medicare: 32 percent
Medicaid: 11 percent
Medicare Advantage: 7 percent
Charity care: 1 percent
Uninsured / Bad debt: 1 percent

(6) Cedars-Sinai Medical Center — Los Angeles
Commercial: 42 percent
Medicare: 41 percent
Medicaid: 10 percent
Medicare Advantage: 6 percent
Charity care: 1 percent
Uninsured / Bad debt: 0 percent

(7) NewYork-Presbyterian Hospital — New York City
Commercial: 34 percent
Medicaid: 25 percent
Medicare: 22 percent
Medicare Advantage: 17 percent
Charity Care: 1 percent
Uninsured / Bad debt: 1 percent

(8) NYU Langone Hospital — New York City
Commercial: 42 percent
Medicare: 25 percent
Medicaid: 19 percent
Medicare Advantage: 6 percent
Charity care: 1 percent
Uninsured / Bad debt: 0 percent

(9) UC San Francisco Medical Center
Commercial: 42 percent
Medicaid: 25 percent
Medicare: 25 percent
Medicare Advantage: 5 percent
Charity Care: 1 percent
Uninsured / Bad debt: 0 percent

(10) Northwestern Memorial Hospital — Chicago
Commercial: 52 percent
Medicare: 27 percent
Medicaid: 11 percent
Medicare Advantage: 7 percent
Charity care: 2 percent
Uninsured / Bad debt: 1 percent

(11) Michigan Medicine — Ann Arbor
Commercial: 53 percent
Medicare: 20 percent
Medicaid: 14 percent
Medicare Advantage: 11 percent
Charity care: 1 percent
Uninsured / Bad debt: 1 percent

(12) Stanford Hospital — Palo Alto, Calif.
Commercial: 46 percent
Medicare: 34 percent
Medicaid: 13 percent
Medicare Advantage: 7 percent
Charity care: 0
Uninsured / Bad debt: 0

(13) Penn Presbyterian Medical Center — Philadelphia
Commercial: 46 percent
Medicare: 29 percent
Medicaid: 13 percent
Medicare Advantage: 12 percent
Uninsured / Bad debt: 1 percent
Charity Care: 0

(14) Brigham and Women's Hospital — Boston
Commercial: 53 percent
Medicare: 30 percent
Medicaid: 10 percent
Medicare Advantage: 6 percent
Charity Care: 1 percent
Uninsured / Bad debt: 1 percent

(15) Mayo Clinic Hospital — Phoenix
Commercial: 51 percent
Medicare: 42 percent
Medicare Advantage: 4 percent
Medicaid: 3 percent
Charity Care: 1 percent
Uninsured / Bad debt: 0 percent

(16) Houston Methodist Hospital
Commercial: 43 percent
Medicare: 33 percent
Medicare Advantage: 18 percent
Charity care:3 percent
Medicaid: 2 percent
Uninsured / Bad debt: 1 percent

(17 — tie) Barnes-Jewish Hospital — St. Louis
Commercial: 43 percent
Medicare: 29 percent
Medicare Advantage: 13 percent
Medicaid: 10 percent
Charity care: 4 percent
Uninsured / Bad debt: 1 percent

(17 — tie) Mount Sinai Hospital — New York City
Commercial: 33 percent
Medicaid: 28 percent
Medicare: 22 percent
Medicare Advantage: 15 percent
Charity care: 1 percent
Uninsured / Bad debt: 0 percent

(18) Rush University Medical Center — Chicago
Commercial: 41 percent
Medicare: 31 percent
Medicaid: 20 percent
Medicare Advantage: 6 percent
Charity care: 2 percent
Uninsured / Bad debt: 1 percent

(19) Vanderbilt University Medical Center — Nashville, Tenn.
Commercial: 47 percent
Medicare: 20 percent
Medicaid: 18 percent
Medicare Advantage: 10 percent
Charity care: 4 percent
Uninsured / Bad debt: 1 percent

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[sethco]

What's the deal with all these hospitals (most in urban areas) having 0-1% uninsured?

 

[GassYous]

It's easy when you can shunt all the poor and homeless to bellevue or cook county

 

[nimbus]

What's the deal with all these hospitals (most in urban areas) having 0-1% uninsured?

ACA??

 

[TheLoneWolf]

Does it not seem rather unusual that some of these places have 7% payors as Medicaid? I have been to Cleveland clinic and rotated near Johns Hopkins. Rough areas with high poverty. How is that possible? I would have thought Medicaid made a third to half of the payers in some of those places.

 

[Guillemot]

This is why top hospitals advertise on national television. Those who can afford to travel there for care will either have commercial insurance or at least medicare. Some may be so rich that they even pay cash or donate to the endowment.

 

[nimbus]

Does it not seem rather unusual that some of these places have 7% payors as Medicaid? I have been to Cleveland clinic and rotated near Johns Hopkins. Rough areas with high poverty. How is that possible? I would have thought Medicaid made a third to half of the payers in some of those places.

Only Mayo is 7% Medicaid. Cleveland Clinic is 12% Medicaid and Hopkins is 22% which sounds reasonable. Seems like all these places overwhelm their Medicaid population by drawing well insured and/or highly resourced patients from a national or international pool.

 

[GassYous]

Hate the patients that are like "well when i was at the cleveland clinic they did blah blah blah"

Uh ok go back there then?

 

[zizzer]

I know CCF isn't a level 1 trauma center, so that helps a bit. Also, a ton of rich Middle Eastern patients traveling there for their care. I almost considered learning a bit of Arabic similar for my own convenience when I was there.

 

[cards67]

It's wealthy patients, donors and people with good insurance. Look who the buildings are named after. It might be a Sheik. When I interviewed at CCF I think they said something like 50% of their patients are local, the rest are domestic or int'l. i.e. people who have money. A hospital I worked at, not even nice one, a middle-eastern country paid for one of their wealthy citizens to get transplanted there. Wealthy people will flock to "best/famous" hospitals for a second opinion. I had friends at UCLA tell me how patients don't want to leave because it's so nice there. I had lectures from attendings at some of these places sharing how they "improved" their numbers. I've heard my share of shady practices by these big hospitals too.

 

[nimbus]

It's wealthy patients, donors and people with good insurance. Look who the buildings are named after. It might be a Sheik. When I interviewed at CCF I think they said something like 50% of their patients are local, the rest are domestic or int'l. i.e. people who have money. A hospital I worked at, not even nice one, a middle-eastern country paid for one of their wealthy citizens to get transplanted there. Wealthy people will flock to "best/famous" hospitals for a second opinion. I had friends at UCLA tell me how patients don't want to leave because it's so nice there. I had lectures from attendings at some of these places sharing how they "improved" their numbers. I've heard my share of shady practices by these big hospitals too.

In NYC, the name was often Sackler (of Purdue Pharma). I took all my preclinical lectures in Sackler Hall. At one time I believe their name was up at Mt. Sinai, Cornell, and NYU.


And you’re right about shady practices….

Massachusetts General Hospital resolves overlapping surgery suit for $14.6M - Becker's Hospital Review | Healthcare News & Analysis

Boston-based Massachusetts General Hospital has agreed to pay $14.6 million to settle a federal whistleblower lawsuit alleging that the hospital violated Medicare and Medicaid rules when some of its orthopedic surgeons engaged in concurrent surgeries, according to The Boston Globe.

www.beckershospitalreview.com

 

[anbuitachi]

there are a lot of smaller poorer hospitals in NYC for medicaid patients.

I hear like 50% of NYC public hospital (theres like ~10 of them or something) are medicaid, and other half is uninsured...

 

[nimbus]

there are a lot of smaller poorer hospitals in NYC for medicaid patients.

I hear like 50% of NYC public hospital (theres like ~10 of them or something) are medicaid, and other half is uninsured...

It's easy when you can shunt all the poor and homeless to bellevue or cook county

 

[deleted941485]

What's the deal with all these hospitals (most in urban areas) having 0-1% uninsured?

Obamacare!

 

[coffeebythelake]

What's the deal with all these hospitals (most in urban areas) having 0-1% uninsured?

There is always another hospital down the street for the poors