US Hospitals Experienced Substantial Productivity Growth During 2002–11

Published in Health Affairs, Schaeffer Center faculty John Romley, Dana Goldman, and Neeraj Sood provide evidence that hospital productivity increased from 2002 to 2011, suggesting that the US health care system could be performing better than many believe.

Romley, Goldman, and Sood analyzed data of elderly Medicare beneficiaries with heart attacks, heart failure, or pneumonia over the period from 2002-2011 using a novel study design that adjusts for trends in quality of care and illness severity – factors that have not been adequately addressed in previous studies.

When Romley and his colleagues took quality of care and illness severity into consideration in their model, they found that the annual rates of productivity growth significantly improved to +0.78 percent per year for heart attack, +0.62 percent for heart failure, and +1.90 percent for pneumonia. These contrast with negative calculated productivity growth rates, which don’t factor in trends in the severity of patient conditions or outcomes achieved after hospitalization: -0.64 percent per year for heart attacks, -0.91 percent for heart failure, and -0.39 percent for pneumonia.

With the Affordable Care Act linking Medicare reimbursement rates to economywide productivity, some observers have questioned whether hospitals will be able to balance their budgets without compromising quality or services, if productivity grows relatively rapidly in the broader economy.  Today’s study results show that this concern may be unwarranted. The findings show that productivity in the inpatient setting has improved in recent years, with its growth rate for pneumonia- which accounted for 1.1 million hospital stays in 2010- outpacing the national productivity growth rate.

“Moreover, innovative payment and delivery approaches under the ACA and among private payers may increase the incentives of hospital leaders and managers to achieve productivity gains in the future,” state the authors in the study.  “Thus, quality of care need not decline even if reimbursement does not keep up with health care cost inflation.”

The full study is available at Health Affairs.

Citation: Romley, J. A., Goldman, D. P., & Sood, N. (2015). US hospitals experienced substantial productivity growth during 2002–11. Health Affairs34(3), 511-518.