TABLE OF CONTENTS

CHAPTER 2.0: Organizational Trends

Chart 2.1: Number of Community Hospitals, 1981 – 2005

Chart 2.2: Number of Beds and Number of Beds per 1,000 Persons, 1981 – 2005

Chart 2.3: Beds per 1,000 by State, 2005

Chart 2.4: Number of Hospitals in Health Systems, 2000 – 2005

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

Chart 2.6: Number of Freestanding Ambulatory Care Surgery Centers, 1996, 1998, and 2000 – 2006

Chart 2.7: Percentage of Hospitals with Physician Affiliates by Type of Relationship, 1995 – 2005

Chart 2.8: Percentage of Hospitals with Insurance Products by Type of Insurance, 1995 – 2005

Chart 2.9: Percentage of Hospitals Offering “Non-hospital” Services, 1995 – 2005

Chart 2.10: Announced Hospital Mergers and Acquisitions, 1998 – 2005

Chart 2.1: Number of Community Hospitals,(1) 1981 – 2005

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2005, 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.

All Hospitals

Urban Hospitals

Rural Hospitals

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05

Hos

pita

ls

(2)

Chart 2.2: Number of Beds and Number of Beds per 1,000 Persons, 1981 – 2005

Number of Beds

Number of Beds per 1,000

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05

Bed

s

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

Bed

s pe

r T

hous

and

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2005, for community hospitals.

Chart 2.3: Beds per 1,000 by State, 2005

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2005, for community hospitals. US Census Bureau: National and State Population Estimates, July 1, 2005. Link: http://www.census.gov/popest/states/tables/NST-EST2006-01.xls.

RI 2.23DE 2.26DC 6.42

3 – 3.99

2 – 2.99

<2

4 – 4.99

> 5

Chart 2.4: Number of Hospitals in Health Systems,(1) 2000 – 2005

2,400

2,500

2,600

2,700

2000 2001 2002 2003 2004 2005

Hos

pita

ls

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2005, 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.*2005 values are estimated based upon current trends.

Hospital-owned Facilities, 47%

Freestanding Facilities, 37%

Physician Offices, 16%

0%

20%

40%

60%

80%

100%

81 83 85 87 89 91 93 95 97 99 01 03 05*

Per

cent

of

Out

patie

nt S

urge

ries

Chart 2.6: Number of Freestanding Ambulatory Care Surgery Centers, 1996, 1998, and 2000 – 2006

2,4252,754 2,864

3,508 3,5703,836

4,601

5,095 5,197

0

1,400

2,800

4,200

5,600

1996 1998 2000 2001 2002 2003 2004 2005 2006

Am

bula

tory

Car

e S

urge

ry C

ente

rs

Source: Verispan, 2006 Guide to Healthcare Market Segments, 2006. 

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

by Type of Relationship, 1995 – 2005

IPA

Group Practice without Walls

Management Service Organization

Physician Hospital Organization

0%

5%

10%

15%

20%

25%

30%

35%

95 96 97 98 99 00 01 02 03 04 05

Per

cent

age

of H

ospi

tals

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2005, 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.

Chart 2.8: Percentage of Hospitals with Insurance Products by Type of Insurance, 1995 – 2005

Health Maintenance Organization

Preferred Provider Organization

Indemnity Fee for Service

0%

5%

10%

15%

20%

25%

30%

35%

95 96 97 98 99 00 01 02 03 04 05

Per

cent

age

of H

ospi

tals

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2005, for community hospitals.

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

1995 – 2005

Home Health Service

Skilled Nursing Facility

Other Long Term CareAssisted Living

Hospice

Meals on Wheels

0%

10%

20%

30%

40%

50%

60%

70%

80%

95 96 97 98 99 00 01 02 03 04 05

Per

cent

age

of H

ospi

tals

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2005, for community hospitals. (1) Includes services offered in hospital, health system, network or joint venture.

Chart 2.10: Announced Hospital Mergers and Acquisitions, 1998 – 2005

Source: Irving Levin Associates, Inc., The Health Care Acquisition Report, Twelfth Edition, 2006.

86 8358

3859 51

287

175

132118

101

56

236

88

139

110

0

50

100

150

200

250

300

350

1998 1999 2000 2001 2002 2003 2004 2005

Number of Deals Number of Hospitals