Health Care Indicators Carolyn S. Donham, Brenda T. Maple, and Arthur L. Sensenig

This regular feature of the journal includes without interference introduced by seasona discussion ofeach of the followingfour topics: al fluctuations. In the national health community hospital statistics; employment, accounts, indicators such as these play an hours, and earnings in the private health important role in the estimation of the latsector; health care prices; and national est historical year of health care expendieconomic indicators. These statistics are tures. Information that is more comprevaluable in their own right for understanding hensive tends to lag behind the close of a the relationship between the health care sectorcalendar year by 9 to 12 months or more. and the overall economy. In addition, they Therefore, we rely extensively on indicaallow us to anticipate the direction and tors such as these to anticipate and predict magnitude of health care cost changes prior to changes in health care sector expenditures the availability of more comprehensive data. for the most recent year. Other indicators help to identify specific reasons (e.g., INTRODUCTION increases in price inflation or declines in utilization) for expenditure change. This article presents statistics on health In the following sections, we will identify care utilization, prices, expenses, employimportant indicators of health care and ment, and work hours, as well as on nationnational economic activity and their al economic activity. Some of these statissources. We will then describe what these tics are based on sample surveys conductindicators tell us about general economic ed monthly or quarterly by government and health sector activity during the most agencies or private organizations, and are recent quarter. available 1 to 3 months after the completion of the period. These statistics provide an COMMUNITY HOSPITAL STATISTICS early indication of changes occurring within the general economy and in the health Since 1963, the American Hospital care sector. Association (AHA), in cooperation with The accompanying tables report selectmember hospitals, has been collecting data ed quarterly statistics for 1991 through the on the operation of community hospitals first quarter of 1994, and the calendar year through its National Hospital Panel Survey. aggregation of quarterly information for Community hospitals, which comprised the past 3 years. Additional tables show the more than 80 percent of all hospital facilichange from the same period 1 year earlier. ties in the United States in 1993, include all For quarterly information, this calculation non-Federal, short-term general, and other permits analysis of quarterly data to focus special hospitals open to the public. They on the direction and magnitude of changes, exclude hospital units of institutions; psychiatric facilities; tuberculosis, other respiratory, and chronic disease hospitals; The authors are with the Office of the Actuary, Health Care Financing Administration (HCFA). The opinions expressed are institutions for the mentally retarded; those of the authors and do not necessarily reflect HCFA's views and alcohol and chemical dependency or policy position. HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1

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hospitals. The survey samples approximately one-third of all U.S. community hospitals. The sample is designed to produce estimates of community hospital indicators by bed size and region (American Hospital Association, 1963-94). In Tables 1 and 2, statistics covering expenses, utilization, beds, and personnel depict trends in the operation of community hospitals annually from 1991 and quarterly for selected quarters for 1991 through 1994. Figures 1 and 2 show changes from the same quarter 1 year earlier for various measures of hospital operating expenses and utilization for 1985 to 1994. For purposes of national health expenditures (NHE), survey statistics on revenues (not shown on Table 1) are analyzed in estimating the growth in the largest component of health care costs—community hospital expenditures. This one segment of NHE accounted for 33 percent of all health spending in 1993 (Levit et al., 1994). The survey also identifies important factors influencing expenditure growth patterns, such as changes in the number of beds in operation, number of admissions, length of stay, use of outpatient facilities, and number of surgeries. PRIVATE HEALTH SECTOR: EMPLOYMENT, HOURS, AND EARNINGS The Bureau of Labor Statistics (BLS) collects monthly information on employment for all workers, and earnings and work hours for non-supervisory workers in a sample of 385,000 establishments. Data are collected through cooperative agreements with State agencies that also use this information to create State and local area statistics. The survey is designed to collect industry-specific information on wage and salary jobs in non-agricultural industries. It 296

excludes statistics on self-employed persons and on those employed in the military (U.S. Department of Labor, 1994a). Employment in this survey is defined as number of jobs. Persons holding multiple jobs would be counted multiple times. Approximately 5 percent of the population hold more than one job at any one time. (Other surveys that are household-based, such as the Current Population Survey [CPS], also record employment. In the CPS, however, each person's employment status is counted only once, as either employed, unemployed, or not in the labor force.) Once each year, monthly establishment-based employment statistics are adjusted to benchmarks created from annual establishment census information, resulting in revisions to previously published employment estimates. Tables 3 and 4 present statistics on employment, average hourly earnings, and average weekly hours in private (non-government) health service establishments. Similar statistics for the private non-agricultural sector, included on these tables, provide a basis for comparing the economy as a whole with the health sector in employment, earnings, and work hours. Figure 3 shows changes from the same quarter 1 year earlier in employment in the private non-agricultural sector and the health services industry for 1985 to 1994. Table 5 summarizes business activity in the health sector and the overall economy by measuring change in the implied non-supervisory work hours and payroll. Implied work hours are the product of the number of non-supervisory employees and average weekly hours. Implied non-supervisory payrolls are calculated by multiplying implied work hours by average hourly earnings. For purposes of NHE, changes in work hours by industry combined with changes in prices (discussed in a later

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section) can be used to gauge the direction and magnitude of expenditure change in specific industries. We use these composite indicators in the estimation of growth in physician and dental expenditures for the most recent period. We study the historical relationship of changes in this indicator to changes in expenditures and estimate this relationship for the most recent period. PRICES Consumer Prices BLS publishes monthly information on changes in prices paid by consumers for a fixed market basket of goods and services. Tables 6 and 7 present information on the all urban consumer price index (CPI) that measures changes in prices faced by 80 percent of the non-institutionalized population in the United States. (The more restrictive wage earner CPI gauges prices faced by wage earners and clerical workers. These workers account for 32 percent of the non-institutionalized population [U.S. Department of Labor, 1994b].) The index reflects changes in prices charged for the same quality and quantity of goods or services purchased in the base period. For most items, the base period of 198284 is used to define the share of consumer expenditures purchasing specific services and products. Those shares or weights remain constant in all years, even though consumption patterns of the household may change overtime.This type of index is called afixedweight or Laspeyres index. CPIs for health care goods and services depict price changes for out-of-pocket expenditures made directly by consumers. The composite CPI for medical care weights together product-specific or service-specific CPIs in proportion to household out-ofpocket expenditures for these items. For

example, the composite medical care CPI measures inflation for the 3 percent of hospital expenditures that are made out of pocket by consumers; the remaining 97 percent of the costs of hospital care paid by private health insurers, Medicare, Medicaid, and other payers are not weighted into the CPI for medical care. In addition, some medical care sector indexes measure changes in list or charged prices, rather than in prices actually received by providers after discounts are deducted. In several health care areas, received or transaction prices are difficult to capture, although BLS is making advances in this area. In the NHE, a combination of CPIs for selected medical care items, input price indexes for nursing homes, and the CPI for hospital and related services, adjusted by HCFA to provide transaction price changes, are used as measures of inflation for the health industry. The indexes are used to develop a fixed-weight price index for personal health care to depict price changes affecting the entire health care industry more accurately than does the overall CPI medical care index (Letsch, 1993). Background on Input Price Indexes In 1979, HCFA developed the Medicare hospital input price index (hospital market basket) which was designed to measure the pure price changes associated with expenditure changes for hospital services. In the early 1980s, the skilled nursing facility (SNF) and home health agency (HHA) input price indexes, often referred to as "market baskets," were developed to price a consistent set of goods and services over time. Also in the early 1980s, the original Medicare hospital input price index was revised for use in updating payment rates for the prospective payment system (PPS). All of these indexes have played an

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important role in helping to set Medicare payment percent increases and in understanding the contribution of input price increases to growing health expenditures. The input price indexes, or market baskets, are Laspeyres or fixed-weight indexes that are constructed in two steps. First, a base period is selected. For example, for the PPS hospital input price index, the base period is 1987. Cost categories, such as food, fuel, and labor, are identified and their 1987 expenditure amounts determined. The proportion or share of total expenditures included in specific spending categories is calculated. These proportions are called cost or expenditure weights. There are 28 expenditure categories in the 1987-based PPS hospital input price index. Second, a price proxy is selected to match each expenditure category. Its purpose is to measure the rate of price increase of the goods or services in that category. The price proxy index for each spending category is multiplied by the expenditure weight for the category. The sum of these products (weights multiplied by the price index) over all cost categories yields the composite input price index for any given time period, usually a fiscal year or a calendar year. The percent change in the input price index is an estimate of price change over time for a fixed quantity of goods and services purchased by a provider. The input price indexes are estimated on a historical basis and forecasted out several years. The HCFA-chosen price proxies are forecasted under contract with Data Resources, Inc./McGraw Hill (DRI). Following every calendar year quarter, in March, June, September, and December, DRI updates its macroeconomic forecasts of wages and prices based on updated historical information and revised forecast assumptions. Some of the data in Tables 8 through 13 are forecasted and are expected 298

to change as more recent historical data become available and subsequent quarterly forecasts are received. The methodology and price proxy definitions used in the input price indexes are described in the Federal Register notices that accompany the revisions of the PPS, HHA, and SNF cost limits. A description of the current structure of the PPS input price index was published in the September 4, 1990, Federal Register. The most recent PPS update for payment rates was published in the September 1, 1993, Federal Register. The latest HHA regulatory input price index was published in the July 8, 1993, Federal Register, and the latest SNF input price index was published in the October 7, 1992, Federal Register. Periodically, the input price indexes are revised to a new base year so that cost weights will reflect changes in the mix of goods and services that are purchased. Each revision allows for new base weights, a new base year, and changes to certain price variables used for price proxies. Each input price index is presented in two tables: The first table shows the quarterly levels for each price index, and the second is a percentage change table. The hospital input price index for PPS is in Tables 8 and 9. The SNF input price index is in Tables 10 and 11. The HHA input price index is in Tables 12 and 13. NATIONAL ECONOMIC INDICATORS National economic indicators provide a context for understanding health-specific indicators and how change in the health sector relates to change in the economy as a whole. Tables 14 and 15 present national indicators of output and employment. Gross domestic product (GDP) measures the output of U.S. economy as the market value of goods and services produced

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within the geographic boundaries of the United States by U.S. or foreign citizens or companies. Constant dollar or "real" GDP removes the effects of price changes from the valuation of goods and services produced, so that the growth of real GDP reflects changes in the "physical quantity" of the output of the economy (U.S. Department of Commerce, 1994). First Quarter Indicators The growth in operating expenses of community hospitals continued to decelerate in the first quarter of 1994. Measured over the same quarter a year earlier, total operating expenses increased 4.6 percent in the first quarter of 1994, the lowest growth rate since the first quarter of 1985. The growth rate in total operating expenses has decelerated markedly in the last 2 years, as the 4.6-percent increase in the first quarter of 1994 is less than one-half of the 11.5-percent increase registered in the first quarter of 1992. Both labor and nonlabor expenses contributed to the continued deceleration in the growth of operating expenses. Labor expenses increased 4.5 percent in the first quarter, as measured over the same quarter a year earlier, while non-labor expenses increased 4.8 percent. These increases compare with increases of 7.7 percent and 7.3 percent, respectively, in the first quarter of 1993. Inpatient expenses followed the same trend as total operating expenses in the first quarter of 1994, increasing 3.1 percent from the first quarter of 1993 (Figure 1). Statistics on community hospital utilization indicate that in the first quarter of 1994 admissions increased slightly while the adult length of stay decreased (Figure 2). Admissions in community hospitals increased 0.2 percent from the first quarter of 1993 to the first quarter of 1994, while

the adult length of stay decreased from 6.4 to 6.2 days. Taken together, these two factors led to a decrease in the number of inpatient days. The number of inpatient days decreased 2.9 percent from the first quarter of 1993 to the first quarter of 1994. Employment in the health care industry increased more rapidly than employment in the overall economy in the first quarter of 1994. However, the difference between the rate of growth in health care employment and the rate of growth in overall employment was smaller in the first quarter of 1994 than it has been since the beginning of the 1990-91 recession. Employment in health services grew 3.1 percent from first quarter 1993 to first quarter 1994, increasing to a level of 8.9 million workers. This was essentially the same growth as the 3.1 percent registered from the first quarter of 1992 to the first quarter of 1993. In comparison, employment in the private non-agricultural sector grew 2.3 percent from the first quarter of 1993 to the first quarter of 1994, an acceleration of 0.8 percentage point from the 1.5-percent growth registered from the first quarter of 1992 to the first quarter of 1993 (Figure 3). Implied non-supervisory work hours and payrolls, developed from the BLS establishment survey, are frequently cited as composite measures of economic activity. Implied work hours are the product of the number of non-supervisory employees and average weekly hours. Implied non-supervisory payrolls are calculated by multiplying implied work hours by average hourly earnings. For private health service establishments, growth in both of these measures was approximately equal to the growth in the private non-agricultural sector in the first quarter of 1994. Implied non-supervisory work hours in the health services industry grew 3.0 percent

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from the first quarter of 1993 to the first The most significant changes in prices quarter of 1994, compared with an increase for medical goods and services in the first of 3.1 percent for the privatenon-agricultural quartersector. of 1994Implied were innon-supervisory prescription drugs payrolls in the health services industry grew and outpatient hospital services. Consumer 5.8 percent from the first quarter of 1993 to prices for prescription drugs, as measured the first quarter of 1994, compared with an by the CPI, increased 3.0 percent from the increase of 5.9 percent for the private nonfirst quarter of 1993 to the first quarter of agricultural sector. Within the health serv1994. This followed an even larger decelerices industry, private hospitals were ation in the preceding year, when price responsible for most of the deceleration in increases for prescription drugs increased these measures. Private hospitals contin9.9 percent in the first quarter of 1992, ued to be the slowest-growing segment of compared with 5.0 in the first quarter of the health care sector. Implied non-super1993. In effect, in the first quarter of 1994, visory payrolls in private hospitals grew 2.8 consumer prices for prescription drugs percent from the first quarter of 1993 to the were increasing at only one-third the rate first quarter of 1994, while implied nonobserved 2 years previously. Consumer supervisory work hours increased 0.4 perprice increases for outpatient hospital servcent in the same period. ices, as measured by the CPI, also decelerated rapidly in the first quarter of 1994. Consumer prices for outpatient hospital Consumer prices, as measured by the services increased 6.5 percent from the CPI for all urban consumers, increased 2.5 first quarter of 1993 to the first quarter of percent from the first quarter of 1993 to the first quarter of 1994, a slight deceleration 1994, compared with an increase of 10.1 from the 3.2-percent increase registered percent from the first quarter of 1992 to the from the first quarter of 1992 to the first first quarter of 1993. quarter of 1993. The increase in consumer Overall economic conditions continued prices for medical care, as measured by the to improve in the first quarter of 1994. The CPI, was 5.0 percent from the first quarter current expansion continued, as the first of 1993 to the first quarter of 1994, a decelquarter of 1994 marked the twelfth conseceration from the 6.3-percent increase regisutive quarter of growth in the economy. tered from the first quarter of 1992 to the Real GDP increased 3.7 percent from first first quarter of 1993. Consumer prices for quarter 1993 to first quarter 1994, a slight medical goods and services continued to acceleration in the rate of growth from the increase more rapidly than consumer prices 3.2-percent increase recorded in the prein the rest of the economy in the first quarceding 12 months. Inflation, measured by ter of 1994. However, price increases for the change in the implicit price deflator for medical goods and services are also decelGDP, continued to moderate in the first erating more rapidly than price increases in quarter of 1994, as the rate of increase in the rest of the economy. In effect, the gap prices decelerated from the first quarter between increases in consumer prices for all of 1993 to the first quarter of 1994. The items and consumer prices for medical care implicit price deflator for GDP, a narrowed in first quarter 1994. This pattern measure of aggregate price changes in the of converging price increases follows a economy, increased 1.7 percent from the trend established in 1992 (Figure 4). first quarter of 1993 to the first quarter of 300

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1994, compared with an increase of 2.5 percent from the first quarter of 1992 to the first quarter of 1993. REFERENCES American Hospital Association: National Hospital Panel Survey. Unpublished. Chicago. 1963-94. American Hospital Association: Hospital Statistics, 1992-93 Edition. Chicago. 1992. Federal Register: Medicare Program; Changes to the Inpatient Hospital Prospective Payment System and Fiscal Year 1991 Rates; Final Rule. Vol. 55, No. 170, 36043-36050 and 36169-36173. Office of the Federal Register, National Archives and Records Administration. Washington. U.S. Government Printing Office, September 4, 1990. Federal Register: Medicare Program; Changes to the Inpatient Hospital Prospective Payment System and Fiscal Year 1994 Rates; Final Rule. Vol. 58, No. 168, 46455. Office of the Federal Register, National Archives and Records Administration. Washington. U.S. Government Printing Office, September 1, 1993a. Federal Register: Medicare Program; Schedules of limits of Home Health Agency Cost per Visit for Cost Reporting Periods Beginning On or After July 8, 1993. Vol. 58, No. 129, 36748. Office of the Federal Register, National Archives and Records Administration. Washington. U.S. Government Printing Office, July 8, 1993b.

Federal Register. Medicare Program; Schedules of Limits of Skilled Nursing Facility Inpatient Routine Service Costs; Final rule. Vol. 57, No.129, 4617748187. Office of the Federal Register, National Archives and Records Administration. Washington. U.S. Government Printing Office, October 7, 1992. Levit, K.R., Lazenby, H.C., Cowan, C.A., et al.: National Health Expenditures, 1993. Health Care Financing Review 16(1):247-294, Fall 1994. Letsch, S.W.: National Health Care Spending in 1991. Health Affairs 12(1):94-110, Spring 1993. U.S. Department of Commerce: National Income and Product Accounts. Survey of Current Business. Vol. 74, No. 7. Bureau of Economic Analysis. Washington. U.S. Government Printing Office, July 1994. U.S. Department of Labor: Employment and Earnings. Vol. 40, No. 6. Bureau of Labor Statistics. Washington. U.S. Government Printing Office, June 1993a. U.S. Department of Labor: Notes on Current Labor Statistics: Price Data. Monthly Labor Review. Vol. 116, No. 7. Bureau of Labor Statistics. Washington. U.S. Government Printing Office, July 1993b. For inquiries concerning input price index data, contact Brenda T. Maple at (410) 966-7954. For all other inquiries, contact Carolyn S. Donham at (410) 966-7947. Reprint Requests: Carolyn S. Donham, Room L-1, 1705 Equitable Building, 6325 Security Boulevard, Baltimore, Maryland 21207.

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301

302 22,710 390,188 902 61.4

22,463 366,243 908 62.1

21,983 344,116 912 63.5 3,323 3.7 84 278,911

3,300 3.6 85 281,502

3,249 3.6 87 282,874

71,908

3,242 3.5 22

915 66.3

82,471

5,379

8,253 54,578 6.6

72,789

3,277 3.6 22

909 65.6

89,168

5,608

8,357 54,238 6.5

47,495 876 5,683

$63,739 34,143 29,597

1992 Q1

3,331 3.7 21 69,334

3,322 3.7 22 72,306

68,351

3,326 3.7 21

901 59.2

895 64.2 904 61.0

897 60.1 905 65.3

98,341

98,662

99,212 97,637

94,677

3,312 3.7 22 71,244

3,315 3.7 21 68,860

5,664 5,665

5,677

5,721

8,368 51,709 6.2

5,646

8,133 49,611 6.1

52,023 1,006 6,217

51,229 1,033 6,299

8,083 49,089 6.1

50,274 1,024 6,220

$71,677 38,420 33,257

1994 Q1

$71,106 38,123 32,983

1993 Q4

8,086 50,150 6.2

50,085 999 6,194

50,447 948 6,041

$70,002 37,578 32,424

1993 Q3

8,351 53,228 6.4

$69,245 37,250 31,994

1993 Q2

$68,527 36,782 31,746

1993 Q1

Adult occupancy rate is the ratio of average daily census to the average number of beds maintained during the reporting period. 2 Adjusted patient days is an aggregate figure reflecting the number of days of inpatient care, plus an estimate of the volume of outpatient services, expressed in units equivalent to an inpatient day in terms of level of effort. It is derived by multiplying the number of outpatient visits by the ratio of outpatient revenue per outpatient visit, to inpatient revenue per inpatient day, and adding the product to the number of inpatient days. NOTES: Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: American Hospital Association: National Hospital Panel Survey Reports. Chicago. Monthly reports for January 1991 -March 1994.

1

Adjusted Patient Days in Thousands

Full-Time Equivalent (FTE) Personnel Total in Thousands Number per Bed Adjusted Patient Days2 per FTE

Beds in Thousands Adult Occupancy Rate1

Outpatient Visits in Thousands

Surgical Operations in Thousands

32,652 202,078 6.2

32,411 206,440 6.4

43,406 795 5,260

202,055 1,000 6,188

32,670 211,475 6.5

$57,189 30,971 26,218

1991 Q1

$278,880 149,733 129,147

1993

Utilization Admissions in Thousands Inpatient Days in Thousands Adult Length of Stay in Days

191,401 927 5,905

$260,994 140,112 120,882

Calendar Year 1992

178,401 844 5,461

$238,633 128,704 109,929

1991

Inpatient Expense in Millions Amount per Patient Day Amount per Admission

Operating Expenses Total in Millions Labor in Millions Non-Labor in Millions

Item

Table 1 Selected Community Hospital Statistics: 1991-94

SOS

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number1 Calendar Year

6.5 -0.7 -0.7

2.2 6.4 -0.5 -1.4 1.6 2.0 -2.0 -0.5

0.4 5.4 -1.0 -0.9 0.6 1.7 -1.0 -0.4

Surgical Operations

Outpatient Visits

Beds Adult Occupancy Rate1

Full-Time Equivalent (FTE) Personnel Total Number per Bed Adjusted Patient Days per FTE

Adjusted Patient Days

-0.9

0.7 1.4 -1.6

0.7 -2.1 -2.8

-2.4

0.9 2.2 -3.3

-1.2 -2.3

4.0

-1.3

1.4 1.8 -2.0 -0.7

1.2

-0.4 -0.2

1.1 1.7 0.1

-0.6 -0.7

6.2

0.7

4.2 8.1

-0.1 -1.9 -1.8

6.2 8.2 6.3

7.5 7.7 7.3

1.3 -0.6 -1.9

9.4 10.1 8.0

6.6 11.6 10.0 -3.1 -4.5 -1.4

11.5 10.2 12.9

-1.0

-1.3

0.5 1.2 -1.8

-0.8 -1.1

-0.7 -1.0 1.3 2.0 -2.2

6.4

0.8

1.4 6.6

1.0 -2.6 -3.5

5.0 7.8 4.0

6.3 6.2 6.5

-0.2 -2.3 -2.1

5.9 8.4 6.1

7.3 8.0 6.5

-0.7

-0.3 0.5 -0.4

-0.8 -0.6

7.0

1.5

2.3 -1.8 -4.0

5.1 7.0 2.7

6.3 5.7 7.0

1992 1993 1993 1993 1993 Q2 Q3 Q4 Q1 Q1 Percent Change From the Same Period of Previous Year

9.0 9.4 8.6

1991 Q1

Change in rate, rather than percent change. NOTES: Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: American Hospital Association: National Hospital Panel Survey Reports. Chicago. Monthly reports for January 1990-March 1994.

1

1.1

-0.8 -2.4 -1.6

-1.1 -2.5 -1.4

5.6 7.8 4.8

Utilization Admissions Inpatient Days Adult Length of Stay

7.3 9.9 8.1

7.6 10.3 8.8

6.9 6.9 6.8

Inpatient Expenses Amount per Patient Day Amount per Admission

9.4 8.9 10.0

9.9 9.2 10.7

1991 1992 1993 Annual Percent Change

Operating Expenses Total Labor Non-Labor

item

Table 2 Percent Change in Selected Community Hospital Statistics: 1991-94

-1.5

-0.3 0.9 -1.2

-1.2 -1.1

3.9

0.3

0.2 -2.9 -3.1

3.1 6.2 2.9

4.6 4.5 4.8

1994 Q1

304 1,404.5 1,155.4 31.9 $11.13

Offices and Clinics of Medical Doctors (SIC 801) Total Employment in Thousands

Non-Supervisory Workers: Employment in Thousands Average Weekly Hours Average Hourly Earnings

1,492.6 1,347.4 32.1 $7.56 3,655.1 3,352.5 34.2 $12.50

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands

Non-Supervisory Workers: Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

Non-Supervisory Workers: Employment in Thousands Average Weekly Hours Average Hourly Earnings

See footnotes at end of fable.

463.5 28.3 $10.62

Non-Supervisory Workers: Employment in Thousands Average Weekly Hours Average Hourly Earnings

527.6

7,275.8 32.5 $10.96

Non-Supervisory Workers: Employment in Thousands Average Weekly Hours Average Hourly Earnings

Offices and Clinics of Dentists (SIC 802) Total Employment in Thousands

8,490.0

8,182.9

3,442.4 34.4 $13.03

3,749.9

1,384.8 32.3 $7.86

1,532.8

473.2 28.3 $11.02

540.6

1,201.5 32.2 $11.41

1,463.1

7,546.1 32.8 $11.39

Calendar Year 1992

1991

Type of Establishment and Measure Health Services (SIC 80) Total Employment in Thousands

3,471.3 34.6 $13.46

3,786.8

1,425.8 32.2 $8.16

1,579.7

490.1 28.3 $11.43

560.3

1,235.3 32.2 $11.88

1,511.9

7,777.7 32.8 $11.78

8,766.6

1993

3,314.0 34.0 $12.16

3,615.9

1,323.5 32.0 $7.46

1,466.3

455.9 28.3 $10.47

519.1

1,129.4 31.8 $11.00

1,371.9

7,142.1 32.4 $10.73

8,033.1

1991 Q1

3,415.0 34.4 $12.85

3,720.4

1,370.6 32.2 $7.75

1,518.3

467.4 28.5 $10.91

533.8

1,184.0 32.3 $11.22

1,440.3

7,444.4 32.8 $11.23

8,374.8

1992 Q1

3,465.3 34.6 $13.37

3,776.4

1,402.3 32.0 $8.06

1,552.6

479.9 28.1 $11.26

548.4

1,219.0 32.1 $11.72

1,489.3

7,669.5 32.7 $11.69

8,637.5

1993 Q1

3,472.8 34.5 $13.37

3,785.8

1,418.2 32.2 $8.10

1,570.4

486.6 28.4 $11.35

556.5

1,231.7 32.2 $11.85

1,505.3

7,751.5 32.8 $11.71

8,730.2

1993 Q2

3,480.4 34.6 $13.49

3,798.0

1,434.9 32.6 $8.20

1,589.6

493.7 28.2 $11.46

564.2

1,244.5 32.3 $11.91

1,523.9

7,825.7 32.9 $11.80

8,822.3

1993 Q3

3,466.8 34.6 $13.61

3,787.2

1,448.0 32.0 $8.29

1,606.1

500.1 28.3 $11.68

572.1

1,245.9 32.3 $12.06

1,529.0

7,864.1 32.8 $11.92

8,876.3

1993 Q4

1994 Q1

3,462.2 34.7 $13.70

3,784.4

1,450.0 32.0 $8.37

1,609.8

505.4 28.2 $11.77

577.2

1,255.5 32.4 $12.15

1,536.6

7,892.6 32.8 $12.01

8,908.9

Table 3 Employment, Hours, and Earnings in Private Health Service Establishments, by Selected Type of Establishment: 1991-94 1

305

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1 89,854 72,650 34.3 $10.32 4,958.2 3,655.1 233.5 416.7 652.9

Non-Supervisory Workers: Employment in Thousands Average Weekly Hours Average Hourly Earnings

Employment in Thousands Ail Hospitals Private Hospitals (SIC 806) Federal Hospitals State Hospitals Local Hospitals 5,067.9 3,749.9 234.7 418.7 664.6

72,931 34.4 $10.57

89,959

Calendar Year 1992

5,110.8 3,786.8 232.4 414.0 677.6

74,623 34.5 $10.83

91,708

1993

4,913.5 3,615.9 230.8 417.7 649.2

71,559 33.8 $10.22

88,788

1991 Q1

5,035.5 3,720.4 235.9 419.8 659.3

71,132 34.1 $10.50

88,112

1992 Q1

5,092.8 3,776.4 231.5 415.1 669.8

72,541 34.0 $10.77

89,478

1993 Q1

5,106.7 3,785.8 232.0 414.3 674.7

74,537 34.5 $10.79

91,619

1993 Q2

5,128.9 3,798.0 233.7 414.4 682.8

75,586 34.8 $10.81

92,742

1993 Q3

5,114.6 3,787.2 232.3 412.1 683.0

75,827 34.6 $10.96

92,992

1993 Q4

5,111.7 3,784.4 231.5 409.6 686.1

74,382 34.2 $11.05

91,507

1994 Q1

Excludes hospitals, clinics, and other health-related establishments run by all governments. NOTES: Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series, whenever possible. Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1991-June 1994.

1991

Type of Establishment and Measure All Private Non-Agricultural Establishments Total Employment in Thousands

1

Table 3—Continued

Employment, Hours, and Earnings in Private1 Health Service Establishments, by Selected Type of Establishment: 1991-94

903

4.7 -0.0 5.3

5.0 4.6 0.4 5.3

2.9 3.1 -0.4 4.7

5.5 5.4 0.1 4.4 3.0 3.2 -0.0 6.0

Non-Supervisory Workers: Employment Average Weekly Hours Average Hourly Earnings

Offices and Clinics of Medical Doctors (SIC 801) Total Employment

Non-Supervisory Workers: Employment Average Weekly Hours Average Hourly Earnings

Offices and Clinics of Dentists (SIC 802) Total Employment

Non-Supervisory Workers: Employment Average Weekly Hours Average Hourly Earnings

Nursing and Personal Care Facilities (SIC 805) Total Employment

Non-Supervisory Workers: Employment Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment

Non-Supervisory Workers: Employment Average Weekly Hours Average Hourly Earnings

See footnotes at end of table.

4.7

2.7 0.6 4.2

2.6

2.8 0.5 3.9

2.7

2.1 0.2 3.8

2.5

4.0 0.8 2.5

4.2

3.7 0.7 3.9

3.8

0.8 0.5 3.3

1.0

3.0 -0.4 3.9

3.1

3.6 -0.3 3.8

3.7

2.8 0.2 4.1

3.3

3.1 0.1 3.4

3.3

Calendar Year 1991 1992 1993 Annual Percent Change

Health Services (SIC 80) Total Employment

Type of Establishment and Measure

3.6 -0.6 4.6

3.4

5.9 0.8 5.3

5.9

2.3 0.0 5.8

2.1

4.5 -0.2 6.7

4.7

5.0 -0.2 4.9

5.0

1991 Q1

3.0 1.2 5.6

2.9

3.6 0.8 3.9

3.5

2.5 0.7 4.2

2.8

4.8 1.6 2.0

5.0

4.2 1.3 4.7

4.3

1.5 0.5 4.1

1.5

2.3 -0.7 4.0

2.3

2.7 -1.3 3.2

2.7

3.0 -0.4 4.4

3.4

3.0 -0.2 4.1

3.1

1.1 0.5 3.6

1.2

2.9 0.4 3.6

2.9

3.3 0.7 3.4

3.4

2.9 0.7 4.7

3.4

3.1 0.5 3.6

3.3

0.6 0.4 2.9

0.8

3.1 -0.4 3.7

3.3

3.8 -0.4 4.2

3.8

2.9 0.2 3.8

3.5

3.1 0.0 3.1

3.4

0.1 0.5 2.8

0.4

3.5 -0.9 4.2

3.8

4.5 -0.2 4.3

4.7

2.4 0.3 3.5

3.0

3.0 0.0 3.0

3.3

1993 1993 1992 1993 1993 Q4 Q2 Q3 Q1 Q1 Percent Change From the Same Period of Previous Year

Table 4 Percent Change in Employment, Hours, and Earnings in Private1 Health Service Establishments, by Selected Type of Establishment: 1991-94

-0.1 0.5 2.4

0.2

3.4 0.1 3.8

3.7

5.3 0.1 4.6

5.3

3.0 0.7 3.6

3.2

2.9 0.1 2.7

3.1

1994 Q1

307

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1 2.2 3.0 0.8 -2.2 1.1

Employment All Hospitals Private Hospitals (SIC 806) Federal Hospitals State Hospitals Local Hospitals 2.2 2.6 0.5 0.5 1.8

0.4 0.2 2.4

0.1

0.8 1.0 -1.0 -1.1 2.0

2.3 0.3 2.5

1.9

2.3 3.4 -0.6 -2.8 1.1

-1.3 -1.1 3.3

-1.0

1991 Q1

2.5 2.9 2.2 0.5 1.6

-0.6 0.7 2.8

-0.8

1.1 1.5 -1.9 -1.1 1.6

2.0 -0.1 2.5

1.5

1.0 1.2 -1.5 -1.3 1.9

2.2 0.5 2.5

1.8

0.8 0.8 -0.4 -1.1 2.2

2.5 0.6 2.3

2.1

0.5 0.4 -0.2 -1.1 2.1

2.6 0.4 2.5

2.3

1992 1993 1993 1993 1993 Q3 Q4 Q1 Q1 Q2 Percent Change From the Same Period of Previous Year

0.4 0.2 0.0 -1.3 2.4

2.5 0.6 2.6

2.3

1994 Q1

SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1990-June 1994.

NOTES: Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible. Q designates quarter of year. Quarterly data are not seasonally adjusted.

Excludes hospitals, clinics, and other health-related establishments run by all governments.

-1.6 -0.6 3.1

Non-Supervisory Workers: Employment Average Weekly Hours Average Hourly Earnings

1

-1.4

Calendar Year 1993 1991 1992 Annual Percent Change

All Private Non-Agricultural Establishments Total Employment

Type of Establishment and Measure

Table 4—Continued Percent Change in Employment, Hours, and Earnings in Private1 Health Service Establishments, by Selected Type of Establishment: 1991-94

308 10.6 5.1

7.5 2.6

10.1 5.5 9.4 3.2

0.9 -2.1

Offices and Clinics of Medical Doctors (SIC 801) Payrolls Work Hours

Offices and Clinics of Dentists (SIC 802) Payrolls Work Hours

Nursing and Personal Care Facilities (SIC 805) Payrolls Work Hours

Private Hospitals (SIC 806) Payrolls Work Hours

All Private Non-Agricultural Establishments Payrolls Work Hours 3.1 0.6

7.6 3.3

7.4 3.3

6.2 2.3

7.5 4.8

8.5 4.4

5.2 2.7

4.7 1.3

6.5 2.5

7.2 3.3

7.3 3.0

6.7 3.1

0.9 -2.4

7.7 3.0

12.4 6.8

8.2 2.3

11.2 4.3

9.9 4.8

1991 Q1

2.9 0.1

10.1 4.3

8.5 4.4

7.6 3.3

8.6 6.5

10.6 5.6

4.5 1.9

6.1 2.0

5.6 1.6

4.6 1.4

7.1 2.5

7.0 2.8

5.3 2.7

5.3 1.6

7.1 3.3

7.6 4.1

8.6 3.7

7.4 3.7

5.5 3.1

4.0 1.0

6.5 2.7

7.8 3.4

7.0 3.1

6.4 3.1

5.6 3.0

3.4 0.6

6.9 2.6

8.7 4.2

6.3 2.8

6.1 3.0

1992 1993 1993 1993 1993 Q4 Q2 Q3 Q1 Q1 Percent Change From the Same Period of Previous Year

5.9 3.1

2.8 0.4

7.5 3.5

10.3 5.4

7.5 3.7

5.8 3.0

1994 Q1

SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1990-June 1994.

NOTES: Data presented here incorporate conversion to the 1987 Standard industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series, whenever possible. Q designates quarter of year. Quarterly data are not seasonally adjusted.

Excludes hospitals, clinics, and other health-related establishments run by all governments.

10.3 4.7

1

Calendar Year 1991 1992 1993 Annual Percent Change

Private Health Service Establishments (SIC 80) Payrolls Work Hours

Type of Establishment

Table 5 Percent Change in Implied Non-Supervisory Payrolls and Work Hours in Private1 Health Service Establishments, by Selected Type of Establishment: 1991-94

603

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number l 137.5 131.9 103.0 138.7 151.2 190.1 190.5 175.8 181.2 178.7 214.0 208.7 172.3 168.7 188.0 214.7 131.2 158.2 150.9

133.8 128.7 102.4 136.8 146.3 177.0 177.1 165.7 170.5 167.4 196.1 191.9 158.0 153.4 176.8 199.7 126.2 152.4 145.0

All Items Less Medical Care Apparel and Upkeep Energy Food and Beverages Housing: Shelter

Medical Care Medical Care Services1 Professional Services Physicians' Services Dental Services Hospital and Related Services Hospital Room Other Inpatient Services2 Outpatient Services2

Medical Care Commodities Prescription Drugs Non-Prescription Drugs and Medical Supplies2 Internal and Respiratory Over-the-Counter Drugs Non-Prescription Medical Equipment and Supplies

184.9 210.9 129.3

171.7 192.9 124.1

155.9

163.5

195.0 223.0 135.5

141.4

150.1

155.3

185.9 186.1 172.3 177.2 174.7 208.1 202.8 168.0 163.5

172.4 172.6 162.3 167.4 162.7 190.9 187.3 153.7 148.9

201.4 202.9 184.6 191.3 188.1 231.9 226.4 185.6 184.3

150.4

136.0 130.5 99.3 138.3 149.8

132.6 126.3 103.2 136.1 144.6

141.2 133.7 104.1 141.6 155.7

144.5

1992 Q1 138.7

1991 Q1 134.8

1993

153.8

160.4

193.0 221.4 133.2

197.7 198.8 181.6 187.7 184.8 226.2 220.6 181.1 179.9

140.0 133.1 102.7 140.7 154.3

143.1

1993 Q1

156.4

163.4

194.2 221.6 135.6

200.3 201.8 184.1 190.5 187.6 230.0 224.6 183.9 183.0

141.0 134.6 104.7 141.4 155.2

144.2

1993 Q2

156.5

165.3

196.0 223.9 136.7

202.8 204.4 185.9 192.7 189.2 233.8 228.2 187.2 185.6

141.5 132.0 105.4 141.5 156.6

144.8

1993 Q3

156.7

164.9

196.7 225.2 136.5

204.8 206.7 187.1 194.2 190.8 237.7 232.0 190.4 188.7

142.4 135.0 103.8 142.7 156.9

145.8

1993 Q4

2

Includes net cost of private health insurance not shown in professional or hospital and related sen/ices. December 1986 = 100. NOTES: 1982-84 = 100.0 unless noted. Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: CPI Detailed Report. Washington. U.S. Government Printing Office. Monthly reports for January 1991 -March 1994.

1

140.3

136.2

All Items

1992

1991

Item

Calendar Year

Table 6 Selected Items of the Consumer Price Index for All Urban Consumers: 1991-94

156.7

165.2

198.5 228.0 136.7

207.5 209.5 189.3 196.7 193.0 241.3 235.3 193.5 191.5

143.3 133.0 101.7 143.9 159.0

146.7

1994 Q1

310 7.4 7.6 6.1 6.3 6.7 9.1 8.8 9.1 10.0 6.4 7.6 3.9 3.8 4.1

8.7 8.9 6.2 6.0 7.5 10.2 9.4 10.7 10.6 8.2 9.9 4.7 4.5 5.0

3.3

3.3

3.3

3.7 3.9

4.6

5.5

5.2

8.4 9.9

9.6 9.8 6.6 7.0 6.8 11.3 10.4 12.5 11.1

5.0 4.5 6.9 4.1 5.6

5.3

1991 Q1

6.2

3.3

4.2

7.7 9.3

7.8 7.9 6.2 5.9 7.4 9.0 8.3 9.3 9.8

2.6 3.4 -3.7 1.6 3.6

2.4

3.3

3.0

4.3 5.0

6.3 6.8 5.4 5.9 5.8 8.7 8.8 7.8 10.1

2.9 2.0 3.4 1.8 3.0

4.0

3.2

3.5

3.4 3.3

6.1 6.8 5.3 5.7 6.0 8.8 9.0 8.0 10.0

2.9 1.6 2.0 2.1 3.1

3.5

3.4

3.4

3.7 3.8

5.9 6.4 5.0 5.6 4.9 8.3 8.4 7.6 9.1

2.5 0.8 -0.3 2.0 3.0

3.1

3.5

3.3

3.3 3.3

5.5 6.0 4.5 5.2 4.5 7.8 7.8 7.6 8.0

2.5 1.0 -0.4 2.5 2.9

1.9

3.0

2.6

2.9 3.0

5.0 5.4 4.3 4.8 4.4 6.7 6.6 6.8 6.5

2.4 -0.1 -0.9 2.3 3.0

2.5

1993 Q3

Percent Change From the Same Period of Previous Year 2.9 3.2 3.1 2.7 2.7

1993 Q2

1994 Q1

1993 Q1

1993 Q4

1992 Q1

Includes net cost of private health insurance not shown in professional or hospital and related services. NOTES: Q designates quarter of year. Quarterly data are not seasonally adjusted. SOURCE: U.S. Department of Labor, Bureau of Labor Statistics: CPI Detailed Report. Washington. U.S. Government Printing Office. Monthly reports for January 1990-March 1994.

1

Medical Care Commodities Prescription Drugs Non-Prescription Drugs and Medical Supplies Internal and Respiratory Over-the-Counter Drugs Non-Prescription Medical Equipment and Supplies

6.0 6.5 5.1 5.6 5.3 8.4 8.5 7.8 9.3

2.7 1.4 1.1 2.1 3.0

2.7 2.5 0.5 1.4 3.4

3.9 3.7 0.4 3.6 4.5

All Items Less Medical Care Apparel and Upkeep Energy Food and Beverages Housing: Shelter

Medical Care Medical Care Services1 Professional Services Physicians' Services Dental Services Hospital and Related Services Hospital Room Other Inpatient Services Outpatient Services

3.0

3.0

4.2

All Items

1993

1991

Item

Calendar Year 1992

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers: 1991-94

ITS

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16. Number 1 61.713 52.216 9.497 1.649 2.368 0.624 1.135 0.343 0.230 0.036 1.433 32.837 21.788 3.873 3.299 2.111 1.188 3.126 2.672 2.623 2.323 1.399 1.142 0.497 0.833 11.050 3.845 1.992 1.233 0.987 0.588 0.372 1.233 0.800

Compensation Wages and Salaries Employee Benefits Other Professional Fees Energy and Utilities Fuel Oil, Coal, and Other Fuel Electricity Natural Gas Motor Gasoline Water and Sewerage Maintenance Professional Liability Insurance All Other Other Products Pharmaceuticals Food Direct Purchase Contract Service Chemicals and Cleaning Products Surgical and Medical Instruments Photographic Supplies Rubber and Plastics Paper Products Apparel Minor Machinery and Equipment Miscellaneous Products Other Services Business Services Computer and Data Processing Transportation and Shipping Telephone Blood Services Postage Other—Labor Intensive Other—Non-Labor Intensive

See footnotes at end of table.

100.000

Total

Expense Category1

Base Year Weights 19872 126.2 124.2 136.9 123.9 108.9 108.3 111.6 96.8 110.9 134.7 133.8 120.3 120.1 148.1 115.8 113.1 120.7 115.0 112.5 114.2 112.2 115.1 111.2 112.3 116.5 120.6 120.9 129.5 119.8 103.4 111.3 131.9 119.1 123.4

1992 Q1 23.9 127.0 125.0 138.3 124.9 114.6 120.5 114.9 92.3 126.8 137.0 134.5 121.0 121.0 150.6 116.5 114.0 121.1 115.8 113.2 113.9 112.5 115.7 112.0 112.1 117.6 120.9 120.0 130.2 121.5 103.1 115.4 131.9 119.6 124.4

1992 Q2 124.8 128.5 126.2 140.9 126.4 120.0 125.0 120.4 101.5 129.5 140.3 135.3 121.6 121.7 152.1 116.5 113.7 121.6 118.1 113.3 114.2 113.0 115.4 112.4 112.0 118.0 121.4 120.4 131.3 122.3 102.8 112.9 131.9 120.5 125.4

1992 Q3 126.1 1993 Q1 127.7 130.8 128.1 145.2 128.3 113.2 117.9 112.5 102.0 115.7 143.2 137.5 122.5 122.5 155.8 117.3 114.2 122.6 117.7 115.1 112.6 113.4 114.6 113.1 112.7 118.9 122.6 121.9 133.0 124.4 103.4 111.1 131.9 121.6 127.3

126.7 129.4 127.0 142.6 127.1 117.0 123.9 113.5 109.6 122.6 141.9 136.3 122.0 122.1 153.5 116.5 113.5 122.0 118.1 113.7 114.2 113.4 115.1 113.1 112.2 118.5 121.8 120.2 132.4 124.0 102.7 112.3 131.9 121.0 126.3

1992 Q4 131.6 128.9 146.4 129.2 116.9 120.0 115.8 107.8 123.3 144.7 138.5 123.4 123.4 157.7 118.2 115.3 123.3 119.1 116.0 112.7 113.6 115.3 113.5 112.7 119.9 123.5 122.1 135.4 125.2 103.2 113.4 131.9 122.3 128.3

128.6

1993 Q2 132.8 130.0 147.7 130.3 115.9 110.3 121.9 103.3 115.2 147.3 139.5 123.7 123.5 158.8 118.6 115.7 123.8 118.0 115.4 112.8 113.8 114.9 115.1 112.8 118.8 124.0 122.4 136.1 125.4 103.8 114.0 131.9 123.1 128.8

129.4

1993 Q3

133.6 130.9 148.9 131.0 113.0 115.2 113.7 107.5 105.9 148.8 140.6 124.0 123.8 159.4 119.1 116.2 124.3 117.3 115.8 113.5 114.1 114.7 115.4 112.9 118.8 124.5 122.5 137.5 127.3 104.4 112.5 131.9 123.5 129.7

130.1

1993 Q4

Table 8 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index, by Expense Category: 1992-95

312 61.713 52.216 9.497 1.649 2.368 0.624 0.343 1.135 0.230 0.036 1.433 32.837 21.788 3.873 3.299 2.111 1.188 3.126 2.672 2.623 2.323 1.399 1.142 0.497 0.833 11.050 3.845 1.992 1.233 0.987 0.588 0.372 1.233 0.800

Compensation Wages and Salaries Employee Benefits Other Professional Fees Energy and Utilities Fuel Oil, Coal, and Other Fuel Natural Gas Electricity Motor Gasoline Water and Sewerage Maintenance Professional Liability Insurance All Other Other Products Pharmaceuticals Food Direct Purchase Contract Service Chemicals and Cleaning Products Surgical and Medical Instruments Photographic Supplies Rubber and Plastics Paper Products Apparel Minor Machinery and Equipment Miscellaneous Products Other Services Business Services Computer and Data Processing Transportation and Shipping Telephone Blood Services Postage Other—Labor Intensive Other—Non-Labor Intensive 134.9 131.8 151.7 132.0 109.3 106.6 107.5 111.9 99.6 150.9 141.3 124.7 124.3 161.8 120.2 117.6 124.7 115.8 116.0 114.6 113.9 114.0 115.5 113.4 119.1 125.7 125.1 139.4 127.1 105.1 106.8 131.9 124.6 130.5

1994 Q1 131.0 135.8 132.6 153.2 133.0 112.9 109.0 113.1 114.5 108.6 152.8 142.3 125.4 124.8 163.1 120.9 118.4 125.5 116.9 116.2 115.1 114.0 113.3 115.4 114.0 120.0 126.6 125.5 140.9 128.5 105.5 109.4 131.9 125.1 131.9

131.9

1994 Q2

137.3 133.9 156.0 134.5 115.2 113.3 110.1 116.8 114.5 155.5 143.7 126.2 125.6 163.7 121.9 119.2 126.6 118.1 116.7 115.6 114.5 114.7 115.8 114.8 120.7 127.4 126.1 142.2 129.6 106.3 108.3 131.9 126.2 133.1

133.2

1994 Q3 138.5 135.0 157.8 135.4 116.9 124.7 108.5 114.1 116.0 157.4 145.5 127.1 126.3 165.2 122.3 119.1 127.8 118.5 118.0 115.5 114.7 116.0 116.1 115.4 121.8 128.6 127.3 143.2 132.1 106.2 110.9 131.9 127.7 134.1

134.3

1994 Q4 139.9 136.1 160.6 136.6 116.0 122.5 110.4 114.7 106.4 160.1 147.3 128.6 127.5 167.6 123.5 120.2 129.3 1?9.5 119.2 115.7 114.8 118.6 116.3 116.5 122.7 130.7 129.4 144.6 132.3 107.0 112.5 152.1 129.0 135.0

1995 Q1 135.7 140.9 137.0 162.2 137.5 118.6 120.7 112.4 116.9 123.7 162.1 149.1 129.4 128.3 168.8 124.5 120.9 130.8 120.2 119.6 116.0 115.2 120.5 117.3 117.2 123.5 131.7 129.9 145.8 135.4 107.8 112.1 152.1 129.8 136.4

136.7

1995 Q2 142.7 138.6 165.4 139.2 120.2 121.1 111.7 119.6 126.0 165.0 151.2 130.4 129.4 169.6 125.4 121.6 132.0 123.2 119.7 116.8 115.8 121.9 117.9 118.1 124.2 132.5 130.5 147.4 136.4 108.3 110.4 152.1 131.4 137.6

1995 Q3 138.2

144.0 139.8 167.2 140.2 122.8 136.7 112.7 117.0 122.1 166.4 153.7 131.4 130.3 171.5 125.7 121.5 133.2 124.4 121.0 117.4 115.8 123.3 118.0 118.8 125.4 133.7 131.7 148.6 138.3 108.4 112.8 152.1 132.6 138.8

139.5

1995 Q4

2

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1990). Category weights may not sum to total because of rounding. NOTES: Data through 1994, quarter 1 are historical. Data beginning with 1994, quarter 2 are forecasted. Q designates quarter of year. SOURCES: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Second quarter 1994 forecasts were produced by Data Resources, Inc./McGraw-Hill.

1

100.000

Base Year Weights 19872

Total

Expense Category

1

Table 8—Continued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index, by Expense Category: 1992-95

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1

See footnotes at end of table.

Compensation Wages and Salaries Employee Benefits Other Professional Fees Energy and Utilities Fuel Oil, Coal, and Other Fuel Electricity Natural Gas Motor Gasoline Water and Sewerage Maintenance Professional Liability Insurance All Other Other Products Pharmaceuticals Food Direct Purchase Contract Service Chemicals and Cleaning Products Surgical and Medical Instruments Photographic Supplies Rubber and Plastics Paper Products Apparel Minor Machinery and Equipment Miscellaneous Products Other Services Business Services Computer and Data Processing Transportation and Shipping Telephone Blood Services Postage Other—Labor Intensive Other—Non-Labor Intensive

Total

Expense Category1

61.713 52.216 9.497 1.649 2.368 0.624 1.135 0.343 0.230 0.036 1.433 32.837 21.788 3.873 3.299 2.111 1.188 3.126 2.672 2.623 2.323 1.399 1.142 0.497 0.833 11.050 3.845 1.992 1.233 0.987 0.588 0.372 1.233 0.800

Base Year Weights 19872 100.000 4.5 4.2 6.4 4.3 -5.5 -18.3 5.3 -3.0 -15.5 7.6 2.5 1.8 1.2 8.3 0.8 -0.6 3.1 -4.0 1.6 -1.4 0.4 -2.7 1.9 1.4 1.4 3.0 2.9 2.2 1.4 1.7 2.1 13.1 4.1 3.6

1992 Q1 3.4 4.3 3.9 6.3 4.2 -6.2 -17.7 3.4 -4.2 -15.1 7.6 4.0 1.5 1.0 7.9 0.7 -0.5 2.8 -5.2 1.8 -1.2 -0.1 -2.7 1.7 0.9 0.8 2.6 2.5 1.5 1.0 1.7 4.5 8.8 3.9 3.2

3.1

1992 Q2

4.1 3.7 6.2 4.0 -5.0 14.4 1.8 -1.9 -11.2 7.1 4.9 1.5 1.1 7.2 0.9 0.0 2.4 -4.4 1.9 -0.7 -0.3 -2.1 1.6 0.5 0.8 2.4 2.4 1.3 1.0 1.2 6.5 4.9 3.4 3.0

1992 Q3 3.1 3.9 3.4 6.2 3.9 -0.9 -5.5 1.2 2.0 -2.6 6.8 3.3 1.7 1.4 6.5 0.8 0.2 2.0 -2.3 2.2 -0.2 0.0 -1.4 1.7 0.3 1.2 2.2 2.1 1.4 2.2 0.6 5.8 1.2 2.9 3.0

3.7 3.3 6.2 3.8 2.3 3.2 1.1 5.0 2.0 6.5 3.1 1.8 1.8 5.9 1.0 0.5 1.7 0.1 2.3 -0.4 0.6 -0.6 1.8 0.2 1.6 1.9 1.5 1.8 3.0 0.2 4.5 0.0 2.4 3.1

Four Quarters Ending 1992 1993 Q4 Q1 3.1 3.1 3.6 3.1 6.1 3.6 2.5 1.8 1.1 10.5 1.1 6.2 2.8 2.0 2.0 5.4 1.1 0.8 1.7 1.7 2.3 -0.6 0.9 -0.4 1.7 0.3 1.8 1.9 1.5 2.6 3.2 0.0 1.7 0.0 2.2 3.1

1993 Q2 3.1 3.5 3.1 5.8 3.4 0.9 -2.4 1.2 9.0 -2.6 5.9 2.8 1.9 1.9 5.0 1.3 1.0 1.7 1.4 2.3 -0.9 0.9 -0.4 1.9 0.5 1.6 1.9 1.4 3.1 3.1 0.2 0.2 0.0 2.1 3.0

1993 Q3 2.9

3.5 3.0 5.3 3.3 -0.3 -3.0 0.8 5.1 -6.1 5.4 3.0 1.8 1.7 4.5 1.7 1.6 1.8 1.1 2.1 -1.1 0.8 -0.4 1.9 0.6 1.2 2.0 1.5 3.6 3.0 0.7 -0.2 0.0 2.1 3.0

1993 Q4 2.9

Table 9 Percent Change in Four-Quarter Moving Averages in the Prospective Payment System Hospital Input Price Index: 1992-95

314 61.713 52.216 9.497 1.649 2.368 0.624 1.135 0.343 0.230 0.036 1.433 32.837 21.788 3.873 3.299 2.111 1.188 3.126 2.672 2.623 2.323 1.399 1.142 0.497 0.833 11.050 3.845 1.992 1.233 0.987 0.588 0.372 1.233 0.800

Compensation Wages and Salaries Employee Benefits Other Professional Fees Energy and Utilities Fuel Oil, Coal, and Other Fuel Electricity Natural Gas Motor Gasoline Water and Sewerage Maintenance Professional Liability Insurance All Other Other Products Pharmaceuticals Food Direct Purchase Contract Service Chemicals and Cleaning Products Surgical and Medical Instruments Photographic Supplies Rubber and Plastics Paper Products Apparel Minor Machinery and Equipment Miscellaneous Products Other Services Business Services Computer and Data Processing Transportation and Shipping Telephone Blood Services Postage Other—Labor Intensive Other—Non-Labor Intensive

3.2 3.0 4.6 3.0 -3.5 -9.4 0.0 2.5 -12.6 5.2 2.9 1.7 1.4 3.9 2.2 2.4 1.8 -1.1 1.2 0.5 0.5 -0.8 2.1 0.8 0.3 2.4 2.2 4.1 2.5 1.6 -1.6 0.0 2.3 2.7

2.6

1994 Q2

3.3 2.9 4.8 3.0 -2.7 -5.9 -1.5 3.7 -10.1 5.4 2.9 1.8 1.4 3.5 2.4 2.8 1.9 -1.0 1.0 1.4 0.5 -0.7 1.6 1.1 0.5 2.5 2.6 4.3 2.7 2.0 -3.1 0.0 2.4 2.8

2.7

1994 Q3

3.3 3.0 5.2 3.1 -1.0 -2.1 -1.5 4.4 -4.6 5.6 3.0 2.0 1.6 3.5 2.5 2.8 2.1 -0.6 1.0 2.0 0.5 -0.3 1.2 1.5 1.1 2.8 3.1 4.4 3.0 2.0 -3.4 0.0 2.7 3.0

2.8

1994 Q4

3.5 3.1 5.5 3.3 1.3 3.8 -0.7 3.7 0.4 5.8 3.4 2.3 1.9 3.4 2.6 2.6 2.6 0.6 1.5 1.8 0.6 0.8 0.9 2.0 1.8 3.1 3.3 4.1 3.5 2.1 -1.2 3.8 2.9 3.2

3.1

1995 Q1

Four Quarters Ending

3.6 3.2 5.9 3.4 3.5 9.1 0.1 2.3 7.3 5.8 3.9 2.7 2.3 3.5 2.8 2.5 3.2 1.8 2.2 1.5 0.8 2.8 0.9 2.4 2.5 3.5 3.5 4.0 4.2 2.0 0.3 7.7 3.3 3.4

3.3

1995 Q2

3.8 3.3 6.0 3.4 4.7 10.1 1.8 1.1 10.1 6.0 4.5 3.0 2.6 3.6 2.8 2.2 3.7 2.9 2.5 1.1 0.9 4.4 1.1 2.6 2.9 3.8 3.6 3.7 4.6 1.9 2.0 11.5 3.7 3.4

3.6

1995 Q3

3.9 3.4 6.0 3.5 5.1 10.4 2.4 1.8 9.0 6.0 5.0 3.3 2.9 3.7 2.8 2.1 4.1 3.9 2.7 1.1 1.0 5.7 1.4 2.8 3.0 4.0 3.5 3.7 4.9 2.0 2.8 15.4 3.8 3.4

3.7

1995 Q4

2

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1990). Category weights may not sum to total because of rounding. NOTES: Data through 1994, quarter 1 are historical. Data beginning with 1994, quarter 2 are forecasted. Q designates quarter of year. Percent change data shown are four-quarter moving averages. The following is an example of how a percent change is calculated: Use the quarterly index levels shown in Tables 9, 11, and 13. Choose the four-quarter period ending for which you would like to calculate the percent change (e.g., year-end 1994, quarter 3). Count back three quarters so that you have a total of four (e.g., 1994, quarter 3; 1994, quarter 2; 1994, quarter 1; 1993, quarter 4). Average these four quarters (add the index levels and divide by 4). Now take the four quarters previous to the four quarters that you just used (e.g., 1993, quarter 3; 1993, quarter 2; 1993, quarter 1; 1992, quarter 4). Average these four quarters. Finally, compute a percent change using the two averages. SOURCE: Health Care Financing Administration, Office of the Acturary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Second quarter 1994 forecasts were produced by Data Resources, Inc/McGraw-Hill.

1

2.7

100.000

Expense Category1 Total 3.3 3.0 4.9 3.1 -2.1 -7.2 0.4 5.1 -10.2 5.2 3.0 1.8 1.6 4.2 2.0 2.1 1.8 0.1 1.7 -0.3 0.7 -0.4 2.0 0.6 0.8 2.3 2.0 4.1 2.6 1.1 -1.1 0.0 2.2 2.8

1994 Q1

Base Year Weights 19872

Table 9—Continued Percent Change in Four-Quarter Moving Averages in the Prospective Payment System Hospital Input Price Index: 1992-95

Table 10 Quarterly Index Levels in the Skilled Nursing Facility Input Price Index, by Expense Category: 1992-95

Expense Category1 Total Compensation Wages and Salaries Employee Benefits Fuel and Other Energy Fuel Oil and Coal Electricity Natural Gas Water and Sewerage Maintenance Food Direct Purchase Contract Service All Other Pharmaceuticals Supplies Health Services Other Business Services Miscellaneous Costs

Total Compensation Wages and Salaries Employee Benefits Fuel and Other Energy Fuel Oil and Coal Electricity Natural Gas Water and Sewerage Maintenance Food Direct Purchase Contract Service All Other Pharmaceuticals Supplies Health Services Other Business Services Miscellaneous Costs

Base Year Weights 19772 100.000

1992 Q1 236.2

1992 Q2 238.1

1992 Q3 240.5

1992 Q4 242.4

1993 Q1 244.8

70.620 63.020 7.600 4.270 1.660 1.210 0.910 0.490 9.740 4.930 4.810 15.370 1.500 3.280 1.210 4.590 4.790

239.3 237.3 256.3 221.3 204.2 216.8 226.1 281.3 186.6 164.6 209.1 257.3 345.4 228.9 303.0 266.6 228.9

241.3 239.1 259.2 223.0 205.2 217.8 228.7 285.9 187.2 165.3 209.6 260.0 351.2 230.7 308.1 269.0 230.7

243.9 241.7 262.2 227.2 210.4 218.7 234.0 292.8 187.4 164.7 210.7 262.3 354.9 232.5 312.1 271.3 232.5

245.8 243.4 265.6 228.6 208.6 220.7 239.3 296.3 188.3 165.3 211.8 264.7 358.2 234.4 315.5 274.2 234.4

Base Year Weights 19772 100.000

1994 Q1 254.3

1994 Q2 255.6

1994 Q3 257.9

70.620 63.020 7.600 4.270 1.660 1.210 0.910 0.490 9.740 4.930 4.810 15.370 1.500 3.280 1.210 4.590 4.790

259.0 255.9 285.5 234.1 207.0 222.2 255.5 315.1 194.1 171.1 217.7 276.0 377.4 242.1 336.2 286.7 242.1

260.3 256.7 289.8 233.0 202.9 222.8 255.3 319.1 195.2 172.0 219.0 278.6 380.4 244.1 340.9 289.6 244.1

262.7 259.2 291.8 235.1 205.6 223.7 256.0 324.5 196.7 173.1 220.9 280.9 381.9 246.2 345.3 292.0 246.2

1993 Q2 246.8

1993 Q3 249.3

1993 Q4 251.8

248.6 246.3 267.6 227.9 207.5 219.7 237.7 298.9 189.1 166.2 212.6 267.3 363.5 236.1 320.9 276.6 236.1

250.4 247.7 273.3 231.1 208.8 222.6 244.7 302.0 190.5 167.3 214.3 269.9 367.8 237.9 325.7 279.5 237.9

253.4 250.5 276.6 233.2 207.5 224.5 251.3 307.5 191.0 167.5 215.0 271.8 370.4 239.0 329.5 282.0 239.0

256.3 253.4 279.9 232.3 203.8 224.9 252.0 310.7 193.1 69.4 217.4 273.8 371.9 240.8 331.9 284.3 240.8

1994 Q4 260.4

1995 Q1 264.2

1995 Q2 266.0

1995 Q3 269.0

1995 Q4 271.3

265.4 261.9 294.6 237.0 207.7 224.7 257.3 328.6 198.1 174.0 222.7 283.5 385.3 248.3 349.7 294.6 248.3

269.8 266.3 298.6 239.0 210.0 225.8 258.5 334.1 199.4 174.9 224.4 286.4 391.1 250.4 355.2 297.3 250.4

271.6 267.9 301.8 240.5 211.7 226.8 258.7 338.3 200.6 175.7 226.1 288.9 393.9 252.4 360.2 300.0 252.4

275.0 271.4 304.9 242.9 214.6 227.7 259.7 344.5 201.9 176.6 227.7 291.3 395.7 254.5 365.3 302.6 254.5

277.3 273.6 307.8 245.5 218.7 228.7 261.8 347.4 203.1 177.5 229.4 294.3 400.0 257.1 369.8 305.4 257.1

1 For 2

data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1992). Category weights may not sum to total because of rounding. NOTES: Data through 1994, quarter 1 are historical. Data beginning with 1994, quarter 2 are forecasted. Q designates quarter of year. SOURCES: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Second quarter 1994 forecasts were produced by Data Resources, Inc./McGraw-Hill.

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1

315

Table 11 Percent Change in Four-Quarter Averages in the Skilled Nursing Facility Input Price Index, by Expense Category: 1992-95

Expense Category1 Total Compensation Wages and Salaries Employee Benefits Fuel and Other Energy Fuel Oil and Coal Electricity Natural Gas Water and Sewerage Maintenance Food Direct Purchase Contract Service All Other Pharmaceuticals Supplies Health Services Other Business Services Miscellaneous Costs

Total Compensation Wages and Salaries Employee Benefits Fuel and Other Energy Fuel Oil and Coal Electricity Natural Gas Water and Sewerage Maintenance Food Direct Purchase Contract Service All Other Pharmaceuticals Supplies Health Services Other Business Services Miscellaneous Costs

Base Year Weights 19772 100.000 70.620 63.020 7.600 4.270 1.660 1.210 0.910 0.490 9.740 4.930 4.810 15.370 1.500 3.280 1.210 4.590 4.790

Base Year Weights 19772 100.000 70.620 63.020 7.600 4.270 1.660 1.210 0.910 0.490 9.740 4.930 4.810 15.370 1.500 3.280 1.210 4.590 4.790

Four Quarters Ending 1992 Q1 4.0

1992 Q2 3.8

1992 Q3 3.7

1992 Q4 3.8

1993 Q1 3.8

1993 Q2 3.7

1993 Q3 3.6

1993 Q4 3.7

4.5 4.1 7.8 -1.3 -8.3 3.2 0.6 7.6 1.4 -0.6 3.0 4.7 8.3 3.6 5.7 4.5 3.6

4.3 3.9 7.7 -1.9 -9.6 3.0 0.5 7.6 1.3 -0.5 2.7 4.3 7.9 3.2 5.9 4.2 3.2

4.3 3.9 7.3 -1.5 -8.5 2.6 0.9 7.1 1.3 0.0 2.3 4.1 7.2 3.0 6.1 3.9 3.0

4.2 3.9 6.8 0.5 -3.8 2.0 1.9 6.8 1.2 0.1 2.0 4.0 6.5 3.0 6.3 3.8 3.0

4.1 3.9 5.9 2.2 -0.1 1.9 3.5 6.5 1.2 0.5 1.8 4.0 5.9 3.1 6.3 3.7 3.1

4.0 3.8 5.6 2.8 0.7 1.9 4.9 6.2 1.4 0.8 1.8 3.9 5.4 3.1 6.1 3.8 3.1

3.9 3.7 5.3 2.7 0.0 2.0 6.1 5.9 1.5 1.0 1.9 3.8 5.0 3.0 5.9 3.9 3.0

3.9 3.8 5.2 2.7 -0.1 2.0 6.2 5.4 1.9 1.6 2.1 3.7 4.5 3.0 5.6 3.8 3.0

1994 Q1 3.8

1994 Q2 3.7

1994 Q3 3.7

1995 Q3 3.9

1995 Q4

4.0 3.8 5.8 2.6 -0.6 2.0 6.8 5.2 2.2 2.1 2.3 3.5 4.2 2.8 5.3 3.8 2.8

4.1 3.8 5.9 1.9 -1.7 1.4 6.1 5.2 2.4 2.5 2.3 3.4 3.9 2.7 5.1 3.7 2.7

4.0 3.8 5.9 1.5 -1.6 0.7 4.7 5.4 2.7 2.9 2.5 3.3 3.5 2.7 4.9 3.6 2.7

4.2 4.1 4.6 2.7 3.0 1.3 1.5 6.0 2.7 2.3 3.0 3.7 3.6 3.3 5.6 3.6 3.3

4.4 4.4 4.4 3.1 3.9 1.7 1.4 6.0 2.7 2.1 3.1 3.7 3.7 3.4 5.7 3.6 3.4

Four Quarters Ending 1994 1995 1995 Q4 Q2 Q1 3.7 3.6 3.6 3.9 3.6 5.9 1.6 -0.5 0.2 3.9 5.6 2.7 2.9 2.4 3.3 3.5 2.8 4.9 3.6 2.8

3.8 3.6 5.3 1.5 -0.1 0.3 2.3 5.8 2.7 2.8 2.6 3.5 3.4 3.0 5.1 3.6 3.0

3.9 3.8 4.9 2.0 1.7 0.7 1.6 5.8 2.8 2.6 2.9 3.6 3.5 3.2 5.4 3.6 3.2

4.1

1

For data sources used to estimate the Input price index relative weights and choice of price proxies, see the Federal Register (1992). Category weights may not sum to total because of rounding. NOTES: Data through 1994, quarter 1 are historical. Data beginning with 1994, quarter 2 are forecasted. Q designates quarter of year. Percent change data shown are four-quarter moving averages. The following is an example of how a percent change Is calculated. Use the quarterly Index levels shown In Tables 8, 10, and 12. Choose the four-quarter period ending for which you would like to calculate the percent change (e.g., year-end 1994, quarter 3). Count back three quarters so that you have a total of four (e.g., 1994, quarter 3; 1994, quarter 2; 1994, quarter 1; 1993, quarter 4). Average these four quarters (add the Index levels and divide by 4). Now, take the four quarters previous to the four quarters that you Just used (e.g., 1993, quarter 3; 1993, quarter 2; 1993, quarter 1; 1992, quarter 4). Average these four quarters. Finally, compute a percent change using the two averages. SOURCES: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Second quarter 1994 forecasts were produced by Data Resources, Inc./McGraw-Hill. 2

316

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1

Table 12 Quarterly Index Levels of the Home Health Agency Input Price Index, by Expense Category: 1992-95 1

Expense Category Total

Compensation Wages and Salaries Employee Benefits Transportation Office Costs Medical and Nursing Supplies Rental and Leasing Energy and Utilities Miscellaneous Costs Contract Services

Total Compensation Wages and Salaries Employee Benefits Transportation Office Costs Rental and Leasing Energy and Utilities Miscellaneous Costs Contract Services

Base Year 1992 Weights 19762 Q1 100.000 283.9

1992 Q2 285.5

1992 Q3 289.6

1992 Q4 292.7

1993 Q1 295.2

1993 Q2 296.2

1993 Q3 298.8

1993 Q4 301.4

294.3 295.4 284.9 225.7 287.1 248.1 238.5 249.2 243.7 283.9

295.8 296.7 288.1 229.0 289.7 248.5 239.4 251.3 245.7 285.5

300.5 301.6 291.4 230.5 292.1 249.8 240.5 256.1 247.5 289.6

303.8 304.9 295.2 233.7 295.2 251.3 242.7 257.7 249.5 292.7

306.6 307.7 297.4 234.4 297.8 254.1 243.8 256.9 251.4 295.2

307.2 307.6 303.8 235.9 301.0 258.5 245.3 260.5 253.3 296.2

310.2 310.5 307.5 236.4 303.7 258.6 246.5 262.9 254.5 298.8

313.0 313.2 311.1 239.9 306.1 259.0 248.0 261.9 256.4 301.4

Base Year 1994 Weights 19762 Q1 100.000 303.4

1994 Q2 305.1

1994 Q3 309.0

1994 Q4 311.4

1995 Q1 313.5

1995 Q2 316.7

1995 Q3 321.1

1995 Q4 324.5

316.9 316.2 322.1 242.1 311.8 251.1 262.9 259.9 305.1

321.2 320.8 324.4 244.3 314.4 253.9 265.3 262.1 309.0

323.5 323.0 327.4 248.9 317.2 257.9 267.5 264.4 311.4

325.5 324.8 331.9 249.3 320.1 261.8 269.8 266.6 313.5

328.7 327.9 335.4 255.2 323.0 266.7 271.6 268.7 316.7

333.7 333.1 338.9 257.0 325.8 273.8 274.3 270.9 321.1

337.2 336.6 342.1 260.7 328.8 278.6 277.3 273.7 324.5

73.040 65.140 7.900 4.870 2.790 2.810 1.350 1.170 7.100 6.870

73.040 65.140 7.900 4.870 2.790 1.350 1.170 7.100 6.870

315.2 315.0 317.3 239.5 308.7 249.8 264.1 257.7 303.4

1

For data sources used to estimate the input price index relative weights and choice of price proxies, see the Federal Register (1993b). Category weights may not sum to total because of rounding. NOTES: Data through 1994, quarter 1 are historical. Data beginning with 1994, quarter 2 are forecasted.Q designates quarter of year. SOURCES: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Second quarter 1994 forecasts were produced by Data Resources, Inc./McGraw-Hill. 2

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1

317

Table 13 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index, by Expense Category: 1992-95

Expense Category1 Total Compensation Wages and Salaries Employee Benefits Transportation Office Costs Medical and Nursing Supplies Rental and Leasing Energy and Utilities Miscellaneous Costs Contract Services

Total Compensation Wages and Salaries Employee Benefits Transportation Office Costs Medical and Nursing Supplies Rental and Leasing Energy and Utilities Miscellaneous Costs Contract Services

Base Year Weights 19762 100.000

1992 Q1 5.8

1992 Q2 5.2

1992 Q3

73.040 65.140 7.900 4.870 2.790 2.810 1.350 1.170 7.100 6.870

6.4 6.3 7.8 1.4 4.5 5.5 3.3 -1.3 3.6 5.8

5.8 5.6 7.7 1.0 4.2 5.2 2.9 -1.9 3.2 5.2

5.0 4.8 7.3 1.0 3.9 4.9 2.6 -1.5 3.0 4.6

Base Year Weights 19762 100.000

1994 Q1 3.2

1994 Q2 3.0

1994 Q3 3.0

73.040 65.140 7.900 4.870 2.790 2.810 1.350 1.170 7.100 6.870

3.2 2.9 5.8 2.6 3.8 3.1 2.4 2.7 2.8 3.2

3.0 2.7 5.9 2.5 3.7 2.3 2.4 2.0 2.7 3.0

3.1 2.8 5.9 2.7 3.6 1.7 2.5 1.6 2.7 3.0

4.6

Four Quarters Ending 1992 1993 1993 Q4 Q1 Q2 4.2 3.9 3.9 4.5 4.2 6.8 2.2 3.8 4.1 2.5 0.5 3.0 4.2

4.1 3.9 5.9 3.0 3.7 3.2 2.3 2.2 3.1 3.9

Four Quarters Ending 1994 1995 Q4 Q1 3.1 3.3 3.2 2.9 5.9 3.0 3.6 1.4 3.0 1.7 2.8 3.1

3.3 3.1 5.3 3.5 3.6 1.6 3.5 1.5 3.0 3.3

1993 Q3 3.7

1993 Q4 3.5

4.0 3.8 5.6 3.2 3.8 3.2 2.3 2.8 3.1 3.9

3.8 3.7 5.3 3.1 3.9 3.2 2.4 2.8 3.0 3.7

3.6 3.4 5.2 3.0 3.8 3.3 2.3 2.8 3.0 3.5

1995 Q2 3.5

1995 Q3 3.6

1995 Q4 3.8

3.5 3.3 4.9 4.2 3.6 2.3 4.5 2.1 3.2 3.5

3.6 3.4 4.6 4.6 3.6 2.7 5.7 2.7 3.3 3.6

3.8 3.7 4.4 4.9 3.6 3.1 6.7 3.1 3.4 3.8

1

For data sources used to estimate the input price index relative weights and choice of price proxies, see Federal Register (1993b). Category weights may not sum to total because of rounding. NOTES: Data through 1994, quarter 1 are historical. Data beginning with 1994, quarter 2 are forecasted. Q designates quarter of year. Percent change data shown are four-quarter moving averages. The following is an example of how a percent change is calculated, Use the quarterly index levels shown in Tables 9, 11, and 13. Choose the four-quarter period ending for which you would like to calculate the percent change (e.g., year-end 1994, quarter 3). Count back three quarters so that you have a total of four (e.g., 1994, quarter 3; 1994, quarter 2; 1994, quarter 1; 1993, quarter 4). Average these four quarters (add the index levels and divide by 4). Now take the four quarters previous to the four quarters that you just used (e.g., 1993, quarter 3; 1993, quarter 2; 1993, quarter 1; 1992, quarter 4). Average these four quarters. Finally, compute a percent change using the two averages. SOURCES: Health Care Financing Administration, Office of the Actuary: Data from the Office of National Health Statistics, Division of Health Cost Analysis. Second quarter 1994 forecasts were produced by Data Resources, Inc./McGraw-Hill. 2

318

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1

6IS

136.2 133.8 128.7 102.4 136.8 146.3 177.0 120.4

Producer Price Index,3 Finished Consumer Goods

123.0

144.5 141.2 133.7 104.1 141.6 155.7 201.4

140.3 137.5 131.9 103.0 138.7 151.2 190.1 121.7

125.5

121.9

$5,375 $4,689 193 4.1

8,767 32.8 $11.78

91,708 34.5 $10.83

6.8

120.4

134.8 132.6 126.3 103.2 136.1 144.6 172.4

116.8

$4,797 $4,177 213 5.1

8,033 32.4 $10.73

88,788 33.8 $10.22

6.5

116.4

$5,637 $4,842

Q1

1991

$6,236 $5,075

$5,897 $4,919

122.8

143.1 140.0 133.1 102.7 140.7 154.3 197.7 120.2

124.4 138.7 136.0 130.5 99.3 138.3 149.8 185.9

$5,256 $4,598 185 4.0

8,638 32.7 $11.69

89,478 34.0 $10.77

7.6

120.5

$5,032 $4,401 235 5.3

8,375 32.8 $11.23

88,112 34.1 $10.50

7.3

119.9

122.9

1993 Q1

Q1

1992

124.2

144.2 141.0 134.6 104.7 141.4 155.2 200.3

125.2

$5,365 $4,679 214 4.6

8,730 32.8 $11.71

91,619 34.5 $10.79

6.9

123.4

$6,300 $5,105

1993 Q2

122.8

144.8 141.5 132.0 105.4 141.5 156.6 202.8

125.8

$5,396 $4,701 182 3.9

8,822 32.9 $11.80

92,742 34.8 $10.81

6.6

123.7

$6,359 $5,139

1993 Q3

122.3

145.8 142.4 135.0 103.8 142.7 156.9 204.8

126.6

$5,485 $4,778 189 4.0

8,876 32.8 $11.92

92,992 34.6 $10.96

6.1

124.1

$6,478 $5,218

1993 Q4

122.5

146.7 143.3 133.0 101.7 143.9 159.0 207.5

127.5

$5,556 $4,833 176 3.6

8,909 32.8 $12.01

91,507 34.2 $11.05

6.6

125.0

$6,575 $5,261

1994 Q1

starting in January 1994 the unemployment rate is calculated on a modified basis, using the 1990 Current Population Survey. The unemployment rates shown prior to January 1994 are not comparable to the rates for January 1994 forward. 2 Base period = 1982-84, unless noted. 3 Formerly called the "Wholesale Price Index." NOTES: Q designates quarter of year. Unlike Tables 1-13 quarterly data on GDP, personal income, disposable personal income, and savings are seasonally adjusted at annual rates. In addition, the unemployment rate is seasonally adjusted. SOURCES: U.S. Department of Commerce, Bureau of Economic Analysis: Survey of Current Business. Washington. U.S. Government Printing Office. Monthly reports for January 1991-June 1994; U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1991-June 1994.

1

118.1

Consumer Price Index, All Items All Items Less Medical Care Apparel and Upkeep Energy Food and Beverages Housing: Shelter Medical Care

$4,860 $4,237 212 5.0

Personal Income and Savings Income in Billions Disposable Income in Billions Savings in Billions Personal Savings Rate

Prices2 Gross Domestic Product Fixed-Weight Price Index (1987 = 100.0)

8,490 32.8 $11.39

8,183 32.5 $10.96 $5,154 $4,506 248 5.5

89,959 34.4 $10.57

89,854 34.3 $10.32

7.4

120.9

117.6 6.7

$6,343 $5,135

$6,020 $4,979

$5,725 $4,868 123.5

1993

Calendar Year 1992

1991

Private Non-Agricultural Workers: Total Employment in Thousands Average Weekly Hours Average Hourly Earnings Health Services Workers: Total Employment in Thousands Average Weekly Hours Average Hourly Earnings

Employment, Hours, and Earnings Unemployment Rate, All Workers1

Indicator Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987=100.0)

Table 14 Selected National Economic Indicators: 1991-94

320 4.0 4.6 24.4 0.8

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate2

1.9

Producer Price Index,4 Finished Consumer Goods

1.1

3.0 2.7 1.4 1.1 2.1 3.0 6.0

3.0

4.3 4.1 -22.3 -1.4

3.3 0.1 3.4

1.9 0.3 2.5

-0.6

5.4 3.1 2.2

3.5

5.3 5.0 4.5 6.9 4.1 5.6 9.6

4.6

4.6 5.1 20.6 0.7

5.0 -0.2 4.9

-1.0 -1.1 3.3

1.3

3.2 -1.1 4.4

1991 Q1

-0.2

2.9 2.6 3.4 -3.7 1.6 3.6 7.8

3.2

4.9 5.4 10.3 0.2

4.3 1.3 4.7

-0.8 0.7 2.8

0.7

4.6 1.6 3.0

2.1

3.2 2.9 2.0 3.4 1.8 3.0 6.3

3.2

4.4 4.5 -21.3 -1.3

3.1 -0.2 4.1

1.5 -0.1 2.5

0.4

5.8 3.2 2.5

1993

2.1

3.1 2.9 1.6 2.0 2.1 3.1 6.1

3.0

5.1 4.8 -12.2 -0.9

3.3 0.5 3.6

1.8 0.5 2.5

-0.6

5.5 3.2 2.2

-0.2

2.7 2.5 1.0 -0.4 2.5 2.9 5.5

2.7 2.5 0.8 -0.3 2.0 3.0 5.9 0.4

2.8

2.8 2.6 -34.1 -2.2

3.3 0.0 3.0

2.3 0.4 2.5

-1.2

5.0 3.1 1.8

2.9

4.8 4.5 -19.3 -1.1

3.4 0.0 3.1

2.1 0.6 2.3

-0.9

5.2 3.0 2.2

1993 1993 1993 Q2 Q3 Q4 Q1 Q1 Percent Change from the Same Period of Previous Year

1992

-0.3

2.5 2.4 -0.1 -0.9 2.3 3.0 5.0

2.5

5.7 5.1 -4.9 -0.4

3.1 0.1 2.7

2.3 0.6 2.6

-1.1

5.4 3.7 1.7

1994 Q1

Starting in January 1994 the unemployment rate is calculated on a modified basis, using the 1990 Current Population Survey. The unemployment rates shown prior to January 1994 are not comparable to the rates for January 1994 forward. 2 Change in rate, rather than percent change. 3 Base period = 1982-84, unless noted. 4 Formerly called the "Wholesale Price Index." NOTES: Q designates quarter of year. Unlike Tables 1-13 quarterly data on GDP, personal income, disposable personal income, and savings are seasonally adjusted at annual rates. In addition, the unemployment rate is seasonally adjusted. SOURCES: U.S. Department of Commerce, Bureau of Economic Analysis: Survey of Current Business. Washington. U.S. Government Printing Office. Monthly reports for January 1990-June 1994; U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1990-June 1994.

1.0

3.0 2.7 2.5 0.5 1.4 3.4 7.4

4.2 3.9 3.7 0.4 3.6 4.5 8.7

Consumer Price Index, All Items All Items Less Medical Care Apparel and Upkeep Energy Food and Beverages Housing: Shelter Medical Care

1

3.2

4.0

Prices3 Gross Domestic Product Fixed-Weight Price Index (1987 =100.0)

6.1 6.4 17.2 0.5

3.8 0.7 3.9

4.7 -0.0 5.3

0.7 0.1 0.2 2.4

1.2

Employment, Hours, and Earnings Unemployment Rate, All Workers1

5.2 2.3 2.8

-1.4 -0.6 3.1

3.2 -0.6 3.8

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 = 100.0)

Private Non-Agricultural Workers: Total Employment Average Weekly Hours Average Hourly Earnings Health Services Workers: Total Employment Average Weekly Hours Average Hourly Earnings

1991

Indicator

Calendar Year 1992 1993 Annual Percent Change

Table 15 Percent Change in Selected National Economic Indicators: 1991-94

Figure 1 Percent Change in Operating Expenses of Community Hospitals From the Same Period of Previous Year: 1985-94 14

12

10

8

6 ' Total Operating Expenses

4

Inpatient Expenses

2

0 1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

Quarters SOURCE: American Hospital Association. National Hospital Panel Survey Reports. Chicago. Monthly reports for January 1984March 1994.

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number 1

321

Figure 2 Percent Change in Admissions and Adult Length of Stay From the Same Period of Previous Year: 1985-94 4

2

0

-2

-4 Admissions Adult Length of Stay

-6

-8 1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

Quarters SOURCE: American Hospital Association. National Hospital Panel Survey Reports. Chicago. Monthly reports for January 1984March 1994.

322

HEALTH CARE FINANCING REVIEW/Fall 1994/Volume 16, Number l

Figure 3 Percent Change in Employment From the Same Period of Previous Year: 1985-94

6

Percentage Points

4

2

0 All Private Total Employment Health Service Total Employment -2

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

Quarters SOURCES: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings. Washington. U.S. Government Printing Office. Monthly reports for January 1984-June 1994.

12

Percentage Points

10

8

6

4

Consumer Price Index—Prescription Drugs

2

Consumer Price Index—All Items Less Medical Care Consumer Price Index—Medical Care

0

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

Quarters SOURCES: U.S. Department of Labor, Bureau of Labor Statistics: CPI Detailed Report. Washington. U.S. Government Printing Office. Monthly reports for January 1984-March 1994; U.S. Department of Commerce, Bureau of Economic Analysis: Survey of Current Business. Washington. U.S. Government Printing Office. Monthly reports for January 1984-May 1994.

Health Care Indicators.

THIS REGULAR FEATURE OF THE JOURNAL INCLUDES A DISCUSSION OF EACH OF THE FOLLOWING FOUR TOPICS: community hospital statistics; employment, hours, and ...
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