Hospitals across the nation compete in a number of ways, including on quality of care and price, and many use benchmarking to determine the top priorities for improvement. The continuous benchmarking process allows hospital executives to see how their organizations stack up against regional competitors as well as national leaders.
Becker's Hospital Review has collected benchmarks related to some of the most important day-to-day areas hospital executives oversee: quality, finance, staffing and utilization.
Finance
Key ratios
Source: Moody's Investors Service, "Not-for-profit and public healthcare – US: Medians" report, September 2019.
The medians are based on an analysis of audited fiscal 2018 financial statements for 284 freestanding hospitals, single-state health systems and multistate health systems, representing 79 percent of all Moody's-rated healthcare entities. Children's hospitals, hospitals for which five years of data are not available and certain specialty hospitals were not eligible for inclusion in the medians.
1. Maintained bed occupancy: 66.6 percent
2. Operating margin: 1.8 percent
3. Excess margin: 4.3 percent
4. Operating cash flow margin: 7.9 percent
5. Return on assets: 3.6 percent
6. Three-year operating revenue CAGR: 5.6 percent
7. Three-year operating expense CAGR: 6.4 percent
8. Cash on hand: 200.9 days
9. Annual operating revenue growth rate: 5.5 percent
10. Annual operating expense growth rate: 5.4 percent
11. Total debt-to-capitalization: 33.7 percent
12. Total debt-to-operating revenue: 33.3 percent
13. Current ratio: 1.9x
14. Cushion ratio: 21.6x
15. Annual debt service coverage: 4.7x
16. Maximum annual debt service coverage: 4.4x
17. Debt-to-cash flow: 3.1x
18. Capital spending ratio: 1.2x
19. Accounts receivable: 45.9 days
20. Average payment period: 61.4 days
21. Average age of plant: 11.7 years
Hospital margins by credit rating group
Source: S&P Global Ratings "U.S. Not-For-Profit Health Care System Median Financial Ratios — 2018 vs. 2017" report, September 2019.
AA+ rating
22. Operating margin: 5.5 percent
23. Operating EBIDA margin: 12 percent
24. Excess margin: 9.2 percent
25. EBIDA margin: 14.8 percent
AA rating
26. Operating margin: 4.4 percent
27. Operating EBIDA margin: 10.1 percent
28. Excess margin: 6.7 percent
29. EBIDA margin: 12.4 percent
AA- rating
30. Operating margin: 3.4 percent
31. Operating EBIDA margin: 9.5 percent
32. Excess margin: 4.0 percent
33. EBIDA margin: 10.4 percent
A+ rating
34. Operating margin: 1.6 percent
35. Operating EBIDA margin: 7.4 percent
36. Excess margin: 3.3 percent
37. EBIDA margin: 10.1 percent
A rating
38. Operating margin: 2.1 percent
39. Operating EBIDA margin: 7.6 percent
40. Excess margin: 3.3 percent
41. EBIDA margin: 8.6 percent
A- rating
42. Operating margin: 1 percent
43. Operating EBIDA margin: 7.8 percent
44. Excess margin: 2.5 percent
45. EBIDA margin: 8.3 percent
Average adjusted expenses per inpatient day
Source: Kaiser State Health Facts, accessed in 2020 and based on 2018 data.
Adjusted expenses per inpatient day include all operating and nonoperating expenses for registered U.S. community hospitals, defined as public, nonfederal, short-term general and other hospitals. The figures are an estimate of the expenses incurred in a day of inpatient care and have been adjusted higher to reflect an estimate of the volume of outpatient services.
46. Nonprofit hospitals: $2,653
47. For-profit hospitals: $2,093
48. State/local government hospitals: $2,260
Prescription drug spending
Source: NORC at the University of Chicago's "Recent Trends in Hospital Drug Spending and Manufacturer Shortages" report, January 2019. Figures below are based on 2017 data.
49. Average prescription drug spending per adjusted admission at U.S. community hospitals: $555
50. Average outpatient prescription drug spending per adjusted admission at U.S. community hospitals: $523
51. Average inpatient prescription drug spending per admission at U.S. community hospitals: $756
52. GPO hospital spending on Activase: $210 million
53. GPO hospital spending on Remicade: $138 million
54. GPO hospital spending on Humira: $122 million
55. GPO hospital spending on Rituxan: $92 million
56. GPO hospital spending on Neulasta: $92 million
57. GPO hospital spending on Prolia: $85 million
58. GPO hospital spending on Harvoni: $83 million
59. GPO hospital spending on Procrit: $80 million
60: GPO hospital spending on Lexiscan: $64 million
61. GPO hospital spending on Enbrel: $60 million
Quality and process of care
Source: Hospital Compare, HHS, Complications and Deaths-National Averages, May 2018, and Timely and Effective Care-National Averages, May 2018, the latest available data for these measures.
Hospital-acquired conditions
The following represent the average percentage of patients in the U.S. who experienced the conditions.
62. Collapsed lung due to medical treatment: 0.27 percent
63. A wound that splits open on the abdomen or pelvis after surgery: 0.95 percent
64. Accidental cuts and tears from medical treatment: 1.29 percent
65. Serious blood clots after surgery: 3.85 percent
66. Serious complications: 1 percent
67. Bloodstream infection after surgery: 5.09 percent
68. Postoperative respiratory failure rate: 7.35 percent
69. Pressure sores: 0.52 percent
70. Broken hip from a fall after surgery: 0.11 percent
71. Perioperative hemorrhage or hematoma rate: 2.53 percent
Death rates
72. Death rate for CABG surgery patients: 3.1 percent
73. Death rate for COPD patients: 8.5 percent
74. Death rate for pneumonia patients: 15.6 percent
75. Death rate for stroke patients: 13.8 percent
76. Death rate for heart attack patients: 12.9 percent
77. Death rate for heart failure patients: 11.5 percent
Outpatients with chest pain or possible heart attack
78. Median time to transfer to another facility for acute coronary intervention: 58 minutes
79. Median time before patient received an ECG: 7 minutes
Lower extremity joint replacement patients
80. Rate of complications for hip/knee replacement patients: 2.5 percent
Flu vaccination
81. Healthcare workers who received flu vaccination: 90 percent
Pregnancy and delivery care
82. Mothers whose deliveries were scheduled one to two weeks early when a scheduled delivery was not medically necessary: 2 percent
Emergency department care
83. Average time patient spent in ED after the physician decided to admit as an inpatient but before leaving the ED for the inpatient room: 103 minutes
84. Average time patient spent in the ED before being sent home: 141 minutes
85. Average time patient spent in the ED before being seen by a healthcare professional: 20 minutes
86. Percentage of patients who left the ED before being seen: 2 percent
Staffing
Source: American Hospital Association "Hospital Statistics" report, 2019 Edition.
Average full-time staff
87. Hospitals with six to 24 beds: 101
88. Hospitals with 25 to 49 beds: 176
89. Hospitals with 50 to 99 beds: 302
90. Hospitals with 100 to 199 beds: 683
91. Hospitals with 200 to 299 beds: 1,264
92. Hospitals with 300 to 399 beds: 1,789
93. Hospitals with 400 to 499 beds: 2,670
94. Hospitals with 500 or more beds: 5,341
Average part-time staff
95. Hospitals with six to 24 beds: 52
96. Hospitals with 25 to 49 beds: 84
97. Hospitals with 50 to 99 beds: 141
98. Hospitals with 100 to 199 beds: 286
99. Hospitals with 200 to 299 beds: 472
100. Hospitals with 300 to 399 beds: 604
101. Hospitals with 400 to 499 beds: 1,009
102. Hospitals with 500 or more beds: 1,468
Utilization
Source: American Hospital Association "Hospital Statistics" report, 2019 Edition.
Average admissions per year
103. Hospitals with six to 24 beds: 408
104. Hospitals with 25 to 49 beds: 901
105. Hospitals with 50 to 99 beds: 2,097
106. Hospitals with 100 to 199 beds: 5,809
107. Hospitals with 200 to 299 beds: 11,241
108. Hospitals with 300 to 399 beds: 16,635
109. Hospitals with 400 to 499 beds: 20,801
110. Hospitals with 500 or more beds: 34,593