Press Release

New Study Finds Hospital Outpatients are Sicker and Tend to Come from Lower-Income Communities Compared to Patients Treated in Physician Offices

WASHINGTON (February 26, 2015) – Patients who receive care in a hospital outpatient department (HOPD) are more likely to be minority, poorer and have more severe chronic conditions than patients treated in physician offices. The findings of a new study, conducted for the American Hospital Association by KNG Health Consulting LLC, highlight why proposals under consideration by Congress to reimburse hospitals the same amount as physician offices could threaten access to care for the most vulnerable patients.


“The needs of patients cared for in hospitals are different from those seen at physician offices; treating them like they are the same does not make sense,” said Rich Umbdenstock, AHA president and CEO. “Any proposal that equates them ignores the very different clinical capabilities of and regulatory demands on hospitals. And physician offices aren’t set up to provide access for all or 24/7 emergency services.”


According to the study, relative to those seen in a physician office, patients seen in HOPDs are:

  • 2.5 times more likely to be on Medicaid, self-pay or eligible for charity care;
  • 1.8 times more likely to be eligible for both Medicare and Medicaid;
  • 1.8 times more likely to live in high-poverty areas, and 1.7 times more likely to live in areas with a median income of less than $33,000;
  • 1.7 times more likely to be black or Hispanic; and
  • 1.5 times more likely to live in areas with low rates of college education.


Patients treated in HOPDs tend to have more severe chronic conditions and, in Medicare, have higher prior utilization of hospitals and emergency departments. These patients also are more likely to be in HOPDs for ongoing treatment of a chronic problem or to receive care for a new health problem.


According to the AHA, hospitals are held to far higher regulatory standards because of the complexity of caring for these higher acuity patients.


For a full copy of the report, visit



About the AHA

The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at

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