HEALTHCARE COST & UTILIZATION PROJECT

User Support

Do Your own analysis
Explore Expert Research & Limited Datasets

HCUP Facts and Figures

TABLE OF CONTENTS

HIGHLIGHTS

INTRODUCTION

HCUP PARTNERS

1. OVERVIEW

2. DIAGNOSES

3. PROCEDURES

4. COSTS

5. MHSA

SOURCES/METHODS

DEFINITIONS

FOR MORE INFO

ACKNOWLEDGMENTS

CITATION

FACTS & FIGURES 2008 PDF
EXHIBIT 1.4 Expected Primary Payer (PDF)

Number of discharges by expected primary payer, 2008. Column chart. Number of discharges in millions. Medicare: 14.9; Medicaid: 7.4; private insurance: 14.1; uninsured: 2.1. Note: Uninsured includes discharges classified as self-pay or no charge. Note: There are an additional 1.3 million discharges (3% of discharges) with "other" as the expected primary payer. "Other" payer includes Workers’ Compensation, TRICARE, CHAMPUS, CHAMPVA, Title V, and other government programs.


The primary payer bears the major financial responsibility for the hospital stay. Although other payers, including the patients themselves, may also pay part of the cost of hospitalization, only the expected primary payers are depicted in this section.

  • In 2008, Medicare, which covers patients who are 65 and older or disabled, was the expected primary payer for the largest number of discharges (14.9 million), followed by private insurance (14.1 million).
  • Medicaid, the primary source of insurance for low income families and individuals, was the expected primary payer for 7.4 million discharges.
  • There were 2.1 million uninsured discharges in 2008.

Number and distribution of discharges by expected primary payer, 1997 through 2008. Column chart. Number of discharges in millions. 1997: 34.7; 2002: 37.8; 2008: 39.9. Distribution of discharges. 1997: other: 4%; uninsured: 5%; private insurance: 39%; Medicaid: 16%; Medicare: 36%. 2002: other: 3%; uninsured: 5%; private insurance: 38%; Medicaid: 17%; Medicare: 37%. 2008: other: 3%; uninsured: 5%; private insurance: 35%; Medicaid: 18%; Medicare: 37%. Note: Other includes other payers such as Workers’ Compensation, TRICARE, CHAMPUS, CHAMPVA, Title V, and other government programs. Note: Uninsured includes discharges classified as self–pay or no charge. Note: Excludes a small number of discharges (68,000 or 0.2%) with missing payer.


The number of discharges increased steadily in the 11-year period, growing from 34.7 million in 1997 to 39.9 million in 2008.

  • In 2008, Medicare and Medicaid were the expected primary payers for more than half (55 percent) of all inpatient hospital discharges (accounting for 14.9 and 7.4 million hospital stays, respectively).
    • The percentage of discharges billed to Medicare remained relatively stable from 1997 to 2008 at 36-37 percent.
    • Unlike Medicare, the share of discharges with Medicaid as an expected payer increased throughout most of the period, from 16 percent in 1997 to 18 percent in 2008.
  • Between 1997 and 2008, the percentage of discharges billed to private insurance fell from 39 percent to 35 percent. This reflects the steady decline in the share of the population with private insurance coverage.1
  • In both 1997 and 2008, about 5 percent of discharges were listed as uninsured, amounting to 1.7 million hospital stays in 1997 and 2.1 million in 2008.

Growth in number of discharges by expected primary payer, 1997 through 2008. Bar chart. Cumulative percent growth. Medicaid: 30%; Uninsured: 27%; Medicare: 18%; all discharges: 15%; private insurance: 5%; other: 4%. Note: Uninsured includes discharges classified as self-pay or no charge. Note: Other includes other payers such as Workers’ Compensation, TRICARE, CHAMPUS, CHAMPVA, Title V, and other government programs.

Between 1997 and 2008, the number of hospital discharges grew by 15 percent; however, growth varied widely by expected primary payer.

  • Medicaid discharges (up 30 percent) grew at double the rate of all discharges, followed closely by uninsured discharges (up 27 percent).
  • The number of discharges billed to Medicare grew by 18 percent.
  • While discharges billed to Medicaid, the uninsured, and Medicare experienced substantial growth between 1997 and 2008, growth in the number of discharges billed to private insurance and other payers remained relatively stable (5 percent and 4 percent, respectively).


1Cohen, J. W. and Rhoades, J.A. Group and Non-Group Private Health Insurance Coverage, 1996 to 2007: Estimates for the U.S. Civilian Noninstitutionalized Population under Age 65. Statistical Brief #267. October 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/mepsweb/data_files/publications/st267/stat267.pdf.

Internet Citation: Facts and Figures 2008. Healthcare Cost and Utilization Project (HCUP). October 2010. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/factsandfigures/2008/exhibit1_4.jsp.
Are you having problems viewing or printing pages on this website?
If you have comments, suggestions, and/or questions, please contact hcup@ahrq.gov.
Privacy Notice, Viewers & Players
Last modified 10/7/10