Prepared to Care: The 24/7 Standby Role of America's Hospitals

America's hospitals are vital to meeting the health care needs of the communities they serve by providing a wide range of acute-care and diagnostic services, supporting public health needs, and offering myriad other community services to promote the health and well-being of the community. While many of these services also are provided by other health care providers, three things make the role of the hospital unique:

  • 24/7 ACCESS TO CARE: The provision of health care services, including specialized resources, 24 hours a day, seven days a week (24/7), 365 days a year;
  • THE SAFETY NET ROLE: Caring for all patients who seek emergency care, regardless of ability to pay; and
  • DISASTER READINESS AND RESPONSE: Ensuring that staff and facilities are prepared to care for victims of large-scale accidents, natural disasters, epidemics and terrorist actions.

These critical functions — collectively known as the "standby" role — while often taken for granted, represent an essential component of our nation's health and public safety infrastructure. However, the standby role is not explicitly funded and hospitals face increasing challenges in maintaining this role.

This report and executive summary explore the standby role and its critical importance to the health care system; analyze the nature of demand and the basic and specialized resources required to meet it; outline the capacity and financing pressures hospitals face in maintaining the standby role; and frame critical economic and policy questions that must be addressed to ensure future hospital standby capacity can meet the growing health and public safety challenges.

The accompanying infographic details why hospital outpatient departments have higher costs than physician offices due to their standby and teaching roles, sicker patient population and greater regulatory requirements. The Medicare Payment Advisory Commission is exploring whether to limit hospital outpatient department payments for certain conditions to the physician fee schedule payment, despite hospitals' already negative average Medicare margins.




Executive Summary (PDF)
Full Report (PDF)


Hospital Outpatient Department (HOPD) Costs Higher than Physician Offices Due to Additional Capabilities, Regulations


Will Congress Jeopardize
Patients' Access to Care?


About AHA


Member Constituency Sections

Key Relationships

News Center

Performance Improvement

Advocacy Issues

Products & Services


Research & Trends


155 N. Wacker Dr.
Chicago, Illinois 60606

800 10th Street, N.W.
Two CityCenter, Suite 400
Washington, DC 20001-4956