While navigating razor-thin operating margins and spending over a trillion dollars annually on a workforce in crisis, U.S. hospitals in 2022 remained a trillion-dollar engine of American healthcare, delivering care to over half a million patients every single day.
Key Takeaways
- In 2022, U.S. hospitals reported total expenses of $1.27 trillion, with labor costs accounting for 56% of total hospital spending.
- Community hospitals in the U.S. had net patient revenue of $1.153 trillion in fiscal year 2021.
- Average daily census in U.S. community hospitals was 529,965 patients in 2022.
- Total number of U.S. community hospitals stood at 5,118 in 2022.
- U.S. hospitals had 919,649 staffed beds in 2022.
- Average hospital size was 180 beds per community hospital in 2022.
- U.S. hospitals employed 6.2 million people in 2022.
- Registered nurses comprised 2.8 million of hospital staff in 2022.
- Physicians and surgeons numbered 776,000 working in hospitals in 2022.
- Total admissions to U.S. community hospitals were 33.4 million in 2022.
- Average length of stay in hospitals was 4.6 days in 2022.
- Outpatient visits to hospitals totaled 939 million in 2022.
- 92% of hospitals used EHRs in 2022.
- Telemedicine visits in hospitals reached 1.2 billion in 2022.
- AI adoption in hospitals was 35% for diagnostic imaging in 2022.
The U.S. hospital industry saw rising revenues and labor costs in 2022 after recovering from pandemic losses.
Financial Performance
- In 2022, U.S. hospitals reported total expenses of $1.27 trillion, with labor costs accounting for 56% of total hospital spending.
- Community hospitals in the U.S. had net patient revenue of $1.153 trillion in fiscal year 2021.
- Average daily census in U.S. community hospitals was 529,965 patients in 2022.
- U.S. hospitals' total profit margin averaged 6.3% in 2022, up from -0.5% in 2021.
- Nonprofit hospitals comprised 58% of U.S. community hospitals and generated 64% of net patient revenue in 2021.
- Investor-owned hospitals made up 21% of community hospitals but accounted for 24% of net patient revenue in 2021.
- Hospital bad debt expense reached $55 billion in 2022, representing 4.3% of net patient revenue.
- Medicare paid $182.5 billion to hospitals in 2022, covering 20% of total hospital revenue.
- Medicaid reimbursements to U.S. hospitals totaled $137.2 billion in 2022.
- Private health insurance contributed $536.8 billion to hospital revenue in 2022.
- Operating margins for rural hospitals averaged -2.4% in 2022, compared to 7.9% for urban hospitals.
- Total hospital capital expenditures reached $128 billion in 2022.
- Hospitals invested $12.6 billion in information technology in 2022.
- Supply chain costs for hospitals rose 15.2% year-over-year in 2022.
- Charity care provided by U.S. hospitals amounted to $50.4 billion in 2021.
- Hospital revenue per adjusted admission averaged $16,702 in 2022.
- In 2022, U.S. hospitals' total revenue hit $1.3 trillion, a 4.2% increase YoY.
- Operating expenses for hospitals grew 8.1% to $1.28 trillion in 2022.
- Medicare Advantage payments to hospitals averaged 82% of fee-for-service rates in 2022.
- Uncompensated care costs for hospitals were $41.6 billion in 2022.
- Hospital outpatient revenue share was 52% of total net patient revenue in 2022.
- ICU expenses accounted for 15% of total hospital spending in 2022.
- Drug costs rose 9.4% YoY to $38 billion in hospitals in 2022.
Financial Performance Interpretation
While American hospitals technically kept the lights on in 2022 with a slender 6.3% average profit, that wafer-thin margin was precariously propped up by over a trillion dollars in patient revenue and beset by soaring labor and supply costs, a sobering $55 billion in bad debt, and the stark reality that for rural hospitals, the financial prognosis remains critically negative.
Human Resources
- U.S. hospitals employed 6.2 million people in 2022.
- Registered nurses comprised 2.8 million of hospital staff in 2022.
- Physicians and surgeons numbered 776,000 working in hospitals in 2022.
- Hospital FTEs totaled 5.4 million in 2022.
- Nurse turnover rate in hospitals was 27.2% in 2022.
- Hospitals faced a vacancy rate of 17% for RN positions in 2022.
- Average RN salary in hospitals was $89,010 annually in 2022.
- Hospitals spent $110 billion on contract labor in 2022.
- 1.7 million nursing assistants worked in hospitals in 2022.
- Hospital administrators numbered 220,000 in 2022.
- Pharmacists in hospitals totaled 155,000 in 2022.
- Radiology technologists in hospitals were 200,000 in 2022.
- Labor costs as percentage of hospital expenses were 53% in 2022.
- Hospitals hired 250,000 new RNs in 2022.
- Allied health professionals in hospitals numbered 1.2 million in 2022.
- CEO turnover in hospitals was 18% in 2022.
- Hospitals reported 15% vacancy rate for physicians in 2022.
- RN employment growth in hospitals was 3.2% in 2022.
- Hospitals spent $1.1 trillion on workforce in 2022.
- Travel nurse contracts cost $8.5 billion in 2022.
- Diversity: 19% of hospital RNs were Black in 2022.
- Mental health staff shortages affected 88% of hospitals in 2022.
- Average tenure for hospital nurses was 6.8 years in 2022.
- Hospitals trained 150,000 new healthcare workers in 2022.
- Physician assistants in hospitals: 168,000 in 2022.
- Respiratory therapists numbered 133,000 in hospitals in 2022.
- Lab technicians in hospitals: 340,000 in 2022.
- Burnout rate among hospital staff was 62% in 2022.
Human Resources Interpretation
The U.S. hospital industry in 2022 was a multi-trillion dollar human resources crisis masquerading as a healthcare system, where heroic efforts to hire a quarter-million new nurses were nearly undone by one in four of them quitting, all while spending more on temporary travelers than some small nations' GDPs to keep the lights on.
Infrastructure and Capacity
- Total number of U.S. community hospitals stood at 5,118 in 2022.
- U.S. hospitals had 919,649 staffed beds in 2022.
- Average hospital size was 180 beds per community hospital in 2022.
- There were 6,093 hospitals in total in the U.S. in 2022, including non-community facilities.
- Urban hospitals accounted for 82% of all community hospitals in 2022.
- Rural community hospitals numbered 1,006 in 2022.
- Teaching hospitals represented 22% of community hospitals in 2022.
- Hospital occupancy rate averaged 64% in U.S. community hospitals in 2022.
- Critical Access Hospitals numbered 1,360 in 2022, with average 25 beds each.
- Total hospital square footage exceeded 2.9 billion square feet in 2022.
- 3,488 hospitals were members of the American Hospital Association in 2022.
- Psychiatric hospitals totaled 648 in the U.S. in 2022.
- Rehabilitation hospitals numbered 1,110 in 2022.
- Long-term acute care hospitals stood at 309 in 2022.
- 1,775 general medical and surgical hospitals existed in 2022.
- Children's hospitals numbered 223 in the U.S. in 2022.
- Orthopedic specialty hospitals totaled 50 in 2022.
- Hospital bed supply per 1,000 population was 2.5 in 2022.
- 45% of hospitals expanded capacity post-COVID in 2022.
- Modular construction used in 20% of new hospital builds in 2022.
- Average age of U.S. hospitals was 37 years in 2022.
- 1,200 hospitals participated in bundled payment programs in 2022.
- Outpatient surgery centers co-located with 30% of hospitals in 2022.
- Total MRI machines in hospitals: 7,500 in 2022.
- CT scanners numbered 14,000 in U.S. hospitals in 2022.
Infrastructure and Capacity Interpretation
Despite boasting over 2.9 billion square feet of aging infrastructure, the U.S. hospital system presents a curiously vacant sprawl, where the average 180-bed facility quietly operates with only two-thirds of its capacity filled, suggesting we've built a remarkably spacious and underutilized safety net.
Patient Care Metrics
- Total admissions to U.S. community hospitals were 33.4 million in 2022.
- Average length of stay in hospitals was 4.6 days in 2022.
- Outpatient visits to hospitals totaled 939 million in 2022.
- Emergency department visits reached 131 million in 2022.
- Hospital readmission rate within 30 days was 15.7% for Medicare patients in 2022.
- Surgical procedures in hospitals numbered 48 million in 2022.
- Newborns delivered in hospitals totaled 3.6 million in 2022.
- Average cost per inpatient day was $3,025 in 2022.
- Patient satisfaction score (HCAHPS) averaged 72% in 2022.
- Sepsis mortality rate in hospitals was 15.3% in 2022.
- Pneumonia readmission rate was 17.4% within 30 days in 2022.
- Heart failure readmission rate stood at 21.4% in 2022.
- COPD readmission rate was 20.8% in 2022.
- Total hip/knee replacement surgeries in hospitals: 500,000 in 2022.
- Admissions for heart attacks: 1.1 million in 2022.
- Stroke admissions totaled 795,000 in hospitals in 2022.
- Cancer patients admitted: 1.9 million in 2022.
- Sepsis cases treated: 1.7 million in 2022.
- Average ED wait time was 2.5 hours in 2022.
- Left without being seen ED rate: 2.1% in 2022.
- Hospital-acquired infections: 687,000 cases in 2022.
- CLABSI rate: 0.78 per 1,000 catheter days in 2022.
- CAUTI rate: 1.02 per 1,000 catheter days in 2022.
- SSI rate for colorectal surgery: 3.2% in 2022.
- Patient safety grade A hospitals: 30% in 2022.
Patient Care Metrics Interpretation
American hospitals are impressive, chaotic, and costly machines—performing heroic miracles for millions while simultaneously struggling to avoid preventable harm, re-admitting too many, and trying to soothe patients who spent hours waiting only to be billed for a stay more expensive than a luxury hotel.
Technological Adoption
- 92% of hospitals used EHRs in 2022.
- Telemedicine visits in hospitals reached 1.2 billion in 2022.
- AI adoption in hospitals was 35% for diagnostic imaging in 2022.
- Robotic surgery procedures totaled 1.5 million in 2022.
- Cybersecurity incidents in hospitals numbered 725 in 2022.
- Interoperable EHR exchange rate was 78% among hospitals in 2022.
- 65% of hospitals implemented predictive analytics in 2022.
- Wearable device integration in 42% of hospitals in 2022.
- Blockchain pilots for supply chain in 18% of hospitals in 2022.
- 5G networks deployed in 25% of large hospitals in 2022.
- VR therapy used in 15% of rehab hospitals in 2022.
- IoT devices in hospitals averaged 10,000 per large facility in 2022.
- Digital twins for facility management in 12% of hospitals in 2022.
- NLP for clinical documentation in 55% of hospitals in 2022.
- Revenue cycle management automation at 68% in 2022.
- 88% of hospitals achieved Stage 7 HIMSS EMRAM in 2022.
- RPA adoption for admin tasks: 45% in 2022.
- Ambient listening tech piloted in 22% of hospitals in 2022.
- Genomics testing integrated in 28% of hospitals in 2022.
- Cloud computing migration: 75% of hospitals in 2022.
- Patient portals active for 96% of hospitals in 2022.
- AR for surgical planning used in 35% of teaching hospitals in 2022.
- Big data analytics for population health: 52% adoption in 2022.
- Drone delivery for meds tested in 5% of hospitals in 2022.
- Quantum computing research partnerships: 10 hospitals in 2022.
Technological Adoption Interpretation
While hospitals are rapidly becoming high-tech digital fortresses where your data is almost as integrated as your care, don't be surprised if the robot performing your surgery still faxes its report to your primary doctor.
Sources & References
- Reference 1AHAaha.orgVisit source
- Reference 2BECKERSHOSPITALREVIEWbeckershospitalreview.comVisit source
- Reference 3KAUFMANHALLkaufmanhall.comVisit source
- Reference 4CMScms.govVisit source
- Reference 5KFFkff.orgVisit source
- Reference 6HEALTHSYSTEMTRACKERhealthsystemtracker.orgVisit source
- Reference 7CHARTISchartis.comVisit source
- Reference 8DEFINITIVEHCdefinitivehc.comVisit source
- Reference 9HIMSShimss.orgVisit source
- Reference 10SHEPSCENTERshepscenter.unc.eduVisit source
- Reference 11FLEXMONITORINGflexmonitoring.orgVisit source
- Reference 12IFMACONTRACTORSifmacontractors.orgVisit source
- Reference 13SAMHSAsamhsa.govVisit source
- Reference 14NAHCnahc.orgVisit source
- Reference 15BLSbls.govVisit source
- Reference 16AAMCaamc.orgVisit source
- Reference 17NSIONLINEnsionline.comVisit source
- Reference 18ACHIEVECEUachieveceu.comVisit source
- Reference 19ADVISORYadvisory.comVisit source
- Reference 20NURSINGWORLDnursingworld.orgVisit source
- Reference 21MERRITTHAWKINSmerritthawkins.comVisit source
- Reference 22CDCcdc.govVisit source
- Reference 23DATAdata.cms.govVisit source
- Reference 24HEALTHIThealthit.govVisit source
- Reference 25MCKINSEYmckinsey.comVisit source
- Reference 26INTUITIVEintuitive.comVisit source
- Reference 27HIPAAJOURNALhipaajournal.comVisit source
- Reference 28HEALTHCAREITNEWShealthcareitnews.comVisit source
- Reference 29NCBIncbi.nlm.nih.govVisit source
- Reference 30STATISTAstatista.comVisit source
- Reference 31KLASRESEARCHklasresearch.comVisit source
- Reference 32HEALTHCAREDIVEhealthcaredive.comVisit source
- Reference 33IBISWORLDibisworld.comVisit source
- Reference 34CHILDRENSHOSPITALSchildrenshospitals.orgVisit source
- Reference 35OECDoecd.orgVisit source
- Reference 36HFMMAGAZINEhfmmagazine.comVisit source
- Reference 37ASHEashe.orgVisit source
- Reference 38SCARscar.orgVisit source
- Reference 39OECD-ILIBRARYoecd-ilibrary.orgVisit source
- Reference 40FIERCEHEALTHCAREfiercehealthcare.comVisit source
- Reference 41AACNNURSINGaacnnursing.orgVisit source
- Reference 42VIZIENTINCvizientinc.comVisit source
- Reference 43MAYOCLINICPROCEEDINGSmayoclinicproceedings.orgVisit source
- Reference 44CANCERcancer.govVisit source
- Reference 45ACEPacep.orgVisit source
- Reference 46LEAPFROGGROUPleapfroggroup.orgVisit source
- Reference 47DELOITTEdeloitte.comVisit source
- Reference 48GENOMEgenome.govVisit source
- Reference 49IBMibm.comVisit source