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PUBLISHED OCTOBER, 2023
“The world,” said the late Swedish academic Hans Roling, “cannot be understood without numbers. But the world cannot be understood with numbers alone.”
But when it comes to health-care delivery in the Kansas City region—at the acute-care level—the numbers indeed do tell an interesting tale.
For years, Ingram’s has surveyed regional hospitals and medical centers as it has compiled an annual list of the most active facilities in terms of both patient admissions and revenues. Secondary to those metrics, we’ve tracked the number of doctors and nurses employed, the number of outpatient procedures, and other aspects of their operations.
We’ve never presented that data in more than year-over-year snapshots, until now.
Taking a 10-year look back at provider performance at facilities from Topeka to Sedalia yields some interesting insights into how the health-care market has changed over the years. That 10-year period was chosen because it yielded the most consistent results and depth of data among roughly 30 organizations, the smallest of which—community hospitals—jockey for position on those Top 25 lists, earning a spot one year, falling off the next.
The best insights can be drawn from the two dozen largest among the roughly 60 facilities operating in the region, a number that excludes specialty hospitals and clinics that perform surgical and outpatient procedures.
Full data are not available for all 10 years within each metric, but most provide that longer view of movement in this sector. With all that in mind, here are some areas where the numbers provide some insights:
• Market Leaders. The numbers show that three organizations—HCA Midwest Health, Saint Luke’s Health System, and The University of Kansas Health System—now account for more than 62 percent of the available licensed beds among the two dozen largest institutions. Among those three, the six largest HCA facilities had a combined 1,580 licensed beds—18.71 percent of the market. Next came Saint Luke’s with 1,120 (13.26 percent) among its four facilities, and The University of Kansas Health System, making the most of its 1,079 beds, third at 12.78 percent.
• Patient Admissions. If there’s been a clear winner in the fierce competition to attract patients, it’s The University of Kansas Health System. A decade ago, the main hospital at 39th and State Line was roughly 50 percent bigger than its closest competitors—AdventHealth Shawnee Mission, Stormont Vail in Topeka, and North Kansas City Hospital, all of whom were within a few hundred patients of one another in the battle for second place. Last year? With nearly 44,000 admissions, KU Health’s mothership facility was more than twice the size of Saint Luke’s Hospital, which had inched up to No. 2.
• Market Revenues. Across the metro area, the two dozen biggest facilities saw their revenues go from a combined $34.47 billion to $53.07 billion. Adjust for inflation with a standard CPI calculator—a rather imperfect measure when applied to health care—nonetheless shows that overall revenues exceeded the inflation-adjusted $43.03 billion by more than $10 billion.
• Facility Revenues. While overall patient admissions increased 8.02 percent in the past 10 years, revenues reflected the disconnect between patient volumes and costs of treatment and administration. Not surprisingly, The University of Kansas Health System was No. 1, surpassing the $23.4 billion mark in total revenues. That was better than three times the volume at Research Medical Center and Saint Luke’s, each just over $3.9 billion.
• Patient Types. To the extent that costs have been contained, a dramatic increase in outpatient visits has been a contributing factor. In 2013, hospitals reporting those numbers accounted for 4.74 million outpatient visits—an average of more than two per resident of the metro area that year. Last year, that number ballooned to 7.43 million—a per-capita increase of more than 50 percent.
• Staffing. Total employment among the largest hospitals reflected their outsized role in the regional economy: 43,200 in 2013, a number that jumped 25.76 percent by last year. Growth in the numbers of hands-on providers—doctors and nurses—wasn’t far behind. The number of physicians jumped from 9,763 to 11,750 (up 20.87 percent), while the nursing ranks went from 13,000 to 16,088 (up 23.75 percent). Worth noting is that the increases in those ranks implied a lessened load with admitted patients, while the number of outpatients outstripped the increased manpower on a per-capita basis.
