Healthcare Facility Performance and Accessibility in the United States

[Audio] Healthcare Facility Performance and Accessibility in the United States Presentation by (Your name).

[Audio] Analysis of Medicare Hospital General Information Database Examining hospital ownership patterns and emergency services Analyzing quality ratings and performance measures across facilities Investigating geographic distribution and access disparities Evaluating specialized care availability in different regions Data source: Centers for Medicare and Medicaid Services This presentation is examining the healthcare facility performance and their accessibility using the Medicare data. We examine the ownership of the hospitals, emergency services provided, quality of services and the location of the hospitals. The results demonstrate huge disparities in access among states, between cities and rural areas. These disparities impact on health equity and patient outcomes nationwide..

[Audio] Hospital Ownership Distribution Voluntary Non-Profit (Private): 31% - largest category Proprietary (For-Profit): 29% - focused on shareholder returns Government (Hospital District/Authority): 20% - safety-net providers (Data.CMS.Gov., n.d.) Voluntary Non-Profit (Church): 8% - community-focused care Voluntary Non-Profit (Private) Proprietary Government (Hospital District/Authority) Voluntary Non-Profit (Church) Government (Local) Other Categories 156 147 98 42 28 29 The ownership of the hospital significantly influences the processes and support within the community. Non-profit hospitals constitute 31% of the market and reinvest the earnings in the community programs. In profit-driven hospitals, it is 29 percent and the institutions are concerned with shareholder gains. Uninsured people have safety nets in government hospitals. Ownership defines the way resources are distributed, the services provided and the way communities react to health emergencies..

[Audio] Emergency Services and Hospital Types Emergency services crucial for immediate community access to care Critical-access hospitals provide emergency care despite limited resources Geographic access gaps disproportionately affect rural and Latino communities Acute-care, children's, psychiatric, and veterans hospitals serve specialized needs Facility closures force residents to travel long distances for emergency care Community health has got to do with emergency services. It is found to have significant deficiencies in geographic access particularly among the rural populations and minority groups. Critical -access hospitals ensure vital services exist in underserved communities. Hospital closure creates a service vacuum which is life-threatening and reduces the survival rates. Hospitals of various types have different client groups, including children, psychiatric patients and veterans each with their own distinct client needs..

[Audio] Hospital Overall Rating Distribution Five-star rating system: 1 star (below average) to 5 stars (excellent) (Data.CMS.Gov., n.d.) Majority receive 2-3 star ratings indicating mediocre performance 3-star hospitals most common at approximately 130 facilities Higher-rated facilities show better mortality, safety, and readmission outcomes Number of Hospitals 5 Stars 4 Stars 3 Stars 2 Stars 1 Star 42 78 125 63 20 The ratings of quality assist patients in their selection of hospitals and in improving them. The five-star system has a mixture of many performance areas in one score. Majority of hospitals are between 2 and 3 stars which means that they have average performance. Facilities with high ratings have a better performance in terms of mortality prevention, safety, readmission reduction, and patient experience. This open system gives consumers a chance to make informed decisions..

[Audio] Mortality and Safety Measures Mortality measures track preventable deaths from heart attacks, pneumonia, stroke Hospitals categorized as better, same, or worse than national averages Healthcare policies contribute to racial disparities in mortality rates Safety measures monitor infections: bloodstream, urinary tract, surgical complications Eight safety categories including pressure ulcers and patient injuries The mortality and safety indicators reveal the effectiveness of a hospital in preventing deaths and complications. Performance is measured against national performance in seven categories of death. There are still racial differences due to gaps in policies. Safety tracking encompasses eight aspects, one of them being infections and complications during stay. Better clinical practices and safety measures are used in hospitals having lower death rates..

[Audio] Readmission Rates and Patient Education Readmission measures evaluate discharge planning and patient preparation Eleven categories track 30-day return rates for different conditions High readmission numbers suggest inadequate discharge planning Better-performing hospitals have comprehensive discharge mechanisms (Behr et al., 2022) Patient education critical for successful post-discharge recovery National Average Readmission Rate Heart Failure Acute Myocardial Infarction (Heart Attack) Pneumonia COPD (Chronic Obstructive Pulmonary Disease) Coronary Artery Bypass Graft (CABG) Surgery Hip/Knee Replacement Stroke Sepsis Kidney/Urinary Tract Infection Diabetes Gastrointestinal Issues 0.23 0.17599999999999999 0.17799999999999999 0.20499999999999999 0.14499999999999999 4.9000000000000002E-2 0.13400000000000001 0.182 0.16300000000000001 0.157 0.161 The readmission data shed light on the preparedness of a hospital to help patients recover once they have been discharged. There are eleven categories that monitor 30-day returns to most of the conditions. The readmission rates are high, which reveals that the discharge planning and patient education are flawed. Best hospitals have elaborate discharge routines and powerful follow-ups. The numbers assist in the comparison of quality disparities and continuity of care..

[Audio] Geographic Distribution Across States California leads with 95 hospitals and 87 with emergency services Texas, New York, and Florida have largest hospital populations Alabama has 88 hospitals with 79 offering emergency services Significant urban-rural disparity in per-capita hospital availability Number of Hospitals California Arizona Arkansas Alaska Alabama 95 48 42 14 88 Emergency Services Available California Arizona Arkansas Alaska Alabama 87 43 38 12 79 There are big gaps in location of hospitals on a state and regional basis. The number of hospitals is the highest in California, Texas, New York and Florida. Nevertheless, there is a wide distribution of per-capita availability between urban and rural locations. Rural populations have to commute to care. The geographic concentration places an obstacle to underserved populations. The identification of these trends highlights the areas of increased infrastructure..

[Audio] Critical Access Hospitals and Rural Care Provide fundamental services in rural communities unable to support traditional hospitals Receive special Medicare payment and regulatory flexibility to remain viable Serve Alaska, Montana, Wyoming, and Appalachian regions with geographic isolation Typically smaller bed counts but maintain emergency departments Function as healthcare anchors in communities lacking alternatives Critical access designation preserves Critical-access hospitals retain support services to remote rural locations without larger hospitals. They have to survive with special Medicare payments and flexible regulations. They cover remote areas like Alaska, Montana, Wyoming, and the Appalachia. They are small but have emergency departments and acute care. They play a vital role in providing anchors to less dangerous travel distance by communities that do not have a second option..

[Audio] Specialized and Tertiary Care Services Urban concentration of tertiary care: transplants, advanced cardiac surgery, cancer treatment Academic medical centers and university hospitals provide majority of tertiary services Rural residents face high transportation costs and coordination difficulties (Cha et al., 2025) Birthing services declining, creating maternity care deserts in rural areas Cardiac and surgical services concentrated in larger urban facilities In towns, tertiary care is pooled leading to barriers to rural patients that require special care. Transplants, complex heart work and cancer treatment are predominantly serviced in academic centers. The rural residents are charged with high travelling expenses and coordination difficulties. The manifestations of maternity deserts are the closure of obstetric services within the rural hospitals. Big hospitals lead to clusters of cardiac specialties and surgical specialties, which make complex patients journey long distances to receive life saving treatment..

[Audio] Policy Recommendations and Conclusion Preserve critical access hospital designation for rural facility viability Expand telehealth for rural provider specialist consultation and education Reduce mortality rates, prevent infections, minimize readmissions across all facilities Reform payments based on quality of care rather than service volume Support evidence-based practices and care coordination measures Policy should enhance rural health care infrastructure, financial health and workforce provision. With the main access critical designation, the rural hospitals continue to be viable. The development of telehealth links specialists and rural providers. The quality improvement areas should consider reducing mortality, infection prevention, and readmission. The reforms of payment should be on quality rather than volume. Evidence-based policies have the capacity of constructing infrastructure, improving performance, and creating equity of access within the nation..

[Audio] References Behr, C. L., Hull, P., Hsu, J., Newhouse, J. P., & Fung, V. (2022). Geographic access to federally qualified health centers before and after the Affordable Care Act. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-07685-0 Cha, J., Han, A., & Lee, K.-H. (2025). Examining the Impact of Availability and Accessibility of Community Benefit Provisions on County Health Outcomes. Risk Management and Healthcare Policy, Volume 18, 963–974. https://doi.org/10.2147/rmhp.s492160 Data.CMS.Gov. (n.d.). Hospital General Information. https://data.cms.gov/provider-data/dataset/xubh-q36u.