Ethan Rhodes
Hospitals in the United States vary in terms of their ownership and management. While some hospitals are privately owned, there are also state hospitals that are funded and managed by the government. These state hospitals are Medicare-certified and Medicaid-approved and provide a range of services, including short-term acute care, rehabilitation, and long-term care for patients with serious medical conditions. Additionally, state hospitals also include specialty services such as psychiatric care and treatment for military personnel. The number of hospitals can vary across states, with some states having more hospitals than others.
| Characteristics | Values |
|---|---|
| Number of hospitals in the US | 6,093 (as per the American Hospital Association) or 8,214 (as per Definitive Healthcare) |
| Types of hospitals | Short-term acute care hospitals, Critical Access Hospitals (CAH), Rehabilitation hospitals, Long-term acute care hospitals, Children's hospitals, Veterans Affairs (VA) hospitals, Department of Defense hospitals, Community hospitals, Teaching hospitals |
| Example hospitals | John H. Stroger Jr. Hospital of Cook County (Chicago), Lyndon B. Johnson General Hospital (Houston), Greenville General Hospital (Greenville, SC), Martin Luther King Jr./Drew Medical Center (Los Angeles County, CA) |
| Number of state hospitals in Texas | 9 state hospitals and 1 residential youth center |
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What You'll Learn
State hospitals are Medicare-certified and Medicaid-approved
In the United States, state hospitals are Medicare-certified and Medicaid-approved. Medicare is a federal government-sponsored program that provides health insurance for American citizens aged 65 and over. The Centers for Medicare and Medicaid Services (CMS) survey hospitals to assess their compliance with the Medicare Conditions of Participation (CoP) for all services, areas, and locations covered by the hospital's provider agreement under its CMS Certification Number (CCN).
The CMS-1572 Hospital Survey and Deficiencies Report is a Medicare certification survey that can be performed by either the State agency or an outside accrediting organization chosen by the hospital. If a hospital is approved by CMS, it receives a six-digit Medicare number starting with "52." Wisconsin hospitals, for example, must be licensed by the state and CMS to provide certain services.
Psychiatric hospitals that participate in Medicare as a Distinct Part Psychiatric Hospital are not required to participate in their entirety. However, specific components, such as skilled nursing facilities, nursing facilities, and home health agencies, are excluded from the hospital's evaluation for compliance. Critical Access Hospitals (CAH), a designation for hospitals in rural areas, are certified under separate standards.
Medicaid, on the other hand, is a program that provides coverage for individuals with limited access to health insurance. The CARES (Coronavirus Aid, Relief, and Economic Security) Act expanded Medicaid's ability to cover COVID-19-related services for uninsured adults who would have qualified if their state had chosen to expand the program.
It is important to note that not all doctors accept Medicare patients, which can result in higher out-of-pocket costs for individuals enrolled in the program. Physicians who accept Medicare agree to accept Medicare-approved amounts for their services, which are typically lower than private health insurance reimbursements.
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There are over 6,000 hospitals in the US
There are over 6,000 hospitals in the United States, with sources providing a range of specific figures. The American Hospital Association (AHA) reported in 2023 that there were 6,093 hospitals in the US. However, another source states that there were 6,120 hospitals in the country in 2022. The number of hospitals has been steadily declining since 1975 when there were 7,156 hospitals in the US.
The Definitive Healthcare HospitalView product tracks more than 7,300 active hospitals in the US, curated from almost 40 different public, private, and proprietary sources. Another source, however, provides a map of 8,214 hospitals in the country.
The US has several types of hospitals, including short-term acute care hospitals, which are the most common, with 3,888 facilities across the country. Critical Access Hospitals (CAH) are the second most common, with 1,363 facilities in rural areas. There are 457 rehabilitation hospitals, which are the fourth most common, and 384 long-term acute care hospitals, which are the fifth most common. Other types of hospitals include psychiatric, religious non-medical healthcare, rural emergency, children's hospitals, and Veterans Affairs (VA) hospitals.
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Short-term acute care hospitals are the most common
Short-term acute care hospitals account for more than half of all hospitals in the US, with approximately 3,900 active facilities across the country. They are distinct from long-term acute care hospitals, which focus on patients staying more than 25 days and offer comprehensive rehabilitation, respiratory therapy, treatment for head trauma, and pain management services. In contrast, short-term acute care hospitals provide treatment for patients recovering from surgery, those who need treatment for severe injuries, or those who have urgent medical conditions.
The rise of outpatient care centers has resulted in short-term acute care hospitals being used less. This has led to challenges in preventing patient leakage and reducing revenue loss. Despite being the most common type of hospital, short-term acute care hospitals are outnumbered by urgent care clinics and ambulatory surgery centers. While there are around 3,900 short-term acute care hospitals, there are more than 10,000 urgent care clinics and 9,100 ambulatory surgery centers in the US.
One of the challenges facing short-term acute care hospitals is patient length of stay. Longer lengths of stay are associated with higher readmission rates, particularly for cardiovascular issues, and increase the likelihood of patients contracting hospital-acquired infections or other hospital-acquired conditions. This also reduces patient turnover, as fewer beds are available, limiting the number of patients the hospital can treat.
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Texas has nine state hospitals for mental health
Mental health is an important aspect of overall health, and Texas is taking steps to address the needs of its residents. The state has nine state hospitals dedicated to mental health, providing a range of services for individuals with mental health issues. These hospitals are operated by Texas Health and Human Services and are located across the state, serving different populations, including people involved with the justice system.
One example of these state hospitals is the Austin State Hospital (ASH), which has a long history in Texas, previously known as the Texas State Lunatic Asylum until 1925. It is the oldest psychiatric facility in the state and the oldest continuously operating west of the Mississippi River. ASH offers psychiatric services for children, adolescents, and adults facing a broad range of mental illnesses, developmental disabilities, and intellectual disabilities. They provide acute, short-term care to stabilize patients in crisis and prepare them for reintegration into society and long-term outpatient care.
The Texas Legislature has recognized the growing demand for comprehensive mental health services, especially with the added complications caused by the COVID-19 pandemic. As a result, they approved $745 million for the renovation and improvement of psychiatric facilities in the state. This funding is being used to renovate and expand the Austin State Hospital, which is expected to open in June 2024 with modern facilities covering 375,000 square feet and featuring 240 private patient bedrooms.
The state hospitals in Texas play a crucial role in the continuum of care for individuals with mental health issues. They offer emergency medical screenings and comply with the Emergency Medical Treatment and Active Labor Act (EMTALA), ensuring that all patients seeking emergency care are medically screened and stabilized, regardless of insurance or ability to pay. The hospitals also work closely with local mental health authorities to ensure that inpatient hospitalization is appropriate and that patients are treated in the least restrictive environment possible. These measures demonstrate Texas's commitment to providing accessible and effective mental health services to its residents.
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Hospitals include obstetrics, rehabilitation, and eye and ear care
In the United States, there are 6,093 hospitals in total. Community hospitals are defined as all nonfederal, short-term general, and other special hospitals. These special hospitals include obstetrics and gynecology, eye, ear, nose, and throat care, long-term acute care, rehabilitation, orthopaedic, and other individually described specialty services.
Obstetrics and gynecology services are provided by rural hospitals in the US. A survey was conducted of 306 rural hospitals across nine states, including Colorado, Iowa, Kentucky, and New York, to describe the types and combinations of clinicians delivering babies, their employment status, and the relationship between hospital birth volume and staffing models. The survey found that 77% of the hospitals had obstetricians attending deliveries, and over half had family physicians doing deliveries.
Regarding eye and ear care, several hospitals in the US are nationally ranked in adult and pediatric ophthalmology specialties. These include:
- Bascom Palmer Eye Institute at the University of Miami Hospital in Miami, FL
- Wills Eye Hospital at Thomas Jefferson University Hospitals in Philadelphia, PA
- Mass Eye and Ear at Massachusetts General Hospital in Boston, MA
- Stein and Doheny Eye Institutes at UCLA Medical Center in Los Angeles, CA
- Cole Eye Institute at Cleveland Clinic in Cleveland, OH
Rehabilitation services are also provided by community hospitals in the US, as mentioned earlier. These hospitals offer short-term, nonfederal services to the general public, excluding institutions such as prison hospitals or college infirmaries.
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Frequently asked questions
There are over 6,000 hospitals in the US, with one source citing over 8,000.
State hospitals are facilities that provide care for people with mental health issues. They are Medicare-certified and Medicaid-approved.
Some examples of state hospitals in the US include the California Department of State Hospitals, the Texas Health and Human Services hospitals, and the John H. Stroger Jr. Hospital of Cook County in Chicago.
