1. Chartbook 2005 Trends in the Overall Health Care Market Chapter 6: The Economic Contribution of Hospitals

2. Chartbook 2005 Trends in the Overall Health Care Market 6-2 Chart 6.1: National Expenditures on Health Services and Supplies as a Percentage of Gross Domestic Product and Breakdown of National Expenditures on Health Services and Supplies 2003 Source: Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group Other – 27% Prescription Drugs – 11% Nursing Home Care – 7% Physician Services – 23% Hospital Care – 32% $1.6 Trillion U.S. GDP 2003 Health Services and Supplies 14.7% Other Sectors 85.3%

3. Chartbook 2005 Trends in the Overall Health Care Market 6-3 Chart 6.2: Number of Full-Time and Part-Time Hospital Employees 1992 - 2003 Source: The Lewin Group analysis of American Hospital Association Annual Survey data, 1992 – 2003, for community hospitals Millions

4. Chartbook 2005 Trends in the Overall Health Care Market 6-4 Chart 6.3: Impact of Community Hospitals on U.S. Economy (in $ billions) 2003 Source: The Lewin Group, using BEA RIMS-II multipliers applied to 2003 American Hospital Association Annual Survey data Direct Effect Ripple EffectTotal Contribution

5. Chartbook 2005 Trends in the Overall Health Care Market 6-5 Chart 6.4: Hospital Employment vs. Employment in Other Industries 2004 (1) Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics Survey, custom data request (1) Data is as of October 2004 Thousands

6. Chartbook 2005 Trends in the Overall Health Care Market 6-6 Chart 6.5: Average Weekly Earnings of Workers, Hospitals (1) vs. All Service-Providing Industries 1990 - 2003 All Service-Providing Industries Hospitals Source: Department of Labor, Bureau of Labor Statistics, Current Employment Statistics Survey (1) Includes physicians employed by hospitals.

7. Chartbook 2005 Trends in the Overall Health Care Market 6-7 Chart 6.6: Hospital Employment by Occupation Type 2003 Installation, Maintenance, and Repair Business and Financial Operations Community and Social Services Food Preparation and Serving Management Building and Grounds Cleaning and Maintenance Other Occupations Healthcare Support Office and Administrative Support Healthcare Practitioner and Technical Source: Department of Labor, Bureau of Labor Statistics, 2003 National Industry-Specific Occupational Employment and Wage Estimates Number of Employees (in thousands)

8. Chartbook 2005 Trends in the Overall Health Care Market Quarterly (3-Month) Percent Change 6-8 Chart 6.7: Percent Change in Employment, Seasonally-Adjusted: Hospital vs. All Industries (Total nonfarm) 2001 – 2004 Source: Department of Labor, Bureau of Labor Statistics; Recession period defined by National Bureau of Economic Research *Note: Qtr 4 data is preliminary. (1) Recession period defined as March 2001 – November 2001 by National Bureau of Economic Research Hospitals All Industries (Total nonfarm) -0.6% -0.4% -0.2% 0.0% 0.2% 0.4% 0.6% 0.8% Qtr 1 0.6% 0.5% 0.6% 0.4% 0.3% 0.4% 0.5% 0.4% 0.1% -0.1% -0.3% -0.4% 0.0% -0.2% 0.0% 0.1% 2001 0.2% 0.3% Recession of 2001 (1) 20022003 0.3% 0.2% Qtr 2Qtr 3Qtr 4Qtr 1Qtr 2Qtr 3Qtr 4Qtr 1Qtr 2Qtr 3Qtr 4Qtr 1Qtr 2Qtr 3Qtr 4* 2004 0.2% 0.3%

9. Chartbook 2005 Trends in the Overall Health Care Market 6-9 Chart 6.8: Percent of Total Regional Employment (1) by Hospitals 2003 Source: The Lewin Group analysis of American Hospital Association 2003 Annual Survey data and 2003 total nonfarm employment data from the Bureau of Labor Statistics (1) Does not include farm employment. New England Mid-Atlantic East North Central West North Central West South Central Mountain Pacific East South Central South Atlantic 3.1% 3.0% 4.3% 3.6% 4.1% 3.5% 4.3%

10. Chartbook 2005 Trends in the Overall Health Care Market 6-10 Chart 6.9: Hospital Ranking Among Employers in Rural Communities 2003 Source: American Hospital Association Survey of Rural Hospitals, October 2003

11. Chartbook 2005 Trends in the Overall Health Care Market 6-11 Source: The Lewin Group, using BEA RIMS-II multipliers applied to 2003 American Hospital Association Annual Survey data Chart 6.10: Impact of Community Hospitals on U.S. Jobs (in millions) 2003

12. Chartbook 2005 Trends in the Overall Health Care Market 6-12 Chart 6.11: Percent of Hospital Costs (1) by Type of Expense 3Q04 Professional Fees - 5.4% Utilities – 1.4% All Other: Non-Labor Intensive – 4.2% All Other: Labor Intensive – 5.4% Postage – 0.8% Telephone – 0.3% Professional Liability Insurance – 0.9% Other Products (e.g., Food, Medical Instruments) Other Services Prescription Drugs 12.2% 6.2% 18.4% Wages & Benefits 63.1% Source: Centers for Medicare and Medicaid Services, September 2004 (1) Does not include capital.

13. Chartbook 2005 Trends in the Overall Health Care Market 6-13 Chart 6.12: Hospital Impact on Sectors of the U.S. Economy (in $ billions) 2003 Source: The Lewin Group analysis of American Hospital Association 2003 Annual Survey data using BEA industry multipliers for the hospital sector. Health Care and Social Assistance$527.0 Manufacturing213.9 Real Estate and Rental & Leasing134.5 Finance and Insurance89.8 Professional, Scientific, and Technical Services60.0 Retail Trade56.4 Wholesale Trade46.4 Information46.1 Administrative and Waste Management Services45.2 Transportation and Warehousing44.6 Accommodation and Food Services35.9 Other Services35.1 Management of Companies and Enterprises29.1 Utilities25.2 Agriculture, Forestry, Fishing, and Hunting20.7 Educational Services11.2 Arts, Entertainment, and Recreation9.9 Mining9.0 Construction7.2 Total$1,447.4 Economic ImpactIndustry

14. Chartbook 2005 Trends in the Overall Health Care Market 6-14 Chart 6.13: Impact of Community Hospitals on U.S. Economy, All States and Total U.S., 2003