Hospital sector in the United States - basic characteristics and current financial challenges

Abstract

The aim of this article is to present the basic characteristics of the U.S. hospital sector (with an emphasis on structure, utilization level and the system of financing) as well as its current challenges and reform trends. Hospitals in the U.S. constitute a complicated and heterogeneous subsystem. There are diverse types of hospitals, functioning independently or in networks, developing innovative care models and using a multiple payer structure. The recent health care reform has created new organizational and financial challenges on both the macro and micro levels. The major ones are: the extension of the insured population; Medicare Hospital Readmissions Reduction Program; new requirements for non-profit hospitals regarding charity services; the role of accountable care organizations (ACOs). Additional challenge results from a strong public pressure for hospital’s price transparency.