Research and Trends

Making Our Case

AHA studies support the advocacy efforts of the association and its member hospitals as they work to provide health care services to communities around the country. This section of the AHA website will provide you with the latest research and analysis of important and emerging trends in the hospital and health care field.  AHA sponsors or conducts policy research in the areas of provider payment, the cost of health care, information technology and other topics to assist members and policy makers in understanding issues critical to America’s hospitals.

Health and Hospital Trends

Every year AHA releases a series of reports that provide up to date information on both health and hospital trends.  Data from various sources including the AHA Annual Survey is compiled and made available through our TrendWatch Chartbook.  Other reports and surveys of hospital leaders are released throughout the year and provide a snapshot of issues like the workforce shortage, ED diversion, health care costs, disaster preparedness and other topics of interest to hospital members, policy makers and the media.

AHA Policy Research

AHA research reports examine key issues to inform the policy making process.  These include the TrendWatch series, a periodic AHA publication that reports on the latest trends affecting hospitals and the health care system  as well as other AHA sponsored studies. 

Featured Reports

The Performance of Provider-sponsored Health Plans: Key Findings, Strategic Implications, October 2015 Members Only
This report examines the attributes of high-performing provider-sponsored health plans and considerations for hospital and health system leaders.

Why Interoperability Matters, October 2015
While health IT tools are essential for building the care system of the future, and hospitals are making significant ongoing investments, too often, the tools are expensive, unwieldy and do not yet support easy information sharing. The current inability for electronic systems to speak the same language to one another and to efficiently and correctly transmit information – to be interoperable – is among the most pressing issues facing health care stakeholders today.

Teaching Hospitals: Preparing Tomorrow's Physicians Today, TrendWatch, June 2015
Teaching hospitals serve as centers for training future health care professionals, while also supporting an environment in which biomedical and clinical research can flourish, offering specialized services and providing patient care, often in the most disadvantaged communities. Training new physicians, a time-intensive process that can take up to 14 years, is an essential part of the mission of teaching hospitals.

Issue Brief: Zeroing in on the Triple Aim, May 2015
Patients expect and deserve excellent care from their health care providers. This paper highlights multiple areas where hospitals are improving care, encouraging healthier lifestyles and reducing costs.

Full Report: Hospitals Are Leading the Way on Improving Care, Enhancing Health, and Reducing Costs (report submitted to the AHA by The Severyn Group) 

Realizing the Promise of Telehealth: Understanding the Legal and Regulatory Challenges, TrendWatch, May 2015
As telehealth increasingly becomes an integral component of our health care delivery system, and patients become more accustomed to its convenience, hospitals, health systems and other providers will seek new ways to use the rapidly evolving technology in diverse and innovative ways.

The Real Cost of the Inefficient Medicare RAC Program, May 2015
The Recovery Audit Contractor (RAC) program was created by Congress to audit providers’ Medicare claims to identify overpayments and underpayments. However, the current structure of the RAC program has led to an overwhelming number of inappropriate denials, with contractors often denying claims for necessary medical care. As a result, the implementation of the RAC program has imposed a significant administrative and financial burden on hospitals.

The infographic is available at: 

Rethinking the Hospital Readmissions Reduction Program, TrendWatch, March 2015
Reducing readmissions is an important way to improve quality and lower health care spending. Hospitals are making significant progress; as reported by the Centers for Medicare & Medicaid Services (CMS), the national readmission rate  fell to 17.5 percent in 2013, after holding steady at around 19 to 19.5 percent for many years. 

Always There, Ready To Care: The 24/7 Role of America’s Hospitals, March 2015
America's hospitals play a  unique role in the health care system serving as the safety net for those unable to pay, being available 24/7 to respond to anything from a broken arm to a mass casualty event, and maintaining the resources to respond to natural and manmade disasters.  This role is not separately funded. Instead costs are spread across all services provided.

Economic Contribution Often Overlooked (2015 Update)
Hospitals employ over 5.6 million workers and with multiplier effects included support a total of 15.7 million jobs and $2.6 million of economic activity. 

Comparison of Care in Hospital Outpatient Departments and Physician Offices Final Report, February 2015
Prepared for the American Hospital Association by KNG Health Consulting, LLC
This study looks at the differences between patients served in a hospital outpatient department compared to a physician office.  Patients who receive care in a hospital outpatient department (HOPD) are more likely to be minority, poorer, have more severe chronic conditions and have higher prior utilization of hospitals and emergency departments than patients treated in physician offices. 

The Promise of Telehealth For Hospitals, Health Systems and Their Communities, TrendWatch, January 2015
Telehealth increasingly is vital to our health care delivery system, enabling health care providers to connect with patients and consulting practitioners across vast distances. Hospitals are embracing the use of telehealth technologies because they offer benefits such as virtual consultations with distant specialists, the ability to perform high-tech monitoring without requiring patients to leave their homes, and less expensive and more convenient care options for patients. 

Private-Sector Hospital Discharge Tools, January 2015
Samples of hospital discharge planning tools that strive to improve transitions to post-acute care and reduce readmissions. 

Comparison of Cancer Patients Treated in Hospital Outpatient Departments and Physician Offices,  November 2014
Prepared for the American Hospital Association by KNG Health Consulting, LLC
Relative to those treated in physician offices, cancer patients served in HOPDs are more likely to be black or Hispanic, self-pay, charity care or Medicaid,  from areas with low household income, high rates of poverty, and low rates of college education, be sicker and have been hospitalized in the prior year.  To the extent these differences result in a higher cost of care, site neutral payments may have adverse effects on patient access to care. 

Accountable Care Organizations: Findings from the Survey of Care Systems and Payment, August 2014
Accountable Care Organizations (ACOs) are a relatively new organizational structure for which little data exist about their organizational structures and operation.  To help fill this information gap, the AHA conducted a survey.  309 ACOs responded to this survey in 2013 which covered such topics as structure and governance, contracts and risk models, key challenges, performance management and information exchange. 

Price Transparency Efforts Accelerate: What Hospitals and Other Stakeholders Are Doing to Support Consumers, TrendWatch, July 2014
Consumers incorporate price information when making most purchasing decisions. While health care services have numerous unique characteristics that make pricing complex and non-uniform across payers, both consumers and providers can benefit from greater price transparency. 

Increasing Consumer Choice in Coverage and Care: Implications for Hospitals, TrendWatch, June 2014
The marketplace for health insurance has become increasingly consumer-driven, with important implications for the way care is paid for and delivered. In an effort to stem the rising costs of providing health insurance, employers are increasingly shifting more costs to employees, selecting lower-cost plan options that restrict access to a narrower range of providers and limiting employer contributions to health insurance premiums to a fixed dollar amount.

The Value of Provider Integration, TrendWatch, March 2014
A new era in care delivery has been emerging as providers focus on improving the patient care experience, enhancing care quality and lowering the cost of patient care. An emphasis on population health has provided the foundation for greater collaboration among providers and the development of coordinated care models. These new models often are “value-based” and providers are at financial risk if quality and cost goals are not achieved.  

Health Care Spending Growth Hits Record Low, March 2014
Since 2010, National Health Expenditures (NHE) have grown at an average annual rate of 3.8%. This represents the lowest rate on record for any four-year period* and is less than half of the average annual growth rate of 9.3% over the same timeframe. A key driver of this trend is the low rate of health care price inflation, for hospitals just 2.0% in 2013. Hospitals represent about a third of NHE. 

Economic Contribution Often Overlooked, 2014 Update
In 2012, America’s hospitals treated 133 million people in their emergency departments, provided care for 542 million other outpatients, performed almost 27 million surgeries, and delivered nearly 4 million babies.Every year, hospitals provide vital health care services like these to millions of people in thousands of communities. However, the importance of hospitals to their communities extends far beyond health care. 

Hospitals Face Challenges Using Electronic Health Records to Generate Clinical Quality Measures
AHA commissioned a study to investigate hospital experiences with implementation of meaningful use stage 1 electronic clinical quality measures (eCQMs).  The study describes the experience with and impact of eCQM implementation in four hospitals.  Based on the experiences, the current approach to automated quality reporting does not yet deliver on the promise of feasibility, validity and reliability of measures or the reduction in reporting burden placed on hospitals. Specific policy changes are needed, starting with meaningful use stage 2, to redirect the electronic clinical quality reporting requirements to focus on a small set of well-tested measures supported by a mature policy infrastructure. 


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