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By Dennis Boone
PUBLISHED APRIL 2025
A point-by-point snapshot of major health care delivery systems and providers in Kansas City set against a background of national trend lines:
If one trend line jumps out among all the other metrics in the Kansas City market, it’s the shift from bedside hospital care to outpatient treatments over the past decade. In 2014, the 25 largest hospitals and health systems delivered about 5.75 million outpatient treatments. By 2023, that figure had ballooned to nearly 8.07 million—an increase of more than 40 percent.
The flip side of that: A decrease in hospitalizations. Combined admissions for the Top 25 facilities were down to 297,942 in 2024. That’s a drop of more than 12 percent compared to pre-pandemic level admissions of 338,422.
Even with ostensibly lower-cost outpatient treatment soaring and demand for hospital beds falling, revenues have gone up substantially over the past decade. The largest 25 institutions had combined revenues of $57.57 billion in 2023 (numbers for 2024 are still being finalized). That’s up from $25.26 billion in 10 years, which would be $34.54 adjusted for inflation. Even at the higher number, hospital revenues are up 66.7 percent.
On an inflation-adjusted basis, the nation’s aggregate health care spend in 2022—$4.465 trillion—was more than 10 times what we spent as a nation in 1970. It went from $434.9 billion (again, in 2022 dollars; the nominal figure for that baseline year was $74.08 billion).
On a national level, insurance company payments for health care services reached nearly $1.45 trillion in 2023, but that represents just 30 percent of the nation’s spending. Medicare and Medicaid combined for 39 percent overall ($1.9 trillion).
For employers, the average cost to provide individual health coverage for an employee hit $8,000 in 2023. That’s up from an inflation-adjusted $4,681 in 2000—an increase of nearly 71 percent.
Nearly 50 million Americans (16.3 percent) lacked health insurance when the Affordable Care Act was passed in 2010. Today? The uninsured rate has been cut by half to 8.2 percent, but that still leaves 27.1 million people without coverage.
Last year, 21.4 million Americans had subsidized health coverage under the ACA’s marketplace. Combined with coverage in states that have approved Medicaid expansion, the total number of those with basic coverage hit 44 million.
The Kaiser Family Foundation reports that the average American’s out-of-pocket health care spend in 2022 hit $1,425. After adjusting for inflation, that’s more than double the equivalent outlay of $677 per person in 1970.
In the post-pandemic era, some troubling trends are emerging related to causes of death in the U.S., but some hopeful signs show up as well. Most concerning is the double-digit increase in deaths attributed to diabetes (up 15.47 percent), liver disease (14.37 percent), kidney disease (13.36 percent), and stroke (10.26 percent). But the two biggest killers saw declines: Heart disease remained No. 1 but dropped 3.33 percent among causes of mortality. At No. 2, the share of cancer deaths fell 2.29 percent.
