Health Care Indicators Carolyn S Donham Brenda T Maple and Katharine R Levit

This regular feature of the journal inshycludes a discussion of each of the followshying four topics community hospital stashytistics employment hours and earnings in the private health sector health care prices and national economic indicators These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy In addition they allow us to anticipate the direction and magnishytude of health care cost changes prior to the availability of more comprehensive data

INTRODUCTION

This article presents statistics on health care utilization prices expenses employment and work hours as well as on national economic activity Some of these statistics are based on sample surshyveys conducted monthly or quarterly by Government agencies or private organizashytions and are available 1 to 3 months after the completion of the period They proshyvide the first glimpse at changes occurshyring within the general economy and the health care sector

The accompanying tables report seshylected quarterly statistics for 1989 through the third quarter of 1992 and the calendar year aggregation of quarterly inshyformation in the past 3 years Additional tables show change from the same period

The authors are with ttte Office of the Actuary Health care FIshynancing Administration (HCFA) and the opinions expressed are those of the authors and do not necessarily reflect HCFAs views or policy position

1 year earlier For quarterly information this calculation permits analysis of quarshyterly data to focus on the direction and magnitude of changes without interfershyence introduced by seasonal fluctuashytions

In the national health accounts indicashytors such as these play an important role In the estimation of the latest historical year of health care expenditures Informashytion that Is more comprehensive tends to lag behind the close of a calendar year by 9 to 12 months ormore Therefore we rely extensively on indicators such as these to anticipate and predict changes in health care sector expenditures for the most reshycent year Other indicators help to Idenshytify specific reasons (eg increases in price inflation or declines in utilization) for expenditure change

In the following sections we will Idenshytify important indicators of health care and national economic activity and their sources We then describe what these inshydicators tell us about general economic and health sector activity during the most recent quarter

COMMUNITY HOSPITAL STATISTICS

Since 1963 the American Hospital Asshysociation in cooperation with member hospitals has collected data on the opershyation of community hospitals through its National Hospital Panel Survey Commushynity hospitals which comprised over 80 percent of ail hospital facilities in the United States in 1990 include all

Health care Finandng ReviewiSpring 19931volumeUNumbef3 249

non-Federal short-term general and other special hospitals open to the public They exclude hospital units of institushytions psychiatric facilities tuberculosis other respiratory and chronic disease hospitals institutions for the mentally reshytarded and alcohol and chemical depenshydency hospitals

The survey samples approximately oneshythird of all US community hospitals The sample is designed to produce estimates of community hospital indicators by bedshysize and region (American Hospital Assoshyciation 1963-90)1n Tables 1 and 2 stallsshytics covering expenses utilization beds and personnel depict trends In the operashytion of community hospitals annually from 1989 through 1991 and for selected quarters from 1989 through 1992

For purposes of national health expenshyditures (NHE) survey statistics on reveshynues (not shown on Table 1) are analyzed in estimating the growth in the largest component of health care costs-comshymunity hospital expenditures This one segment of NHE accounted for 33 pershycent of all health spending in 1991 (Letsch et al 1992) The survey also Identifies imshyportant factors Influencing expenditure growth patterns such as changes in the number of beds In operation number of admissions length of stay use of outpashytient facilities and number of surgeries

PRIVATE HEALTH SECTOR EMPLOYMENT HOURS AND EARNINGS

The US Bureau of Labor Statistics (BLS) collects monthly information on employment for all workers and earnings and work hours for non-supervisory workshyers In a sample of 350000 establishshyments Data are collected through coopshy

erative agreements with State agencies that also use this information to create State and local area statistics The survey is designed to collect Industry-specific Inshyformation on wage and salary jobs in nonshyagricultural industries It excludes statisshytics on self-employed persons and on those employed in the military (US Deshypartment of Labor 1991)

Employment in this survey is defined as numberof jobs Persons holding multishyple jobs would be counted multiple times Approximately 5 percent of the populashytion hold more than one job at any point in time (Other surveys that are householdshybased such as the Current Population Survey [CPS] also record employment In the CPS however each persons employshyment status is counted only once as eishyther employed unemployed or not in the labor force) Once each year monthly establishment-based employment statisshytics are adjusted to benchmarks created from annual establishment census Inforshymation resulting in revisions to previshyously published employment estimates

T abies 3 and 4 present statistics on emshyployment average hourly earnings and average weekly hours In private (non-government) health service estabshylishments Similar statistics for the all-private non-agricultural sector inshycluded on these tables provide a basis for comparing the economy as a whole with the health sector In employment earnshyIngs and work hours Table 5 summarizes business activity In the health sector and the overall economy by measuring change in the implied non-supervisory work hours and payroll Implied work hours are the product of the number of non-supervisory employees and average weekly hours Implied non-supervisory payrolls are calculated by multiplying lm-

Health Care Financing ReviewSpring 1993voiume 14 Number 3 250

non-Federal short-term general and other special hospitals open to the public They exclude hospital units of institushytions psychiatric facilities tuberculosis other respiratory and chronic disease hospitals institutions for the mentally reshytarded and alcohol and chemical depenshydency hospitals

The survey samples approximately oneshythird of all US community hospitals The sample is designed to produce estimates of community hospital indicators by bedshysize and region (American Hospital Assoshyciation 1963-90)1n Tables 1 and 2 stallsshytics covering expenses utilization beds and personnel depict trends In the operashytion of community hospitals annually from 1989 through 1991 and for selected quarters from 1989 through 1992

For purposes of national health expenshyditures (NHE) survey statistics on reveshynues (not shown on Table 1) are analyzed in estimating the growth in the largest component of health care costs-comshymunity hospital expenditures This one segment of NHE accounted for 33 pershycent of all health spending in 1991 (Letsch et al 1992) The survey also Identifies imshyportant factors Influencing expenditure growth patterns such as changes in the number of beds In operation number of admissions length of stay use of outpashytient facilities and number of surgeries

PRIVATE HEALTH SECTOR EMPLOYMENT HOURS AND EARNINGS

The US Bureau of Labor Statistics (BLS) collects monthly information on employment for all workers and earnings and work hours for non-supervisory workshyers In a sample of 350000 establishshyments Data are collected through coopshy

erative agreements with State agencies that also use this information to create State and local area statistics The survey is designed to collect Industry-specific Inshyformation on wage and salary jobs in nonshyagricultural industries It excludes statisshytics on self-employed persons and on those employed in the military (US Deshypartment of Labor 1991)

Employment in this survey is defined as numberof jobs Persons holding multishyple jobs would be counted multiple times Approximately 5 percent of the populashytion hold more than one job at any point in time (Other surveys that are householdshybased such as the Current Population Survey [CPS] also record employment In the CPS however each persons employshyment status is counted only once as eishyther employed unemployed or not in the labor force) Once each year monthly establishment-based employment statisshytics are adjusted to benchmarks created from annual establishment census Inforshymation resulting in revisions to previshyously published employment estimates

T abies 3 and 4 present statistics on emshyployment average hourly earnings and average weekly hours In private (non-government) health service estabshylishments Similar statistics for the all-private non-agricultural sector inshycluded on these tables provide a basis for comparing the economy as a whole with the health sector In employment earnshyIngs and work hours Table 5 summarizes business activity In the health sector and the overall economy by measuring change in the implied non-supervisory work hours and payroll Implied work hours are the product of the number of non-supervisory employees and average weekly hours Implied non-supervisory payrolls are calculated by multiplying lm-

Health Care Financing ReviewSpring 1993voiume 14 Number 3 250

plied work hours by average hourly earnmiddot lngs

For purposes of NHE changes In work hours by industry combined with changes In prices (discussed In a later section) can be used to gauge the direcshytion and magnitude of expenditure change in specific industries We use these composite indicators in the estimashytion of growth in physician and dental exmiddot penditures for the most recent period We study the historical relationship of changes in this indicator to changes in expenditures and estimate this relationmiddot ship for the most recent period

PRICES

Consumebull Prices

BLS publishes monthly information on changes in prices paid by consumers for a fixed market basket of goods and sermiddot vices Tables 6 and 7 present Information on the consumer price Index for all urban consumers (CPImiddotU) that measures changes In prices faced by 80 percent of the non-institutionalized population In the United States (The more restrictive wage earner CPI gauges prices faced by wage earners and clerical workers These workmiddot ers account for 32 percent of the non-institutionalized population [US Demiddot partment of Labor 1990])

The index reflects changes in prices charged for the same quality and quantity of goods or services purchased in the base period For most items the base peshyriod of 1982-84 is used to define the share of consumer expenditures purchasing specific services and products Those shares or weights remain constant in all years even though consumption patterns of the household may change over time

This type of index is called a fixed-weight or Laspeyres index

CPis for health care goods and sershyvices depict price changes for out-ofmiddot pocket expenditures made by consumshyers directly The composite CPI for medical care weights together productshyor service-specific CPis in proportion to household out-of-pocket expenditures for these Items For example the comshyposite medical care CPI measures inflamiddot tion for the 3 percent of hospital expend Imiddot tures that are made out-of-pocket by consumers the remaining 97 percent of the costs of hospital care paid by private health Insurers Medicare Medicaid and other payers are not weighted Into the CPI for medical care In addition some medical care sector indexes measure changes in list or charged prices rather than the prices actually received by proshyviders 3fter discooonts are deducted In several health care areas received or transaction prices are difficult to capshyture although BLS is making advances in this area

In the NHE a combination of CPis for selected medical care items input price indexes for nursing homes and the BLS CPI for hospital and related services admiddot justed by HCFA to provide transaction price changes are used as measures of Inmiddot flatlon for the health industry The inmiddot dexes are used to develop a personal health care fixed-weight price index to deshypict price changes affecting the entire health care industry more accurately than does the overall CPI medical care Index (Letsch 1993)

Background on Input Price Indexes

In 1979 the Health Care Financing Admiddot ministration (HCFA) developed the hosplmiddot

Health care Financing ReviewiSprlng 1993Jvo1ume14 Numbel3 251

tal input price Index to measure the pure price changes associated with expendishyture changes for hospital services In the early 1980s the skilled nursing facility (SNF) and home health agency (HHA) Inshyput price indexes often referred to as market baskets were developed to price a consistent set of goods and sershyvices over time They have played an Imshyportant role in helping to set payment pershycent increases and to understand the contribution of input price increases to growing health expenditures

The Input price indexes or market basshykets are Laspeyres or fixed-weight inshydexes that are constructed in two steps First a base period is selected For examshyple for the prospective payment system (PPS) hospital input price index the base period is 1987 Cost categories such as food fuel and labor are identified and their 1987 expenditure amounts detershymined The proportion or share of total exshypenditures included In specific spending categories is calculated These proporshytions are called cost or expenditure weights There are 28 expenditure categoshyries In the 1987-based PPS hospital input price index

Second a price proxy is selected to match each expenditure category The purpose of the price proxy is to measure the rate of price increase of the goods or services In that expenditure category The price proxy index for each spending cateshygory Is multiplied by the expenditure weight for the category The sum of these products (weights multiplied by the price Index) over all cost categories yields the composite input price index for any given time period usually a fiscal year or a calshyendar year The percent change in the inshyput price Index is an estimate of price change over time for a fixed quantity of

goods and services purchased by a proshyvider

The input price indexes are estimated on a historical basis and forecasted out several years The HCFA-chosen price proxies are forecasted under contract with Data Resources IncMcGraw Hill (DRI) Following every calendar year quarshyter In March June September and Deshycember DRI updates its macroeconomic forecasts of wages and prices based on updated historical Information and reshyvised forecast assumptions Some of the data in Tables 8 through 13 are forecasted and are expected to change as more reshycent historical data become available and subsequent quarterly forecasts are reshyceived

The methodology and price proxy defishynitions used In the input price Indexes are described In the Federal Register notices that accompany the revisions of the PPS HHA and SNF cost limits A description of the current PPS input price Index was published September 4 1990 (Federal Register The latest HHA regulatory Input price Index was published July 1 1992 (Federal Register and the latest SNF inshyput price index was published October 7 1992 (Federal Register

Periodically the input price indexes are revised to a new base year so that cost weights will reflect changes in the mix of goods and services that are purchased Each revision allows for new base weights a new base year and changes to

middot certain price variables used for price proxshyIes

Each input price Index is presented In two tables The first is a percent-change table and the second provides the actual index numbers from which the percentshyages were computed The hospital Input price Index for PPS Is In Tables 8 and 9

Health Care Financing ReviewSpring 19931V01ume 14 Number3 252

The SNF input price index is In Tables 10 and 11 The HHA Input price Index is In Tables 12and 13

NATIONAL ECONOMIC INDICATORS

National economic indicators provide a context for understanding health-specific Indicators and how change In the health sector relates to change In the economy as a whole Tables 14 and 15 present nashytional Indicators of output employment and inflation

Gross domestic product (GOP) meamiddot sures the US economy as the value of output produced within the geographic boundaries of the United States by US or foreign citizens or companies Constant dollar or real GOP removes the effects of prices from the valuation of goods and services produced so that the growth of real GOP reflects changes In the physshyIcal output of the economy (US Departshyment of Commerce 1992)

Third Quarter Indicators

Total expenses In community hospitals grew to $658 billion in the third quarter of 1992 to a level 93 percent higher than the same quarter 1 year earlier Based on the aggregate growth experience in exshypenses during the first three quarters of 1992 growth in expenses for calendar year 1993 should be similar to the 99 pershycent growth in expenses recorded in 1991

Operating expenses cover expenses for services delivered in both the inpatient and outpatient settings Growth in meamiddot sures of inpatient utilization continued to decline In the third quarter of 1992 from the same period 1 year earlier Admismiddot sions fell 09 percent and inpatient days fell 21 percent The decline in days relamiddot

live to admissions resulted In a 01 day reshyduction in the average length of stay to 63 days per admission from the third quarter of 1991 to the third quarter of 1992 Offsetting inpatient utilization demiddot clines were increases in outpatient visits up 64 percent Growth in outpatient visits in the first three quarters of 1992 appear much stronger than growth exhibited in the first three quarters of 1991 (Figure 1)

In the third quarter the average occumiddot pancy rate for community hospitals reached a new low Only 603 percent of staffed hospital beds were occupied (Figure 2) The number of community hosshypital beds in the United States has contlnmiddot uously declined since the first quarter of 1964 when the transition to Medicare proshyspective payment system was under way In the past four quarters the rate of demiddot cline in the number of beds has decelershyated despite a continuing steady drop in the number of inpatient days

Beginning In the fourth quarter of 1990 private non-agricultural employment sufmiddot fared six consecutive quarters of loss when compared with the same period 1 year earlier In the second and third quarmiddot ters of 1992 however employment demiddot cline ceased (Figure 3) In the third quarter of 1992 employment leveled off at 907 million jobs In the health services sector the number of jobs while still growing is doing so at a decelerating rate in the third quarter health service employment inmiddot creased 33 percent from the same quarshyter In 1990 to 85 million jobs slower than the 37 percent rate one quarter earlier The health sector jobs account for apshyproximately 94 percent of all private nonshyagricultural employment

The gap In growth between non-supershyvisory payroll for all private non-agriculmiddot tural establishments and for private

Health Care Financing ReviewSpring 1993lvolume14Number3 253

health establishments has narrowed in the past two quarters In the first three quarters of 1991 (the height of the recesmiddot slon) growth In private non-agricultural payroll was negligible (02 to 04 percent) when compared with the same period 1 year earlier For private health establishmiddot ments payroll growth remained strong ranging from 96 to 106 percent By the third quarter of 1991 growth in private non-agricultural establishment payroll had risen to 27 percent while payroll growth for health care establishments fell to 76 percent (Figure 4) Most of the demiddot cline in the health Industry comes from slower increases in non-supervisory emmiddot ployment and in average hourly earnings for non-supervisory employees rather than from a slowdown In average weekly hours worked (Figure 5)

Overall prices measured by the Conmiddot sumer Price Index rose 31 percent In the third quarter of 1992 the fourth consecumiddot live quarter of relatively mild Inflation For medical care cost Inflation remained high at 72 percent In the third quarter of 1992 However medical care inflation grew more slowly in this quarter down from 77 percent in the second quarter (Figure 6) Inflation in medical services which accounts for a large proportion of overall medical care inflation grew 75 percent In the third quarter down from 77 percent In the second quarter Inflation for medical commodities experienced a more dramatic deceleration Growth of 57 percent in the third quarter of 1992 down from 71 percent in the second quarmiddot ter (Figure 7) Most of that deceleration is attributable to slower price growth in preshyscription drugs for which the rate of inflamiddot lion fell from 85 to 65 percent between the second and third quarters

In the third quarter of 1992 real growth In gross domestic product creeped upmiddot ward at a rate of 22 percent from the same quarter in 1991 The slow economic recovery from the recession of 1991 has not yet been felt In job growth which had remained unchanged from the same pemiddot riod 1 year earlier The unemployment rate Increased slightly to 76 percent the highest quarterly level since 1983 (Figure 8) Despite sluggish recovery In the rest of the economy growth In the health sector that had remained strong through the reshycession Is slowing Health sector employmiddot men Is growing 1 percentage point slower in the third quarter than it did the previous year In addition medical price Inflation is decelerating although It reshymains significantly higher than all item price Increases

REFERENCES

American Hospital Association National Hospishytal Panel Survey Unpublished Chicago 1963-90 Federal Register Medicare Program Changes to the Inpatient Hospital Prospective Payment Sysshytem and Fiscal Year 1991 Rates Final Rule Vol 55 No 170 36043-l6050 and 36169-36173 Office of the Federal Register National Archives and Records Administration Washington US Govshyernment Printing Office September 4 1990

Federal Register Medicare Program Schedules of Umlts on Home Health Agency Costs Per Visit for Cost Reporting Periods Beginning On or After July 1 1992 Vol 57 No 127 29412middot29413 Office of the Federal Register National Archives and Records Administration Washington US Govshyemment Printing Office July 1 1992a Federal Register Medicare Program Schedules of Limits on Skilled Nursing Home Facility Inpashytient Routine Service Costs Final Rule Vol 57 No 195 461n-48187 Office of the Federal Regisshyter National Archives and Records Admlnlstramiddot tion Washington US Government Printing Ofmiddot flee October7 1992b Letsch SW National Health Care Spending in 1991 Heslth Affairs 12(1)94-110Spring 1993

Health care Financing RevlewSpftng 1993vo~ume 14 Number 3 254

US Department of Commerce National Income and Product Accounts Survey of Current BusJ ness Vol 72 No3 Bureau of Economic Analysis Washington US Government Printing Office March 1992

US Department of Labor Employment and EarnshyIngs Vol 38 No 6 Bureau of Labor Statistics Washington US Government Printing Office June1991

US Department of Labor Notes on Current Lashybor Statistics Price Data Monthly Labor Review Vol113 Noll Bureau of Labor Statistics Washshyington US Government Printing Office Novemshyber1990

For inquiries concerning Input price index data contact Brenda T Maple at (410) 966-7954 For all other Inquiries cooshytact Carolyn S Donham at (410) 966-7947 Reprint requests carotyn S Donham Room l-1 1705 Equitashyble Building 6325 Security Boulevard Baltimore Maryland 21207

Health Care Financing ReviewiSprlng 19931volume 14 Number3 255

Table 1 Selected Community Hospital Statistics 1989-92 8l

11em 1969

Calendar Year 1969 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1990 1991

Operating Expenses Total in Millions $195378 $217113 $238633 $49133 $54902 $60214 $62301 $63739 $64532 $65829

Labor in Millions $106019 $117828 $128704 $26769 $29941 $32516 $33526 $34143 $34501 $35396 Non-Labor in Millions 89359 99286 109929 22363 24961 27698 28775 29597 30031 30434

Inpatient Expense in Millions 152147 165792 178401 38034 41646 44586 46421 47495 47284 47873 Amount per Patient Day 690 765 844 705 786 866 880 878 922 950 Amount per Admission 4586 5021 5461 4634 5097 5522 5689 5683 5838 5980

Utilization Admissions in Thousands 33176 33017 32670 8207 8171 8o75 8160 8357 8102 8005 Inpatient Days in Thousands 220361 216836 211475 53968 53012 51459 52756 54238 51306 50387 Adult Length of Stay in Days 66 66 65 66 65 64 65 65 63 63

Surgical Operations in Thousands 21383 21904 21983 5287 5496 5534 5498 5608 5641 5630

Outpatient Visits in Thousands 308066 326498 344116 78175 83417 87648 87666 89168 91572 93271

Beds in Thousands 930 921 912 926 920 910 909 909 910 908 Adult Occupancy Rate1 649 645 635 632 626 614 631 656 620 603

Full-tJme Equivalent (FTE) personnel Total in Thousands 3162 3229 3249 3173 3241 3252 3259 32n 3290 3310 Number per Bed Adjusted Patient Days2 per FTE

34 89

35 88

36 87

34 22

35 22

36 21

36 22

36 22

36 21

36 21

Adjusted Patient Days In Thousands 282974 283959 282874 69717 69886 69496 70804 72789 70021 69286 I ~

IIr

Ibull z

1 Adult occupancy rate is the ratio of average daily census to the average number of beds maintained during the reporting period 2Adjusted patient days is an aggregate figure reflecting the number of days of inpatient care plus an estimate of the volume of outpatient services expressed In units equivalent to an inpatient day in terms of level of effort It Is derived by multiplying the number of outpatient visits by the ratio of outpatient revenue peroutpatient visits to Inpatient revenue per inpamiddot tient day and adding the product to the number of inpatient days

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for JanuaJY 1989-September 1992

shy

Table 2 Percent Change in Selected Community Hospital Statistics 1989-92

Calendar Year 1989 1990 1991 1991 1992 1992 1992 Item 1989 1990 1991 03 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Operating Expenses Total 99 111 99 92 117 97 112 115 95 93

Labor 100 111 92 92 118 86 99 102 89 89 NonmiddotLabor 98 111 107 91 116 110 129 129 103 99

Inpatient Expenses 83 90 76 77 95 71 93 94 75 74 Amount per Patient Day 93 107 103 90 115 103 93 101 104 97 Amount per Admission 93 95 88 92 100 83 76 80 86 83

Utilization Admissions -10 -05 -11 -14 -04 -12 16 13 -10 -09 Inpatient Days -09 -16 -25 -12 -18 -29 -00 -06 -26 -21 Adult length of Stay 01 -11 -14 02 -13 -18 -16 -19 -16 -12

Surgical Operations 06 24 04 -13 39 07 22 42 12 17

Outpatient Visits 40 60 54 31 67 51 80 81 61 64

Bedbull -13 -09 -10 -15 -08 -10 -07 -06 -03 -03 Adult Occupancy Rate1 05 -04 -09 02 -06 -12 04 -07 -15 -11

FuiimiddotTime Equivalent (FTE) Personnel Total 16 21 06 17 21 03 07 11 14 18 Number per Bed 30 31 17 33 30 14 14 17 17 21 Adjusted Patient Days per

FTE -10 -17 -10 -16 -19 -09 10 01 -22 -21

Adjusted Patient Days 06 03 -04 01 02 -06 17 12 -08 -03 1Change In rate rather than percent change NOTE a designates quarter of year SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for January 1988-$eptember 1992

Health Care Financing RevtewSpring 1993votume 14 Number3 257

Table 3 Employment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92

Ill co

Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment and Measure 1989 1990 1991 03 03 03 04 01 02 03

Health services (SIC 80) Total Employment In Thousands 74837 78312 81772 75348 78964 82386 83075 83566 84316 85105

Non-supervisory Workers Employment in Thousands 66541 69624 72710 67017 70211 73271 73849 74293 74980 75668 Average Weekly Hours 325 325 325 328 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Offices and CUnlcs of MediCal Doctors (SIC 801) Total Employment in Thousands 12737 13429 13978 12836 13556 14110 14177 14201 14337 14510

Non-supervisory Workers Employment in Thousands 10520 11084 11498 10601 11196 11605 11633 11671 11785 11908 Average Weekly Hours 319 318 319 320 319 319 320 322 319 322 Average Hourly Earnings $978 $1058 $1113 $985 $1066 $1114 $1130 $1121 $1130 $1144

Olfices and Clinics of Dentists (SIC 802) Total Employment in Thousands 5012 5140 5274 5043 5157 5312 5344 5330 5387 5403

Non-supervisory Workers

bull ~ ~ ~ a

amp ~ ~

~-~ ~ 0

bull bull z 0

~ bull

Employment in Thousands Average Weekly Hours Average Hourly Earnings

4386 285

$941

4506 284

$1014

4633 283

$1062

4412 283

$943

4518 285

$1023

4673 282

$1064

4690 283

$1077

4886 285

$1090

4695 282

$1097

4731 283

$1098

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands 13607 14194 14988 13704 14296 15129 15275 15359 15478 15652

Non-Supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

12303 318

$680

34402

12825 321

$724

35501

13528 321

$756

36567

12397 322

$685

34612

12918 326

$729

35739

13658 324

$759

36750

13790 322

$766

36991

13863 322

$775

37251

13981 320

$781

37462

14147 327

$789

37728

Non-supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings See footnotes st end of table

31469 340

$1121

32497 342

$1179

33540 342

$1250

31683 342

$1132

32727 344

$1186

33717 344

$1266

33951 343

$1275

34191 344

$1285

34386 344

$1290

34636 345

$1312

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

tal input price Index to measure the pure price changes associated with expendishyture changes for hospital services In the early 1980s the skilled nursing facility (SNF) and home health agency (HHA) Inshyput price indexes often referred to as market baskets were developed to price a consistent set of goods and sershyvices over time They have played an Imshyportant role in helping to set payment pershycent increases and to understand the contribution of input price increases to growing health expenditures

The Input price indexes or market basshykets are Laspeyres or fixed-weight inshydexes that are constructed in two steps First a base period is selected For examshyple for the prospective payment system (PPS) hospital input price index the base period is 1987 Cost categories such as food fuel and labor are identified and their 1987 expenditure amounts detershymined The proportion or share of total exshypenditures included In specific spending categories is calculated These proporshytions are called cost or expenditure weights There are 28 expenditure categoshyries In the 1987-based PPS hospital input price index

Second a price proxy is selected to match each expenditure category The purpose of the price proxy is to measure the rate of price increase of the goods or services In that expenditure category The price proxy index for each spending cateshygory Is multiplied by the expenditure weight for the category The sum of these products (weights multiplied by the price Index) over all cost categories yields the composite input price index for any given time period usually a fiscal year or a calshyendar year The percent change in the inshyput price Index is an estimate of price change over time for a fixed quantity of

goods and services purchased by a proshyvider

The input price indexes are estimated on a historical basis and forecasted out several years The HCFA-chosen price proxies are forecasted under contract with Data Resources IncMcGraw Hill (DRI) Following every calendar year quarshyter In March June September and Deshycember DRI updates its macroeconomic forecasts of wages and prices based on updated historical Information and reshyvised forecast assumptions Some of the data in Tables 8 through 13 are forecasted and are expected to change as more reshycent historical data become available and subsequent quarterly forecasts are reshyceived

The methodology and price proxy defishynitions used In the input price Indexes are described In the Federal Register notices that accompany the revisions of the PPS HHA and SNF cost limits A description of the current PPS input price Index was published September 4 1990 (Federal Register The latest HHA regulatory Input price Index was published July 1 1992 (Federal Register and the latest SNF inshyput price index was published October 7 1992 (Federal Register

Periodically the input price indexes are revised to a new base year so that cost weights will reflect changes in the mix of goods and services that are purchased Each revision allows for new base weights a new base year and changes to

middot certain price variables used for price proxshyIes

Each input price Index is presented In two tables The first is a percent-change table and the second provides the actual index numbers from which the percentshyages were computed The hospital Input price Index for PPS Is In Tables 8 and 9

Health Care Financing ReviewSpring 19931V01ume 14 Number3 252

The SNF input price index is In Tables 10 and 11 The HHA Input price Index is In Tables 12and 13

NATIONAL ECONOMIC INDICATORS

National economic indicators provide a context for understanding health-specific Indicators and how change In the health sector relates to change In the economy as a whole Tables 14 and 15 present nashytional Indicators of output employment and inflation

Gross domestic product (GOP) meamiddot sures the US economy as the value of output produced within the geographic boundaries of the United States by US or foreign citizens or companies Constant dollar or real GOP removes the effects of prices from the valuation of goods and services produced so that the growth of real GOP reflects changes In the physshyIcal output of the economy (US Departshyment of Commerce 1992)

Third Quarter Indicators

Total expenses In community hospitals grew to $658 billion in the third quarter of 1992 to a level 93 percent higher than the same quarter 1 year earlier Based on the aggregate growth experience in exshypenses during the first three quarters of 1992 growth in expenses for calendar year 1993 should be similar to the 99 pershycent growth in expenses recorded in 1991

Operating expenses cover expenses for services delivered in both the inpatient and outpatient settings Growth in meamiddot sures of inpatient utilization continued to decline In the third quarter of 1992 from the same period 1 year earlier Admismiddot sions fell 09 percent and inpatient days fell 21 percent The decline in days relamiddot

live to admissions resulted In a 01 day reshyduction in the average length of stay to 63 days per admission from the third quarter of 1991 to the third quarter of 1992 Offsetting inpatient utilization demiddot clines were increases in outpatient visits up 64 percent Growth in outpatient visits in the first three quarters of 1992 appear much stronger than growth exhibited in the first three quarters of 1991 (Figure 1)

In the third quarter the average occumiddot pancy rate for community hospitals reached a new low Only 603 percent of staffed hospital beds were occupied (Figure 2) The number of community hosshypital beds in the United States has contlnmiddot uously declined since the first quarter of 1964 when the transition to Medicare proshyspective payment system was under way In the past four quarters the rate of demiddot cline in the number of beds has decelershyated despite a continuing steady drop in the number of inpatient days

Beginning In the fourth quarter of 1990 private non-agricultural employment sufmiddot fared six consecutive quarters of loss when compared with the same period 1 year earlier In the second and third quarmiddot ters of 1992 however employment demiddot cline ceased (Figure 3) In the third quarter of 1992 employment leveled off at 907 million jobs In the health services sector the number of jobs while still growing is doing so at a decelerating rate in the third quarter health service employment inmiddot creased 33 percent from the same quarshyter In 1990 to 85 million jobs slower than the 37 percent rate one quarter earlier The health sector jobs account for apshyproximately 94 percent of all private nonshyagricultural employment

The gap In growth between non-supershyvisory payroll for all private non-agriculmiddot tural establishments and for private

Health Care Financing ReviewSpring 1993lvolume14Number3 253

health establishments has narrowed in the past two quarters In the first three quarters of 1991 (the height of the recesmiddot slon) growth In private non-agricultural payroll was negligible (02 to 04 percent) when compared with the same period 1 year earlier For private health establishmiddot ments payroll growth remained strong ranging from 96 to 106 percent By the third quarter of 1991 growth in private non-agricultural establishment payroll had risen to 27 percent while payroll growth for health care establishments fell to 76 percent (Figure 4) Most of the demiddot cline in the health Industry comes from slower increases in non-supervisory emmiddot ployment and in average hourly earnings for non-supervisory employees rather than from a slowdown In average weekly hours worked (Figure 5)

Overall prices measured by the Conmiddot sumer Price Index rose 31 percent In the third quarter of 1992 the fourth consecumiddot live quarter of relatively mild Inflation For medical care cost Inflation remained high at 72 percent In the third quarter of 1992 However medical care inflation grew more slowly in this quarter down from 77 percent in the second quarter (Figure 6) Inflation in medical services which accounts for a large proportion of overall medical care inflation grew 75 percent In the third quarter down from 77 percent In the second quarter Inflation for medical commodities experienced a more dramatic deceleration Growth of 57 percent in the third quarter of 1992 down from 71 percent in the second quarmiddot ter (Figure 7) Most of that deceleration is attributable to slower price growth in preshyscription drugs for which the rate of inflamiddot lion fell from 85 to 65 percent between the second and third quarters

In the third quarter of 1992 real growth In gross domestic product creeped upmiddot ward at a rate of 22 percent from the same quarter in 1991 The slow economic recovery from the recession of 1991 has not yet been felt In job growth which had remained unchanged from the same pemiddot riod 1 year earlier The unemployment rate Increased slightly to 76 percent the highest quarterly level since 1983 (Figure 8) Despite sluggish recovery In the rest of the economy growth In the health sector that had remained strong through the reshycession Is slowing Health sector employmiddot men Is growing 1 percentage point slower in the third quarter than it did the previous year In addition medical price Inflation is decelerating although It reshymains significantly higher than all item price Increases

REFERENCES

American Hospital Association National Hospishytal Panel Survey Unpublished Chicago 1963-90 Federal Register Medicare Program Changes to the Inpatient Hospital Prospective Payment Sysshytem and Fiscal Year 1991 Rates Final Rule Vol 55 No 170 36043-l6050 and 36169-36173 Office of the Federal Register National Archives and Records Administration Washington US Govshyernment Printing Office September 4 1990

Federal Register Medicare Program Schedules of Umlts on Home Health Agency Costs Per Visit for Cost Reporting Periods Beginning On or After July 1 1992 Vol 57 No 127 29412middot29413 Office of the Federal Register National Archives and Records Administration Washington US Govshyemment Printing Office July 1 1992a Federal Register Medicare Program Schedules of Limits on Skilled Nursing Home Facility Inpashytient Routine Service Costs Final Rule Vol 57 No 195 461n-48187 Office of the Federal Regisshyter National Archives and Records Admlnlstramiddot tion Washington US Government Printing Ofmiddot flee October7 1992b Letsch SW National Health Care Spending in 1991 Heslth Affairs 12(1)94-110Spring 1993

Health care Financing RevlewSpftng 1993vo~ume 14 Number 3 254

US Department of Commerce National Income and Product Accounts Survey of Current BusJ ness Vol 72 No3 Bureau of Economic Analysis Washington US Government Printing Office March 1992

US Department of Labor Employment and EarnshyIngs Vol 38 No 6 Bureau of Labor Statistics Washington US Government Printing Office June1991

US Department of Labor Notes on Current Lashybor Statistics Price Data Monthly Labor Review Vol113 Noll Bureau of Labor Statistics Washshyington US Government Printing Office Novemshyber1990

For inquiries concerning Input price index data contact Brenda T Maple at (410) 966-7954 For all other Inquiries cooshytact Carolyn S Donham at (410) 966-7947 Reprint requests carotyn S Donham Room l-1 1705 Equitashyble Building 6325 Security Boulevard Baltimore Maryland 21207

Health Care Financing ReviewiSprlng 19931volume 14 Number3 255

Table 1 Selected Community Hospital Statistics 1989-92 8l

11em 1969

Calendar Year 1969 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1990 1991

Operating Expenses Total in Millions $195378 $217113 $238633 $49133 $54902 $60214 $62301 $63739 $64532 $65829

Labor in Millions $106019 $117828 $128704 $26769 $29941 $32516 $33526 $34143 $34501 $35396 Non-Labor in Millions 89359 99286 109929 22363 24961 27698 28775 29597 30031 30434

Inpatient Expense in Millions 152147 165792 178401 38034 41646 44586 46421 47495 47284 47873 Amount per Patient Day 690 765 844 705 786 866 880 878 922 950 Amount per Admission 4586 5021 5461 4634 5097 5522 5689 5683 5838 5980

Utilization Admissions in Thousands 33176 33017 32670 8207 8171 8o75 8160 8357 8102 8005 Inpatient Days in Thousands 220361 216836 211475 53968 53012 51459 52756 54238 51306 50387 Adult Length of Stay in Days 66 66 65 66 65 64 65 65 63 63

Surgical Operations in Thousands 21383 21904 21983 5287 5496 5534 5498 5608 5641 5630

Outpatient Visits in Thousands 308066 326498 344116 78175 83417 87648 87666 89168 91572 93271

Beds in Thousands 930 921 912 926 920 910 909 909 910 908 Adult Occupancy Rate1 649 645 635 632 626 614 631 656 620 603

Full-tJme Equivalent (FTE) personnel Total in Thousands 3162 3229 3249 3173 3241 3252 3259 32n 3290 3310 Number per Bed Adjusted Patient Days2 per FTE

34 89

35 88

36 87

34 22

35 22

36 21

36 22

36 22

36 21

36 21

Adjusted Patient Days In Thousands 282974 283959 282874 69717 69886 69496 70804 72789 70021 69286 I ~

IIr

Ibull z

1 Adult occupancy rate is the ratio of average daily census to the average number of beds maintained during the reporting period 2Adjusted patient days is an aggregate figure reflecting the number of days of inpatient care plus an estimate of the volume of outpatient services expressed In units equivalent to an inpatient day in terms of level of effort It Is derived by multiplying the number of outpatient visits by the ratio of outpatient revenue peroutpatient visits to Inpatient revenue per inpamiddot tient day and adding the product to the number of inpatient days

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for JanuaJY 1989-September 1992

shy

Table 2 Percent Change in Selected Community Hospital Statistics 1989-92

Calendar Year 1989 1990 1991 1991 1992 1992 1992 Item 1989 1990 1991 03 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Operating Expenses Total 99 111 99 92 117 97 112 115 95 93

Labor 100 111 92 92 118 86 99 102 89 89 NonmiddotLabor 98 111 107 91 116 110 129 129 103 99

Inpatient Expenses 83 90 76 77 95 71 93 94 75 74 Amount per Patient Day 93 107 103 90 115 103 93 101 104 97 Amount per Admission 93 95 88 92 100 83 76 80 86 83

Utilization Admissions -10 -05 -11 -14 -04 -12 16 13 -10 -09 Inpatient Days -09 -16 -25 -12 -18 -29 -00 -06 -26 -21 Adult length of Stay 01 -11 -14 02 -13 -18 -16 -19 -16 -12

Surgical Operations 06 24 04 -13 39 07 22 42 12 17

Outpatient Visits 40 60 54 31 67 51 80 81 61 64

Bedbull -13 -09 -10 -15 -08 -10 -07 -06 -03 -03 Adult Occupancy Rate1 05 -04 -09 02 -06 -12 04 -07 -15 -11

FuiimiddotTime Equivalent (FTE) Personnel Total 16 21 06 17 21 03 07 11 14 18 Number per Bed 30 31 17 33 30 14 14 17 17 21 Adjusted Patient Days per

FTE -10 -17 -10 -16 -19 -09 10 01 -22 -21

Adjusted Patient Days 06 03 -04 01 02 -06 17 12 -08 -03 1Change In rate rather than percent change NOTE a designates quarter of year SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for January 1988-$eptember 1992

Health Care Financing RevtewSpring 1993votume 14 Number3 257

Table 3 Employment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92

Ill co

Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment and Measure 1989 1990 1991 03 03 03 04 01 02 03

Health services (SIC 80) Total Employment In Thousands 74837 78312 81772 75348 78964 82386 83075 83566 84316 85105

Non-supervisory Workers Employment in Thousands 66541 69624 72710 67017 70211 73271 73849 74293 74980 75668 Average Weekly Hours 325 325 325 328 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Offices and CUnlcs of MediCal Doctors (SIC 801) Total Employment in Thousands 12737 13429 13978 12836 13556 14110 14177 14201 14337 14510

Non-supervisory Workers Employment in Thousands 10520 11084 11498 10601 11196 11605 11633 11671 11785 11908 Average Weekly Hours 319 318 319 320 319 319 320 322 319 322 Average Hourly Earnings $978 $1058 $1113 $985 $1066 $1114 $1130 $1121 $1130 $1144

Olfices and Clinics of Dentists (SIC 802) Total Employment in Thousands 5012 5140 5274 5043 5157 5312 5344 5330 5387 5403

Non-supervisory Workers

bull ~ ~ ~ a

amp ~ ~

~-~ ~ 0

bull bull z 0

~ bull

Employment in Thousands Average Weekly Hours Average Hourly Earnings

4386 285

$941

4506 284

$1014

4633 283

$1062

4412 283

$943

4518 285

$1023

4673 282

$1064

4690 283

$1077

4886 285

$1090

4695 282

$1097

4731 283

$1098

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands 13607 14194 14988 13704 14296 15129 15275 15359 15478 15652

Non-Supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

12303 318

$680

34402

12825 321

$724

35501

13528 321

$756

36567

12397 322

$685

34612

12918 326

$729

35739

13658 324

$759

36750

13790 322

$766

36991

13863 322

$775

37251

13981 320

$781

37462

14147 327

$789

37728

Non-supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings See footnotes st end of table

31469 340

$1121

32497 342

$1179

33540 342

$1250

31683 342

$1132

32727 344

$1186

33717 344

$1266

33951 343

$1275

34191 344

$1285

34386 344

$1290

34636 345

$1312

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

The SNF input price index is In Tables 10 and 11 The HHA Input price Index is In Tables 12and 13

NATIONAL ECONOMIC INDICATORS

National economic indicators provide a context for understanding health-specific Indicators and how change In the health sector relates to change In the economy as a whole Tables 14 and 15 present nashytional Indicators of output employment and inflation

Gross domestic product (GOP) meamiddot sures the US economy as the value of output produced within the geographic boundaries of the United States by US or foreign citizens or companies Constant dollar or real GOP removes the effects of prices from the valuation of goods and services produced so that the growth of real GOP reflects changes In the physshyIcal output of the economy (US Departshyment of Commerce 1992)

Third Quarter Indicators

Total expenses In community hospitals grew to $658 billion in the third quarter of 1992 to a level 93 percent higher than the same quarter 1 year earlier Based on the aggregate growth experience in exshypenses during the first three quarters of 1992 growth in expenses for calendar year 1993 should be similar to the 99 pershycent growth in expenses recorded in 1991

Operating expenses cover expenses for services delivered in both the inpatient and outpatient settings Growth in meamiddot sures of inpatient utilization continued to decline In the third quarter of 1992 from the same period 1 year earlier Admismiddot sions fell 09 percent and inpatient days fell 21 percent The decline in days relamiddot

live to admissions resulted In a 01 day reshyduction in the average length of stay to 63 days per admission from the third quarter of 1991 to the third quarter of 1992 Offsetting inpatient utilization demiddot clines were increases in outpatient visits up 64 percent Growth in outpatient visits in the first three quarters of 1992 appear much stronger than growth exhibited in the first three quarters of 1991 (Figure 1)

In the third quarter the average occumiddot pancy rate for community hospitals reached a new low Only 603 percent of staffed hospital beds were occupied (Figure 2) The number of community hosshypital beds in the United States has contlnmiddot uously declined since the first quarter of 1964 when the transition to Medicare proshyspective payment system was under way In the past four quarters the rate of demiddot cline in the number of beds has decelershyated despite a continuing steady drop in the number of inpatient days

Beginning In the fourth quarter of 1990 private non-agricultural employment sufmiddot fared six consecutive quarters of loss when compared with the same period 1 year earlier In the second and third quarmiddot ters of 1992 however employment demiddot cline ceased (Figure 3) In the third quarter of 1992 employment leveled off at 907 million jobs In the health services sector the number of jobs while still growing is doing so at a decelerating rate in the third quarter health service employment inmiddot creased 33 percent from the same quarshyter In 1990 to 85 million jobs slower than the 37 percent rate one quarter earlier The health sector jobs account for apshyproximately 94 percent of all private nonshyagricultural employment

The gap In growth between non-supershyvisory payroll for all private non-agriculmiddot tural establishments and for private

Health Care Financing ReviewSpring 1993lvolume14Number3 253

health establishments has narrowed in the past two quarters In the first three quarters of 1991 (the height of the recesmiddot slon) growth In private non-agricultural payroll was negligible (02 to 04 percent) when compared with the same period 1 year earlier For private health establishmiddot ments payroll growth remained strong ranging from 96 to 106 percent By the third quarter of 1991 growth in private non-agricultural establishment payroll had risen to 27 percent while payroll growth for health care establishments fell to 76 percent (Figure 4) Most of the demiddot cline in the health Industry comes from slower increases in non-supervisory emmiddot ployment and in average hourly earnings for non-supervisory employees rather than from a slowdown In average weekly hours worked (Figure 5)

Overall prices measured by the Conmiddot sumer Price Index rose 31 percent In the third quarter of 1992 the fourth consecumiddot live quarter of relatively mild Inflation For medical care cost Inflation remained high at 72 percent In the third quarter of 1992 However medical care inflation grew more slowly in this quarter down from 77 percent in the second quarter (Figure 6) Inflation in medical services which accounts for a large proportion of overall medical care inflation grew 75 percent In the third quarter down from 77 percent In the second quarter Inflation for medical commodities experienced a more dramatic deceleration Growth of 57 percent in the third quarter of 1992 down from 71 percent in the second quarmiddot ter (Figure 7) Most of that deceleration is attributable to slower price growth in preshyscription drugs for which the rate of inflamiddot lion fell from 85 to 65 percent between the second and third quarters

In the third quarter of 1992 real growth In gross domestic product creeped upmiddot ward at a rate of 22 percent from the same quarter in 1991 The slow economic recovery from the recession of 1991 has not yet been felt In job growth which had remained unchanged from the same pemiddot riod 1 year earlier The unemployment rate Increased slightly to 76 percent the highest quarterly level since 1983 (Figure 8) Despite sluggish recovery In the rest of the economy growth In the health sector that had remained strong through the reshycession Is slowing Health sector employmiddot men Is growing 1 percentage point slower in the third quarter than it did the previous year In addition medical price Inflation is decelerating although It reshymains significantly higher than all item price Increases

REFERENCES

American Hospital Association National Hospishytal Panel Survey Unpublished Chicago 1963-90 Federal Register Medicare Program Changes to the Inpatient Hospital Prospective Payment Sysshytem and Fiscal Year 1991 Rates Final Rule Vol 55 No 170 36043-l6050 and 36169-36173 Office of the Federal Register National Archives and Records Administration Washington US Govshyernment Printing Office September 4 1990

Federal Register Medicare Program Schedules of Umlts on Home Health Agency Costs Per Visit for Cost Reporting Periods Beginning On or After July 1 1992 Vol 57 No 127 29412middot29413 Office of the Federal Register National Archives and Records Administration Washington US Govshyemment Printing Office July 1 1992a Federal Register Medicare Program Schedules of Limits on Skilled Nursing Home Facility Inpashytient Routine Service Costs Final Rule Vol 57 No 195 461n-48187 Office of the Federal Regisshyter National Archives and Records Admlnlstramiddot tion Washington US Government Printing Ofmiddot flee October7 1992b Letsch SW National Health Care Spending in 1991 Heslth Affairs 12(1)94-110Spring 1993

Health care Financing RevlewSpftng 1993vo~ume 14 Number 3 254

US Department of Commerce National Income and Product Accounts Survey of Current BusJ ness Vol 72 No3 Bureau of Economic Analysis Washington US Government Printing Office March 1992

US Department of Labor Employment and EarnshyIngs Vol 38 No 6 Bureau of Labor Statistics Washington US Government Printing Office June1991

US Department of Labor Notes on Current Lashybor Statistics Price Data Monthly Labor Review Vol113 Noll Bureau of Labor Statistics Washshyington US Government Printing Office Novemshyber1990

For inquiries concerning Input price index data contact Brenda T Maple at (410) 966-7954 For all other Inquiries cooshytact Carolyn S Donham at (410) 966-7947 Reprint requests carotyn S Donham Room l-1 1705 Equitashyble Building 6325 Security Boulevard Baltimore Maryland 21207

Health Care Financing ReviewiSprlng 19931volume 14 Number3 255

Table 1 Selected Community Hospital Statistics 1989-92 8l

11em 1969

Calendar Year 1969 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1990 1991

Operating Expenses Total in Millions $195378 $217113 $238633 $49133 $54902 $60214 $62301 $63739 $64532 $65829

Labor in Millions $106019 $117828 $128704 $26769 $29941 $32516 $33526 $34143 $34501 $35396 Non-Labor in Millions 89359 99286 109929 22363 24961 27698 28775 29597 30031 30434

Inpatient Expense in Millions 152147 165792 178401 38034 41646 44586 46421 47495 47284 47873 Amount per Patient Day 690 765 844 705 786 866 880 878 922 950 Amount per Admission 4586 5021 5461 4634 5097 5522 5689 5683 5838 5980

Utilization Admissions in Thousands 33176 33017 32670 8207 8171 8o75 8160 8357 8102 8005 Inpatient Days in Thousands 220361 216836 211475 53968 53012 51459 52756 54238 51306 50387 Adult Length of Stay in Days 66 66 65 66 65 64 65 65 63 63

Surgical Operations in Thousands 21383 21904 21983 5287 5496 5534 5498 5608 5641 5630

Outpatient Visits in Thousands 308066 326498 344116 78175 83417 87648 87666 89168 91572 93271

Beds in Thousands 930 921 912 926 920 910 909 909 910 908 Adult Occupancy Rate1 649 645 635 632 626 614 631 656 620 603

Full-tJme Equivalent (FTE) personnel Total in Thousands 3162 3229 3249 3173 3241 3252 3259 32n 3290 3310 Number per Bed Adjusted Patient Days2 per FTE

34 89

35 88

36 87

34 22

35 22

36 21

36 22

36 22

36 21

36 21

Adjusted Patient Days In Thousands 282974 283959 282874 69717 69886 69496 70804 72789 70021 69286 I ~

IIr

Ibull z

1 Adult occupancy rate is the ratio of average daily census to the average number of beds maintained during the reporting period 2Adjusted patient days is an aggregate figure reflecting the number of days of inpatient care plus an estimate of the volume of outpatient services expressed In units equivalent to an inpatient day in terms of level of effort It Is derived by multiplying the number of outpatient visits by the ratio of outpatient revenue peroutpatient visits to Inpatient revenue per inpamiddot tient day and adding the product to the number of inpatient days

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for JanuaJY 1989-September 1992

shy

Table 2 Percent Change in Selected Community Hospital Statistics 1989-92

Calendar Year 1989 1990 1991 1991 1992 1992 1992 Item 1989 1990 1991 03 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Operating Expenses Total 99 111 99 92 117 97 112 115 95 93

Labor 100 111 92 92 118 86 99 102 89 89 NonmiddotLabor 98 111 107 91 116 110 129 129 103 99

Inpatient Expenses 83 90 76 77 95 71 93 94 75 74 Amount per Patient Day 93 107 103 90 115 103 93 101 104 97 Amount per Admission 93 95 88 92 100 83 76 80 86 83

Utilization Admissions -10 -05 -11 -14 -04 -12 16 13 -10 -09 Inpatient Days -09 -16 -25 -12 -18 -29 -00 -06 -26 -21 Adult length of Stay 01 -11 -14 02 -13 -18 -16 -19 -16 -12

Surgical Operations 06 24 04 -13 39 07 22 42 12 17

Outpatient Visits 40 60 54 31 67 51 80 81 61 64

Bedbull -13 -09 -10 -15 -08 -10 -07 -06 -03 -03 Adult Occupancy Rate1 05 -04 -09 02 -06 -12 04 -07 -15 -11

FuiimiddotTime Equivalent (FTE) Personnel Total 16 21 06 17 21 03 07 11 14 18 Number per Bed 30 31 17 33 30 14 14 17 17 21 Adjusted Patient Days per

FTE -10 -17 -10 -16 -19 -09 10 01 -22 -21

Adjusted Patient Days 06 03 -04 01 02 -06 17 12 -08 -03 1Change In rate rather than percent change NOTE a designates quarter of year SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for January 1988-$eptember 1992

Health Care Financing RevtewSpring 1993votume 14 Number3 257

Table 3 Employment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92

Ill co

Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment and Measure 1989 1990 1991 03 03 03 04 01 02 03

Health services (SIC 80) Total Employment In Thousands 74837 78312 81772 75348 78964 82386 83075 83566 84316 85105

Non-supervisory Workers Employment in Thousands 66541 69624 72710 67017 70211 73271 73849 74293 74980 75668 Average Weekly Hours 325 325 325 328 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Offices and CUnlcs of MediCal Doctors (SIC 801) Total Employment in Thousands 12737 13429 13978 12836 13556 14110 14177 14201 14337 14510

Non-supervisory Workers Employment in Thousands 10520 11084 11498 10601 11196 11605 11633 11671 11785 11908 Average Weekly Hours 319 318 319 320 319 319 320 322 319 322 Average Hourly Earnings $978 $1058 $1113 $985 $1066 $1114 $1130 $1121 $1130 $1144

Olfices and Clinics of Dentists (SIC 802) Total Employment in Thousands 5012 5140 5274 5043 5157 5312 5344 5330 5387 5403

Non-supervisory Workers

bull ~ ~ ~ a

amp ~ ~

~-~ ~ 0

bull bull z 0

~ bull

Employment in Thousands Average Weekly Hours Average Hourly Earnings

4386 285

$941

4506 284

$1014

4633 283

$1062

4412 283

$943

4518 285

$1023

4673 282

$1064

4690 283

$1077

4886 285

$1090

4695 282

$1097

4731 283

$1098

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands 13607 14194 14988 13704 14296 15129 15275 15359 15478 15652

Non-Supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

12303 318

$680

34402

12825 321

$724

35501

13528 321

$756

36567

12397 322

$685

34612

12918 326

$729

35739

13658 324

$759

36750

13790 322

$766

36991

13863 322

$775

37251

13981 320

$781

37462

14147 327

$789

37728

Non-supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings See footnotes st end of table

31469 340

$1121

32497 342

$1179

33540 342

$1250

31683 342

$1132

32727 344

$1186

33717 344

$1266

33951 343

$1275

34191 344

$1285

34386 344

$1290

34636 345

$1312

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

health establishments has narrowed in the past two quarters In the first three quarters of 1991 (the height of the recesmiddot slon) growth In private non-agricultural payroll was negligible (02 to 04 percent) when compared with the same period 1 year earlier For private health establishmiddot ments payroll growth remained strong ranging from 96 to 106 percent By the third quarter of 1991 growth in private non-agricultural establishment payroll had risen to 27 percent while payroll growth for health care establishments fell to 76 percent (Figure 4) Most of the demiddot cline in the health Industry comes from slower increases in non-supervisory emmiddot ployment and in average hourly earnings for non-supervisory employees rather than from a slowdown In average weekly hours worked (Figure 5)

Overall prices measured by the Conmiddot sumer Price Index rose 31 percent In the third quarter of 1992 the fourth consecumiddot live quarter of relatively mild Inflation For medical care cost Inflation remained high at 72 percent In the third quarter of 1992 However medical care inflation grew more slowly in this quarter down from 77 percent in the second quarter (Figure 6) Inflation in medical services which accounts for a large proportion of overall medical care inflation grew 75 percent In the third quarter down from 77 percent In the second quarter Inflation for medical commodities experienced a more dramatic deceleration Growth of 57 percent in the third quarter of 1992 down from 71 percent in the second quarmiddot ter (Figure 7) Most of that deceleration is attributable to slower price growth in preshyscription drugs for which the rate of inflamiddot lion fell from 85 to 65 percent between the second and third quarters

In the third quarter of 1992 real growth In gross domestic product creeped upmiddot ward at a rate of 22 percent from the same quarter in 1991 The slow economic recovery from the recession of 1991 has not yet been felt In job growth which had remained unchanged from the same pemiddot riod 1 year earlier The unemployment rate Increased slightly to 76 percent the highest quarterly level since 1983 (Figure 8) Despite sluggish recovery In the rest of the economy growth In the health sector that had remained strong through the reshycession Is slowing Health sector employmiddot men Is growing 1 percentage point slower in the third quarter than it did the previous year In addition medical price Inflation is decelerating although It reshymains significantly higher than all item price Increases

REFERENCES

American Hospital Association National Hospishytal Panel Survey Unpublished Chicago 1963-90 Federal Register Medicare Program Changes to the Inpatient Hospital Prospective Payment Sysshytem and Fiscal Year 1991 Rates Final Rule Vol 55 No 170 36043-l6050 and 36169-36173 Office of the Federal Register National Archives and Records Administration Washington US Govshyernment Printing Office September 4 1990

Federal Register Medicare Program Schedules of Umlts on Home Health Agency Costs Per Visit for Cost Reporting Periods Beginning On or After July 1 1992 Vol 57 No 127 29412middot29413 Office of the Federal Register National Archives and Records Administration Washington US Govshyemment Printing Office July 1 1992a Federal Register Medicare Program Schedules of Limits on Skilled Nursing Home Facility Inpashytient Routine Service Costs Final Rule Vol 57 No 195 461n-48187 Office of the Federal Regisshyter National Archives and Records Admlnlstramiddot tion Washington US Government Printing Ofmiddot flee October7 1992b Letsch SW National Health Care Spending in 1991 Heslth Affairs 12(1)94-110Spring 1993

Health care Financing RevlewSpftng 1993vo~ume 14 Number 3 254

US Department of Commerce National Income and Product Accounts Survey of Current BusJ ness Vol 72 No3 Bureau of Economic Analysis Washington US Government Printing Office March 1992

US Department of Labor Employment and EarnshyIngs Vol 38 No 6 Bureau of Labor Statistics Washington US Government Printing Office June1991

US Department of Labor Notes on Current Lashybor Statistics Price Data Monthly Labor Review Vol113 Noll Bureau of Labor Statistics Washshyington US Government Printing Office Novemshyber1990

For inquiries concerning Input price index data contact Brenda T Maple at (410) 966-7954 For all other Inquiries cooshytact Carolyn S Donham at (410) 966-7947 Reprint requests carotyn S Donham Room l-1 1705 Equitashyble Building 6325 Security Boulevard Baltimore Maryland 21207

Health Care Financing ReviewiSprlng 19931volume 14 Number3 255

Table 1 Selected Community Hospital Statistics 1989-92 8l

11em 1969

Calendar Year 1969 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1990 1991

Operating Expenses Total in Millions $195378 $217113 $238633 $49133 $54902 $60214 $62301 $63739 $64532 $65829

Labor in Millions $106019 $117828 $128704 $26769 $29941 $32516 $33526 $34143 $34501 $35396 Non-Labor in Millions 89359 99286 109929 22363 24961 27698 28775 29597 30031 30434

Inpatient Expense in Millions 152147 165792 178401 38034 41646 44586 46421 47495 47284 47873 Amount per Patient Day 690 765 844 705 786 866 880 878 922 950 Amount per Admission 4586 5021 5461 4634 5097 5522 5689 5683 5838 5980

Utilization Admissions in Thousands 33176 33017 32670 8207 8171 8o75 8160 8357 8102 8005 Inpatient Days in Thousands 220361 216836 211475 53968 53012 51459 52756 54238 51306 50387 Adult Length of Stay in Days 66 66 65 66 65 64 65 65 63 63

Surgical Operations in Thousands 21383 21904 21983 5287 5496 5534 5498 5608 5641 5630

Outpatient Visits in Thousands 308066 326498 344116 78175 83417 87648 87666 89168 91572 93271

Beds in Thousands 930 921 912 926 920 910 909 909 910 908 Adult Occupancy Rate1 649 645 635 632 626 614 631 656 620 603

Full-tJme Equivalent (FTE) personnel Total in Thousands 3162 3229 3249 3173 3241 3252 3259 32n 3290 3310 Number per Bed Adjusted Patient Days2 per FTE

34 89

35 88

36 87

34 22

35 22

36 21

36 22

36 22

36 21

36 21

Adjusted Patient Days In Thousands 282974 283959 282874 69717 69886 69496 70804 72789 70021 69286 I ~

IIr

Ibull z

1 Adult occupancy rate is the ratio of average daily census to the average number of beds maintained during the reporting period 2Adjusted patient days is an aggregate figure reflecting the number of days of inpatient care plus an estimate of the volume of outpatient services expressed In units equivalent to an inpatient day in terms of level of effort It Is derived by multiplying the number of outpatient visits by the ratio of outpatient revenue peroutpatient visits to Inpatient revenue per inpamiddot tient day and adding the product to the number of inpatient days

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for JanuaJY 1989-September 1992

shy

Table 2 Percent Change in Selected Community Hospital Statistics 1989-92

Calendar Year 1989 1990 1991 1991 1992 1992 1992 Item 1989 1990 1991 03 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Operating Expenses Total 99 111 99 92 117 97 112 115 95 93

Labor 100 111 92 92 118 86 99 102 89 89 NonmiddotLabor 98 111 107 91 116 110 129 129 103 99

Inpatient Expenses 83 90 76 77 95 71 93 94 75 74 Amount per Patient Day 93 107 103 90 115 103 93 101 104 97 Amount per Admission 93 95 88 92 100 83 76 80 86 83

Utilization Admissions -10 -05 -11 -14 -04 -12 16 13 -10 -09 Inpatient Days -09 -16 -25 -12 -18 -29 -00 -06 -26 -21 Adult length of Stay 01 -11 -14 02 -13 -18 -16 -19 -16 -12

Surgical Operations 06 24 04 -13 39 07 22 42 12 17

Outpatient Visits 40 60 54 31 67 51 80 81 61 64

Bedbull -13 -09 -10 -15 -08 -10 -07 -06 -03 -03 Adult Occupancy Rate1 05 -04 -09 02 -06 -12 04 -07 -15 -11

FuiimiddotTime Equivalent (FTE) Personnel Total 16 21 06 17 21 03 07 11 14 18 Number per Bed 30 31 17 33 30 14 14 17 17 21 Adjusted Patient Days per

FTE -10 -17 -10 -16 -19 -09 10 01 -22 -21

Adjusted Patient Days 06 03 -04 01 02 -06 17 12 -08 -03 1Change In rate rather than percent change NOTE a designates quarter of year SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for January 1988-$eptember 1992

Health Care Financing RevtewSpring 1993votume 14 Number3 257

Table 3 Employment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92

Ill co

Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment and Measure 1989 1990 1991 03 03 03 04 01 02 03

Health services (SIC 80) Total Employment In Thousands 74837 78312 81772 75348 78964 82386 83075 83566 84316 85105

Non-supervisory Workers Employment in Thousands 66541 69624 72710 67017 70211 73271 73849 74293 74980 75668 Average Weekly Hours 325 325 325 328 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Offices and CUnlcs of MediCal Doctors (SIC 801) Total Employment in Thousands 12737 13429 13978 12836 13556 14110 14177 14201 14337 14510

Non-supervisory Workers Employment in Thousands 10520 11084 11498 10601 11196 11605 11633 11671 11785 11908 Average Weekly Hours 319 318 319 320 319 319 320 322 319 322 Average Hourly Earnings $978 $1058 $1113 $985 $1066 $1114 $1130 $1121 $1130 $1144

Olfices and Clinics of Dentists (SIC 802) Total Employment in Thousands 5012 5140 5274 5043 5157 5312 5344 5330 5387 5403

Non-supervisory Workers

bull ~ ~ ~ a

amp ~ ~

~-~ ~ 0

bull bull z 0

~ bull

Employment in Thousands Average Weekly Hours Average Hourly Earnings

4386 285

$941

4506 284

$1014

4633 283

$1062

4412 283

$943

4518 285

$1023

4673 282

$1064

4690 283

$1077

4886 285

$1090

4695 282

$1097

4731 283

$1098

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands 13607 14194 14988 13704 14296 15129 15275 15359 15478 15652

Non-Supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

12303 318

$680

34402

12825 321

$724

35501

13528 321

$756

36567

12397 322

$685

34612

12918 326

$729

35739

13658 324

$759

36750

13790 322

$766

36991

13863 322

$775

37251

13981 320

$781

37462

14147 327

$789

37728

Non-supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings See footnotes st end of table

31469 340

$1121

32497 342

$1179

33540 342

$1250

31683 342

$1132

32727 344

$1186

33717 344

$1266

33951 343

$1275

34191 344

$1285

34386 344

$1290

34636 345

$1312

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

US Department of Commerce National Income and Product Accounts Survey of Current BusJ ness Vol 72 No3 Bureau of Economic Analysis Washington US Government Printing Office March 1992

US Department of Labor Employment and EarnshyIngs Vol 38 No 6 Bureau of Labor Statistics Washington US Government Printing Office June1991

US Department of Labor Notes on Current Lashybor Statistics Price Data Monthly Labor Review Vol113 Noll Bureau of Labor Statistics Washshyington US Government Printing Office Novemshyber1990

For inquiries concerning Input price index data contact Brenda T Maple at (410) 966-7954 For all other Inquiries cooshytact Carolyn S Donham at (410) 966-7947 Reprint requests carotyn S Donham Room l-1 1705 Equitashyble Building 6325 Security Boulevard Baltimore Maryland 21207

Health Care Financing ReviewiSprlng 19931volume 14 Number3 255

Table 1 Selected Community Hospital Statistics 1989-92 8l

11em 1969

Calendar Year 1969 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1990 1991

Operating Expenses Total in Millions $195378 $217113 $238633 $49133 $54902 $60214 $62301 $63739 $64532 $65829

Labor in Millions $106019 $117828 $128704 $26769 $29941 $32516 $33526 $34143 $34501 $35396 Non-Labor in Millions 89359 99286 109929 22363 24961 27698 28775 29597 30031 30434

Inpatient Expense in Millions 152147 165792 178401 38034 41646 44586 46421 47495 47284 47873 Amount per Patient Day 690 765 844 705 786 866 880 878 922 950 Amount per Admission 4586 5021 5461 4634 5097 5522 5689 5683 5838 5980

Utilization Admissions in Thousands 33176 33017 32670 8207 8171 8o75 8160 8357 8102 8005 Inpatient Days in Thousands 220361 216836 211475 53968 53012 51459 52756 54238 51306 50387 Adult Length of Stay in Days 66 66 65 66 65 64 65 65 63 63

Surgical Operations in Thousands 21383 21904 21983 5287 5496 5534 5498 5608 5641 5630

Outpatient Visits in Thousands 308066 326498 344116 78175 83417 87648 87666 89168 91572 93271

Beds in Thousands 930 921 912 926 920 910 909 909 910 908 Adult Occupancy Rate1 649 645 635 632 626 614 631 656 620 603

Full-tJme Equivalent (FTE) personnel Total in Thousands 3162 3229 3249 3173 3241 3252 3259 32n 3290 3310 Number per Bed Adjusted Patient Days2 per FTE

34 89

35 88

36 87

34 22

35 22

36 21

36 22

36 22

36 21

36 21

Adjusted Patient Days In Thousands 282974 283959 282874 69717 69886 69496 70804 72789 70021 69286 I ~

IIr

Ibull z

1 Adult occupancy rate is the ratio of average daily census to the average number of beds maintained during the reporting period 2Adjusted patient days is an aggregate figure reflecting the number of days of inpatient care plus an estimate of the volume of outpatient services expressed In units equivalent to an inpatient day in terms of level of effort It Is derived by multiplying the number of outpatient visits by the ratio of outpatient revenue peroutpatient visits to Inpatient revenue per inpamiddot tient day and adding the product to the number of inpatient days

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for JanuaJY 1989-September 1992

shy

Table 2 Percent Change in Selected Community Hospital Statistics 1989-92

Calendar Year 1989 1990 1991 1991 1992 1992 1992 Item 1989 1990 1991 03 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Operating Expenses Total 99 111 99 92 117 97 112 115 95 93

Labor 100 111 92 92 118 86 99 102 89 89 NonmiddotLabor 98 111 107 91 116 110 129 129 103 99

Inpatient Expenses 83 90 76 77 95 71 93 94 75 74 Amount per Patient Day 93 107 103 90 115 103 93 101 104 97 Amount per Admission 93 95 88 92 100 83 76 80 86 83

Utilization Admissions -10 -05 -11 -14 -04 -12 16 13 -10 -09 Inpatient Days -09 -16 -25 -12 -18 -29 -00 -06 -26 -21 Adult length of Stay 01 -11 -14 02 -13 -18 -16 -19 -16 -12

Surgical Operations 06 24 04 -13 39 07 22 42 12 17

Outpatient Visits 40 60 54 31 67 51 80 81 61 64

Bedbull -13 -09 -10 -15 -08 -10 -07 -06 -03 -03 Adult Occupancy Rate1 05 -04 -09 02 -06 -12 04 -07 -15 -11

FuiimiddotTime Equivalent (FTE) Personnel Total 16 21 06 17 21 03 07 11 14 18 Number per Bed 30 31 17 33 30 14 14 17 17 21 Adjusted Patient Days per

FTE -10 -17 -10 -16 -19 -09 10 01 -22 -21

Adjusted Patient Days 06 03 -04 01 02 -06 17 12 -08 -03 1Change In rate rather than percent change NOTE a designates quarter of year SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for January 1988-$eptember 1992

Health Care Financing RevtewSpring 1993votume 14 Number3 257

Table 3 Employment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92

Ill co

Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment and Measure 1989 1990 1991 03 03 03 04 01 02 03

Health services (SIC 80) Total Employment In Thousands 74837 78312 81772 75348 78964 82386 83075 83566 84316 85105

Non-supervisory Workers Employment in Thousands 66541 69624 72710 67017 70211 73271 73849 74293 74980 75668 Average Weekly Hours 325 325 325 328 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Offices and CUnlcs of MediCal Doctors (SIC 801) Total Employment in Thousands 12737 13429 13978 12836 13556 14110 14177 14201 14337 14510

Non-supervisory Workers Employment in Thousands 10520 11084 11498 10601 11196 11605 11633 11671 11785 11908 Average Weekly Hours 319 318 319 320 319 319 320 322 319 322 Average Hourly Earnings $978 $1058 $1113 $985 $1066 $1114 $1130 $1121 $1130 $1144

Olfices and Clinics of Dentists (SIC 802) Total Employment in Thousands 5012 5140 5274 5043 5157 5312 5344 5330 5387 5403

Non-supervisory Workers

bull ~ ~ ~ a

amp ~ ~

~-~ ~ 0

bull bull z 0

~ bull

Employment in Thousands Average Weekly Hours Average Hourly Earnings

4386 285

$941

4506 284

$1014

4633 283

$1062

4412 283

$943

4518 285

$1023

4673 282

$1064

4690 283

$1077

4886 285

$1090

4695 282

$1097

4731 283

$1098

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands 13607 14194 14988 13704 14296 15129 15275 15359 15478 15652

Non-Supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

12303 318

$680

34402

12825 321

$724

35501

13528 321

$756

36567

12397 322

$685

34612

12918 326

$729

35739

13658 324

$759

36750

13790 322

$766

36991

13863 322

$775

37251

13981 320

$781

37462

14147 327

$789

37728

Non-supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings See footnotes st end of table

31469 340

$1121

32497 342

$1179

33540 342

$1250

31683 342

$1132

32727 344

$1186

33717 344

$1266

33951 343

$1275

34191 344

$1285

34386 344

$1290

34636 345

$1312

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 1 Selected Community Hospital Statistics 1989-92 8l

11em 1969

Calendar Year 1969 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1990 1991

Operating Expenses Total in Millions $195378 $217113 $238633 $49133 $54902 $60214 $62301 $63739 $64532 $65829

Labor in Millions $106019 $117828 $128704 $26769 $29941 $32516 $33526 $34143 $34501 $35396 Non-Labor in Millions 89359 99286 109929 22363 24961 27698 28775 29597 30031 30434

Inpatient Expense in Millions 152147 165792 178401 38034 41646 44586 46421 47495 47284 47873 Amount per Patient Day 690 765 844 705 786 866 880 878 922 950 Amount per Admission 4586 5021 5461 4634 5097 5522 5689 5683 5838 5980

Utilization Admissions in Thousands 33176 33017 32670 8207 8171 8o75 8160 8357 8102 8005 Inpatient Days in Thousands 220361 216836 211475 53968 53012 51459 52756 54238 51306 50387 Adult Length of Stay in Days 66 66 65 66 65 64 65 65 63 63

Surgical Operations in Thousands 21383 21904 21983 5287 5496 5534 5498 5608 5641 5630

Outpatient Visits in Thousands 308066 326498 344116 78175 83417 87648 87666 89168 91572 93271

Beds in Thousands 930 921 912 926 920 910 909 909 910 908 Adult Occupancy Rate1 649 645 635 632 626 614 631 656 620 603

Full-tJme Equivalent (FTE) personnel Total in Thousands 3162 3229 3249 3173 3241 3252 3259 32n 3290 3310 Number per Bed Adjusted Patient Days2 per FTE

34 89

35 88

36 87

34 22

35 22

36 21

36 22

36 22

36 21

36 21

Adjusted Patient Days In Thousands 282974 283959 282874 69717 69886 69496 70804 72789 70021 69286 I ~

IIr

Ibull z

1 Adult occupancy rate is the ratio of average daily census to the average number of beds maintained during the reporting period 2Adjusted patient days is an aggregate figure reflecting the number of days of inpatient care plus an estimate of the volume of outpatient services expressed In units equivalent to an inpatient day in terms of level of effort It Is derived by multiplying the number of outpatient visits by the ratio of outpatient revenue peroutpatient visits to Inpatient revenue per inpamiddot tient day and adding the product to the number of inpatient days

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for JanuaJY 1989-September 1992

shy

Table 2 Percent Change in Selected Community Hospital Statistics 1989-92

Calendar Year 1989 1990 1991 1991 1992 1992 1992 Item 1989 1990 1991 03 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Operating Expenses Total 99 111 99 92 117 97 112 115 95 93

Labor 100 111 92 92 118 86 99 102 89 89 NonmiddotLabor 98 111 107 91 116 110 129 129 103 99

Inpatient Expenses 83 90 76 77 95 71 93 94 75 74 Amount per Patient Day 93 107 103 90 115 103 93 101 104 97 Amount per Admission 93 95 88 92 100 83 76 80 86 83

Utilization Admissions -10 -05 -11 -14 -04 -12 16 13 -10 -09 Inpatient Days -09 -16 -25 -12 -18 -29 -00 -06 -26 -21 Adult length of Stay 01 -11 -14 02 -13 -18 -16 -19 -16 -12

Surgical Operations 06 24 04 -13 39 07 22 42 12 17

Outpatient Visits 40 60 54 31 67 51 80 81 61 64

Bedbull -13 -09 -10 -15 -08 -10 -07 -06 -03 -03 Adult Occupancy Rate1 05 -04 -09 02 -06 -12 04 -07 -15 -11

FuiimiddotTime Equivalent (FTE) Personnel Total 16 21 06 17 21 03 07 11 14 18 Number per Bed 30 31 17 33 30 14 14 17 17 21 Adjusted Patient Days per

FTE -10 -17 -10 -16 -19 -09 10 01 -22 -21

Adjusted Patient Days 06 03 -04 01 02 -06 17 12 -08 -03 1Change In rate rather than percent change NOTE a designates quarter of year SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for January 1988-$eptember 1992

Health Care Financing RevtewSpring 1993votume 14 Number3 257

Table 3 Employment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92

Ill co

Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment and Measure 1989 1990 1991 03 03 03 04 01 02 03

Health services (SIC 80) Total Employment In Thousands 74837 78312 81772 75348 78964 82386 83075 83566 84316 85105

Non-supervisory Workers Employment in Thousands 66541 69624 72710 67017 70211 73271 73849 74293 74980 75668 Average Weekly Hours 325 325 325 328 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Offices and CUnlcs of MediCal Doctors (SIC 801) Total Employment in Thousands 12737 13429 13978 12836 13556 14110 14177 14201 14337 14510

Non-supervisory Workers Employment in Thousands 10520 11084 11498 10601 11196 11605 11633 11671 11785 11908 Average Weekly Hours 319 318 319 320 319 319 320 322 319 322 Average Hourly Earnings $978 $1058 $1113 $985 $1066 $1114 $1130 $1121 $1130 $1144

Olfices and Clinics of Dentists (SIC 802) Total Employment in Thousands 5012 5140 5274 5043 5157 5312 5344 5330 5387 5403

Non-supervisory Workers

bull ~ ~ ~ a

amp ~ ~

~-~ ~ 0

bull bull z 0

~ bull

Employment in Thousands Average Weekly Hours Average Hourly Earnings

4386 285

$941

4506 284

$1014

4633 283

$1062

4412 283

$943

4518 285

$1023

4673 282

$1064

4690 283

$1077

4886 285

$1090

4695 282

$1097

4731 283

$1098

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands 13607 14194 14988 13704 14296 15129 15275 15359 15478 15652

Non-Supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

12303 318

$680

34402

12825 321

$724

35501

13528 321

$756

36567

12397 322

$685

34612

12918 326

$729

35739

13658 324

$759

36750

13790 322

$766

36991

13863 322

$775

37251

13981 320

$781

37462

14147 327

$789

37728

Non-supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings See footnotes st end of table

31469 340

$1121

32497 342

$1179

33540 342

$1250

31683 342

$1132

32727 344

$1186

33717 344

$1266

33951 343

$1275

34191 344

$1285

34386 344

$1290

34636 345

$1312

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 2 Percent Change in Selected Community Hospital Statistics 1989-92

Calendar Year 1989 1990 1991 1991 1992 1992 1992 Item 1989 1990 1991 03 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Operating Expenses Total 99 111 99 92 117 97 112 115 95 93

Labor 100 111 92 92 118 86 99 102 89 89 NonmiddotLabor 98 111 107 91 116 110 129 129 103 99

Inpatient Expenses 83 90 76 77 95 71 93 94 75 74 Amount per Patient Day 93 107 103 90 115 103 93 101 104 97 Amount per Admission 93 95 88 92 100 83 76 80 86 83

Utilization Admissions -10 -05 -11 -14 -04 -12 16 13 -10 -09 Inpatient Days -09 -16 -25 -12 -18 -29 -00 -06 -26 -21 Adult length of Stay 01 -11 -14 02 -13 -18 -16 -19 -16 -12

Surgical Operations 06 24 04 -13 39 07 22 42 12 17

Outpatient Visits 40 60 54 31 67 51 80 81 61 64

Bedbull -13 -09 -10 -15 -08 -10 -07 -06 -03 -03 Adult Occupancy Rate1 05 -04 -09 02 -06 -12 04 -07 -15 -11

FuiimiddotTime Equivalent (FTE) Personnel Total 16 21 06 17 21 03 07 11 14 18 Number per Bed 30 31 17 33 30 14 14 17 17 21 Adjusted Patient Days per

FTE -10 -17 -10 -16 -19 -09 10 01 -22 -21

Adjusted Patient Days 06 03 -04 01 02 -06 17 12 -08 -03 1Change In rate rather than percent change NOTE a designates quarter of year SOURCE American Hospital Association National Hospital Panel Survey Reports Chicago Monthly reports for January 1988-$eptember 1992

Health Care Financing RevtewSpring 1993votume 14 Number3 257

Table 3 Employment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92

Ill co

Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment and Measure 1989 1990 1991 03 03 03 04 01 02 03

Health services (SIC 80) Total Employment In Thousands 74837 78312 81772 75348 78964 82386 83075 83566 84316 85105

Non-supervisory Workers Employment in Thousands 66541 69624 72710 67017 70211 73271 73849 74293 74980 75668 Average Weekly Hours 325 325 325 328 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Offices and CUnlcs of MediCal Doctors (SIC 801) Total Employment in Thousands 12737 13429 13978 12836 13556 14110 14177 14201 14337 14510

Non-supervisory Workers Employment in Thousands 10520 11084 11498 10601 11196 11605 11633 11671 11785 11908 Average Weekly Hours 319 318 319 320 319 319 320 322 319 322 Average Hourly Earnings $978 $1058 $1113 $985 $1066 $1114 $1130 $1121 $1130 $1144

Olfices and Clinics of Dentists (SIC 802) Total Employment in Thousands 5012 5140 5274 5043 5157 5312 5344 5330 5387 5403

Non-supervisory Workers

bull ~ ~ ~ a

amp ~ ~

~-~ ~ 0

bull bull z 0

~ bull

Employment in Thousands Average Weekly Hours Average Hourly Earnings

4386 285

$941

4506 284

$1014

4633 283

$1062

4412 283

$943

4518 285

$1023

4673 282

$1064

4690 283

$1077

4886 285

$1090

4695 282

$1097

4731 283

$1098

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands 13607 14194 14988 13704 14296 15129 15275 15359 15478 15652

Non-Supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

12303 318

$680

34402

12825 321

$724

35501

13528 321

$756

36567

12397 322

$685

34612

12918 326

$729

35739

13658 324

$759

36750

13790 322

$766

36991

13863 322

$775

37251

13981 320

$781

37462

14147 327

$789

37728

Non-supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings See footnotes st end of table

31469 340

$1121

32497 342

$1179

33540 342

$1250

31683 342

$1132

32727 344

$1186

33717 344

$1266

33951 343

$1275

34191 344

$1285

34386 344

$1290

34636 345

$1312

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 3 Employment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92

Ill co

Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment and Measure 1989 1990 1991 03 03 03 04 01 02 03

Health services (SIC 80) Total Employment In Thousands 74837 78312 81772 75348 78964 82386 83075 83566 84316 85105

Non-supervisory Workers Employment in Thousands 66541 69624 72710 67017 70211 73271 73849 74293 74980 75668 Average Weekly Hours 325 325 325 328 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Offices and CUnlcs of MediCal Doctors (SIC 801) Total Employment in Thousands 12737 13429 13978 12836 13556 14110 14177 14201 14337 14510

Non-supervisory Workers Employment in Thousands 10520 11084 11498 10601 11196 11605 11633 11671 11785 11908 Average Weekly Hours 319 318 319 320 319 319 320 322 319 322 Average Hourly Earnings $978 $1058 $1113 $985 $1066 $1114 $1130 $1121 $1130 $1144

Olfices and Clinics of Dentists (SIC 802) Total Employment in Thousands 5012 5140 5274 5043 5157 5312 5344 5330 5387 5403

Non-supervisory Workers

bull ~ ~ ~ a

amp ~ ~

~-~ ~ 0

bull bull z 0

~ bull

Employment in Thousands Average Weekly Hours Average Hourly Earnings

4386 285

$941

4506 284

$1014

4633 283

$1062

4412 283

$943

4518 285

$1023

4673 282

$1064

4690 283

$1077

4886 285

$1090

4695 282

$1097

4731 283

$1098

Nursing and Personal Care Facilities (SIC 805) Total Employment in Thousands 13607 14194 14988 13704 14296 15129 15275 15359 15478 15652

Non-Supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings

Private Hospitals (SIC 806) Total Employment in Thousands

12303 318

$680

34402

12825 321

$724

35501

13528 321

$756

36567

12397 322

$685

34612

12918 326

$729

35739

13658 324

$759

36750

13790 322

$766

36991

13863 322

$775

37251

13981 320

$781

37462

14147 327

$789

37728

Non-supervisory Workers Employment in Thousands Average Weekly Hours Average Hourly Earnings See footnotes st end of table

31469 340

$1121

32497 342

$1179

33540 342

$1250

31683 342

$1132

32727 344

$1186

33717 344

$1266

33951 343

$1275

34191 344

$1285

34386 344

$1290

34636 345

$1312

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

bull I

~ l i i l c 0 -8 1 bull0

bull z 0

I bull

Table 3-ContlnuodEmployment Hours and Earnings in Private1 Health Service Establishments by Selected Type of Establishment

1989-92Calendar Year

1989 1990 1991 1991 1992 1992 1992 Type of Establishment and Measure 1989 1990 1991 Q3 Q3 Q3 Q4 Q1 Q2 Q3

All Private Non-Agricultural EltabHahments Total Employment In Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665

Non-Supervisory Workers Employment In Thousands 73400 74108 72705 74191 74897 73406 73125 71212 72900 73582 Average Weekly Hours 346 345 343 348 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Employment In Thousands All Hospitals 47419 48540 49636 47650 48792 49859 50148 50509 50798 51175 Private Hospitals (SIC 806) 34402 35501 36567 34612 35739 36750 36991 37251 37462 3n2BFederal Hospitals 2274 2316 2341 2284 2319 2357 2364 2375 2385 2393State Hospitals 4424 4262 4140 4408 4245 4117 4109 4118 4114 4114Local Hospitals 6320 6461 6587 6347 6488 6636 6684 6765 6837 69401Excludes hospitals clinics and other healtiHampIated establishments run by all governments NOTES Data presented here Incorporates conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever po$$lble Q designates quarter of year Quarterly data are not seasonally adjusted

SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eemlngs Washington US Government Printing Office Monthly reports for Janual 1989-0ecember 1992

B

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 4 Percent Change In Employment Hours and Earnings In Prlvate1 Health Service

Establishments by Selected Type of Establishment 1989-92

Type of Establishment and Measure

Calendar Year 1989 03

1990 03

1991 03

1991 Q4

1992 01

1992 02

1992 Q3 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year Heallh Services (SIC 80) Total Employment 51 46 44 49 46 43 43 40 37 33 NonSupevisory Workers Employment 52 46 44 50 46 44 43 40 37 33 Average Weekly Hours 01 03 -00 03 05 -03 02 13 03 06 Average Hourly Earnings 67 59 53 69 57 55 51 46 36 36

Offices and Clinics of Medical Doctors (SIC 801) Total Employment 58 54 41 58 56 41 41 35 31 28

Non-Supervisory Workers Employment 60 54 37 59 56 37 36 33 29 26 Average Weekly Hours 10 -04 04 14 -01 00 07 14 00 07 Average Houry Earnings 79 81 52 86 82 45 39 18 20 27

Offices and Clinics of Dentists (SIC 802) Total Employment 34 26 26 35 23 30 34 26 23 17

Non-Supervisory Workers Employment 33 27 28 35 24 34 36 23 18 12 Average Weekly Hours -01 -02 -04 -01 06 -11 -06 07 -04 04 Average Hourly Earnings 68 78 47 62 88 40 42 41 36 32

Nunlng and Personal Care Facilities SIC 805) Total Employment 35 43 56 34 43 58 54 47 40 35

Non-supervisory Workers Employment 36 42 55 35 42 57 54 47 41 36 Average Weekly Hours 09 09 01 14 13 -05 -03 08 01 07 Average Hourly Earnings 74 65 44 71 64 42 37 39 38 40

Private Hospitals (SIC 806) Total Employment 44 32 30 42 33 28 29 30 30 27

Non-supervisory Workers Employment 45 33 32 43 33 30 31 32 31 27 Average Weekly Hours 00 07 -00 01 07 -01 05 12 04 03 Average Hourly Earnings 67 52 60 69 48 67 62 56 38 36

All Private Non-Agricultural E8tabllshmenta Total Employment 27 10 -17 24 10 -18 -14 -06 01 00

Non-Supervisory Workers Employment 28 10 -19 25 10 -20 -14 -05 03 02 Average Weekly Hours -03 -03 -06 -02 -01 -06 01 08 04 01 Average Hourly Earnings 40 37 31 41 38 30 30 29 24 24

Employment All Hospitals 31 24 23 29 24 22 24 28 28 26 Private Hospitals (SIC 806) 44 32 30 42 33 28 29 30 30 27 Federal Hospitals -55 19 11 -41 15 16 28 29 21 15 State Hospitals -09 -37 -28 -16 -37 -30 -27 -14 -11 -01 Local Hospitals 21 22 20 20 22 23 30 42 46 46 1EJltcludes hospitals clinics and other healthmiddotrelated establishments run by all governments NOTES Data presented here Incorporates conversion to tlle 1987 Standanllnclustrial Classification (SIC) and a historical reconstruction of components back to the Inception of the series whenever possible SOURCE US Department of Labor Bureau of Labor Statistics Employment smJ Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Heahh Care Financing RevleWISprlng 1993volume 14 Number 3 260

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 5 Percent Change In Implied Non-Supervisory Payrolls and Work Hours In Prlvate1 Health

SeiVIce Establishments by Selected Type of Establishment 1989middot92 Calendar Year 1989 1990 1991 1991 1992 1992 1992

Type of Establishment 1989 1990 1991 Q3 03 03 04 01 02 03

Annual Percent Change Percent Change From the Same Period of Previous Year

Private Health Service Establishments (SIC 80) Payrolls 124 111 100 126 113 98 98 102 78 76 Work Hours 53 49 44 53 53 40 45 54 41 39

Offices and Clinics of Medical Doctors (SIC 801) Payrolls 155 135 98 166 141 84 85 86 50 62 Work Hours 71 50 42 73 55 37 44 47 29 34

Offices and Clinics of Dentists (SIC 802) Payrolls 100 105 72 98 118 64 73 73 52 48 Work Hours 32 26 24 34 30 23 29 30 15 16

Nursing and Personal Care Facilities (SIC 805) Payrolls 123 120 102 123 124 96 89 97 82 84 Work Hours 45 51 56 49 56 52 50 56 43 43

Private Hospitals (SIC 806) Payrolls 116 93 94 116 90 99 100 102 75 67 Work Hours 46 40 32 44 40 29 36 44 35 30

All Private NonmiddotAgricultural Establishments Payrolls 66 44 06 66 47 04 16 32 31 27 Work Hours 25 07 -24 23 09 -26 -13 03 07 03 1Excludes hospitals clinics and otherheallhmiddotrelaled establishments run by all governments NOTES Data presented here incorporate conversion to the 1987 Standard Industrial Classification (SIC) and a historical reconstruction of components back to the inception of the series whenever possible Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics Employment and Eamlngs Washington US Government Printing Office Monthly reports for January 1988-Deeember 1992

Heallh Care Financing ReviewSpring 1993volume 1bull NumberS 261

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 6 5elected Items of the Consumer Price Index for All Urban Consumers 1989-92

Item

All Items

calendar Year

1999 1990 1991

1240 1307 1362

1999 03

1247

1990 03

1316

1991 03

1367

1991 04

1377

1992 01

1387

1992 02

1398

1992 03

1409

All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380 Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915 Medical Care Services 1 1489 1627 1771 1503 1647 1787 1818 1861 1889 1921

Professional Services 1464 1561 1657 1475 1577 1670 1691 1723 1747 1770 Physicians Services 1500 1608 1705 1514 1626 1716 1736 1772 1803 1826 Dental Services 1460 1558 1674 1469 1571 1694 1721 1747 1770 1804

Hospital and Related Services 1605 1780 1961 1626 1803 1979 2023 2081 2113 2160 Hospital Room 1581 1754 1919 1598 1776 1933 1974 2028 2061 2106 Other Inpatient Servlces2 Outpatlampnt Services2

1289 1247

1427 1387

1580 1534

1307 1267

1447 1401

1595 1551

1633 1585

1680 1635

1702 1664

1739 1701

Medical Care Commodities 1508 1634 1768 1523 1650 1789 1810 1849 1878 1890 Prescription Drugs 1652 1817 1997 1672 1838 2024 2056 2109 2145 2156 Non-Prescription Drugs and

Medical Suppiles2 1146 1206 1262 1153 1212 1272 1278 1293 1311 1321 Internal and Respiratory

OvermiddotthemiddotCounter Drugs 1387 1459 1524 1394 1464 1537 1537 1553 1584 1599 Non-Prescription Medical

Equipment and Supplies 1311 1380 1450 1321 1389 1459 1480 1501 1504 1512 11ncludes net cost of priYate health Insurance not shown In professional or hospital and related services 2oeoember 1986 = 100 NOTES 1982-84 1000 unless noted Q designates quarter of year Quarterly data not seasonally adjusted SOURCE US Department of Labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1989-September 1992

HeaHh Care Financing ReviewSpring 1993Volume14 Number3 262

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 7 Percent Change in Selected Items of the Consumer Price Index for All Urban Consumers

1989middot92

Item

Calendar Year 1989 03

1990 03

1991 03

1991 04

1992 01

1992 02

1992 03 1989 1990 1991

Annual Percent Change Percent Change From the Same Period of Previous Year

All Items 48 54 42 47 55 39 30 29 31 31

All Items Less Medical Care 46 52 39 44 53 38 28 28 28 28 Apparel and Upkeep 28 46 37 20 57 39 37 34 28 22 Energy 57 82 04 57 68 -07 -81 -37 09 26 Food and Beverages 57 58 36 52 56 31 24 16 08 14 Housing Shelter 45 54 45 46 60 37 38 36 35 33

Medical Cere 77 91 87 77 93 85 80 78 77 72 Medical care Services 76 93 89 77 96 85 80 79 78 75

Professional Services 64 66 62 63 69 59 60 62 62 60 Physicians Services 73 72 60 71 74 55 55 59 65 64 Dental Services 62 67 75 80 89 78 81 74 69 65

Hospital and Related Services 115 109 102 116 109 98 89 90 94 91 Hospital Room 103 109 94 99 111 89 84 83 88 90 Other Inpatient

Services 131 107 107 135 107 102 89 93 95 91 Outpatient Services 109 112 106 116 106 107 98 98 101 97

Medical care Commodities 78 84 82 78 83 84 78 77 71 57 Prescription Drugs 87 100 99 90 99 101 98 93 85 65 NonmiddotPrescriptlon Drugs and

Medical Supplies 60 52 47 57 51 50 37 42 41 39 lnlemal and Respiratory

Overmiddotthe-Counter Drugs 61 52 45 57 50 50 26 33 43 40 NonmiddotPrescrlption Medical

Equipment and Supplies 58 53 50 57 52 50 58 62 39 38 1tncludes net cost of private health Insurance not shown In professional or hospital and related seiVIces NOTE a designates quarter of year SOURCE us Department of labor Bureau of Labor Statistics CPI Detailed Report Washington US Government Printing Office Monthly reports for January 1988-September 1992

Health Care Flnancing ReviewSpring 1993volume 14 Number3 263

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 8 Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Base Year Weights

Four Quarters Ending

1991 1991 1991 1991 1992 1992 1992 1992 Expense Category 1987 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Total 100000 48 48 43 37 34 31 31 32

Wages and Salaries 52216 49 48 46 48 42 39 37 35 Employee Benefits 9497 75 72 70 65 64 63 62 63 Other Professional Fees 1649 47 46 45 43 43 42 40 39 Energy and Utilities 2368 97 107 75 -19 -55 -62 -51 -01

Fuel Oil Coal and Other Fuel 0624 211 217 114 -113 -183 -177 -145 -31 Electricity 1135 43 56 71 71 53 34 16 17 Natural Gas 0343 -25 -17 -09 -16 -30 -42 -22 04 Motor Gasoline 0230 179 189 84 -112 -155 -151 -111 -14 Water and Sewerage Maintenance 0036 65 66 89 73 78 78 71 88

Professional Liability Insurance 1433 -04 -20 -25 13 25 42 57 50 All Other 32838 36 36 32 ~4 18 15 15 18

Other Products 21788 34 33 28 19 12 10 11 15 Pharmaceuticals 3873 84 amp1 83 84 83 79 71 65 Food 3299 37 28 18 12 08 07 09 09

Direct Purchase 2111 32 20 07 00 -06 -05 00 02 Contract SeiVice 1188 45 41 38 34 31 28 24 21

Chemicals and Cleaning Products 3126 09 26 23 -13 -40 -52 -44 -23 Surgical and Medical Instruments 2672 22 20 17 15 16 18 19 23 Photographic Supplies 2623 23 11 -03 -14 -14 -12 -05 01 Rubber and Plastics 2323 13 17 19 13 04 -01 -03 00 Paper Products 1399 11 05 -04 -15 -27 -27 -21 -13 Apparel 1142 24 22 21 21 19 17 16 18 Minor Machinery and Equipment 0497 26 25 23 19 14 09 05 03 Miscellaneous Products 0833 45 48 38 21 14 08 08 13

Other Services 11050 42 41 38 33 30 25 23 23 Business Services 3845 41 37 32 29 28 24 24 25 Computer and Data Processing 1992 60 51 41 30 21 14 12 14 Transportation and Shipping 1233 58 65 57 28 14 10 10 21 Telephone 0987 04 06 1~3 16 17 17 12 06 Blood Services 0588 03 02 -01 10 21 45 86 58 Postage 0372 u 67 108 148 131 88 49 12 Other-labor Intensive 1233 40 39 41 41 41 39 34 31 Other-Nonmiddotlabor Intensive osoo 54 55 50 42 36 32 30 30

See footnotes at end of table

264 Hlth care Financing ReviewSpring 1993volume 1-4 Number 3

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 8-Contlnued Percent Change In Four-Quarter Averages In the Prospective Payment System Hospital

Input Price Index by Expense Category 1991middot94

Expense Category1

Base Year Weights

19872

Four Quarters Ending

1993 01

1993 02

1993 1993 1994 1994 03 04 01 02

1994 03

1994 04

Total 100000 34 35 38 40 41 43 43 44

Wages and Salaries 52216 34 33 35 37 39 40 41 40 Employee Benefits 9497 64 66 67 69 68 65 83 60 Other Professional Fees 1649 39 38 39 41 44 48 47 46 Energy and Utilities 2368 47 56 53 42 22 17 23 30

Fuel 011 Coal and Other Fuel 0624 91 97 93 87 39 30 35 38 Electricity 1135 25 31 33 25 17 14 16 20 Natural Gas 0343 33 68 49 15 03 -05 07 30 Motor Gasoline 0230 40 49 42 29 17 19 32 47 Water and Sewerage Maintenance 0036 87 67 67 M 62 59 58 58

Professional liability Insurance 1433 61 71 80 87 92 97 103 110 All Other 32838 21 25 29 32 35 37 39 40

Other Products 21788 20 25 27 31 34 35 37 38 Pharmaceuticals 3873 61 61 63 64 66 67 67 68 Food 3299 11 13 17 22 25 27 28 28

Direct Purchase 2111 07 10 14 20 23 25 25 24 Contract Service 1188 19 19 22 25 28 30 32 34

Chemicals and Cleaning Products 3126 04 22 28 35 35 35 36 36 Surgical and Medical Instruments 2672 22 22 22 24 27 30 33 33 Photographic Supplies 2623 03 06 07 09 13 17 22 27 Rubber and Plastics 2323 05 08 09 08 07 07 06 07 Paper Products 1399 01 12 25 42 51 57 59 56 Apparel 1142 16 15 14 14 16 19 22 25 Minor Machinery and Equipment 0497 03 05 09 14 18 21 23 25 Miscellaneous Products 0833 18 19 20 20 20 22 23 25

Other Services 11050 24 27 31 35 39 41 43 44 Business Services 3645 23 29 34 37 41 43 45 48 Computer and Data Processing 1992 22 33 44 54 59 63 66 68 Transportation and Shipping 1233 27 31 33 36 40 41 44 45 Telephone 0987 03 03 06 11 16 19 20 20 Blood Services 0588 51 24 06 11 12 22 27 26 Postage 0372 00 00 00 00 00 00 00 00 Other-Labor Intensive 1233 29 30 34 37 38 39 38 37 Other-Non-Labor Intensive 0800 30 30 30 30 30 30 30 30

1For data sources used to estimate the Input price Index relative weights and choice of price proxies see the Federal Reglster(1990) 2eategoryweights may not sum to total because of rounding

NOTES Data tor 1991 are historical Data tor 1992are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is calculated Use the quarterly index levels shown In Tables 9 11 and 13 Choose the four-quarter period ending tor which you would like to calculate the percent change(eg year-end 1993 Quarter3) Count back three quarters so that you have a total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these tour quarters (add the index levels and divide by 4) Now take tile tour quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these tour quarters Finally compute a percent change using the two averages SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourlh quarter 1992foreeasts were made by Data Resources IncMcGraw-Hill

Health Care Financing ReviewSpring 19931votume14Number3 265

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 9 Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Calegoty 1991-94 Base Year

Weights 1991 1991 1991 1991 1992 1992 1992 1992 Expense category1 19872 01 Q2 Q3 Q4 Q1 Q2 03 Q4

Total 100000 1203 1210 1222 1231 1239 1248 1261 1272

Wages and Salaries 52216 1196 1206 1222 1233 1242 1250 1262 1273 Employee Benefits 9497 1288 13Q4 1326 1341 1368 1383 1408 1426 Other Professional Fees 1649 1190 1200 1218 1228 1239 1249 1264 1273 Energy and Utilities 2368 1195 1132 1165 1156 1089 1146 1200 1216

Fuel Oil Coal and Other Fuel 0624 1413 1145 1199 1297 1083 1205 1250 1360 Electricity 1135 1104 1141 1190 1114 1116 1149 1204 1166 Natural Gas 0343 1030 978 944 973 968 923 1015 1050 Motor Gasoline 0230 1287 1262 1256 1223 1109 1268 1295 1284 Water and Sewerage Maintenance 0036 1254 1282 1320 1331 1347 1370 1403 1419

Professional Uability Insurance 1433 1291 1293 1311 1332 1338 1353 1353 1417 All Other 32838 1191 1191 1197 1202 1210 1216 1216 1223

Other Products 21788 1195 1193 1198 1201 1210 1217 1217 1223 Pharmaceuticals 3873 1374 1413 1434 1453 1481 1506 1521 1539 Food 3299 1155 1153 1157 1158 1165 1165 1165 1167

Direct Purchase 2111 1138 1137 1129 1131 1131 1140 1137 1135 Contract Service 1188 1174 1188 1196 1202 1207 1211 1216 1222

Chemicals and Cleaning Products 3126 1237 1198 1170 1173 1150 1158 1181 1183 Surgical and Medical Instruments 2672 1101 1107 1110 1110 1125 1132 1133 1137 Photographic Supplies 2623 1148 1141 1141 1143 1142 1139 1142 1148 Rubber and Plastics 2323 1136 1129 1124 1124 1122 1125 1130 1134 Paper Products 1399 1194 1171 1158 1157 1151 1157 1154 1155 Apparel 1142 1097 1103 1106 1107 1112 1120 1124 1128 Minor Machinery and Equipment 0497 1117 1119 1118 1119 1123 1121 1120 1123 Miscellaneous Products 0833 1160 1161 1161 1166 1165 1176 1180 1189

Other Services 11050 1185 1187 1196 1205 1209 1214 1213 1224 Business Services 3845 1170 1181 1178 1184 1208 1200 1204 1218 Computer and Data Processing 1992 1280 1293 1292 1296 1293 1301 1312 1326 Transportation and Shipping 1233 1193 1186 1191 1202 1198 1215 1223 1235 Telephone 0987 1021 1022 1025 1030 1034 1031 1028 1029 Blood Services 0588 1061 1058 1053 1102 1113 1154 1129 1116 Postage 0372 1257 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1145 1160 1176 1185 1191 1196 1205 1219 Other-Non-labor Intensive 0800 1199 1207 1216 1225 1234 1244 1254 1262

See footnotes at end of table

Health Cere Financing RevQISpllng 1993Volume 14 Number 3

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 9-Contlnued Quarterly Index Levels of the Prospective Payment System Hospital Input Price Index by

Expense Category 1991middot94 Year

Expense Category1 Weights 19872

1991 Q1

1991 Q2

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3

1992 Q4

Total 100000 1285 1296 1313 1326 1341 1353 1370 1384

Wages and Salaries 52216 1284 1293 1311 1324 1337 1346 1364 1377 Employee Benefits 9497 1462 1480 1507 1524 1555 1569 1597 1612 Other Professional Fees 1649 1286 1297 1319 1331 1347 1358 1379 1390 Energy and Utilities 2368 1199 1205 1210 1226 1219 1241 1252 1270

Fuel 011 Coal and Other Fuel 0624 1342 1299 1282 1398 1376 1351 1342 1457 Electricity 1135 1167 1184 1208 1179 1183 1205 1234 1210 Natural Gas 0343 1018 997 992 996 1019 1037 1031 1035 Motor Gasoline 0230 1196 1317 1303 1286 1223 1376 1378 1362 Water and Sewerage Maintenance 0036 1444 1464 1489 1503 1526 1548 1578 1590

Professional Liability Insurance 1433 1444 1471 1505 1546 1588 1629 1678 1730 All Other 32838 1235 1247 1257 1269 1283 1296 1308 1321

Other Products 21788 1234 1246 1256 1266 1280 1292 1304 1315 Pharmaceuticals 3873 1572 1602 1618 1641 1681 1707 1724 1757 Food 3299 1178 1187 1195 1198 1210 1220 1228 1232

Direct Purchase 2111 1148 1157 1165 1165 1177 1185 1192 1192 Contract Service 1188 1231 1240 1249 1257 1270 1281 1292 1302

Chemicals and Cleaning Products 3126 1189 1200 1217 1225 1232 1243 1263 1270 Surgical and Medical Instruments 2672 1147 1155 1160 1173 1188 1193 1199 1209 Photographic Aupplies 2623 1147 1151 1159 1163 1170 1180 1193 1201 Rubber and Plastics 2323 1132 1135 1140 1140 1139 1142 1148 1150 Paper Products 1399 1176 1194 1211 1228 1246 1264 1277 1291 Apparel 1142 1126 1132 1142 1147 1149 1160 1172 1178 Minor Machinery and Equipment 0497 1126 1133 1140 1146 1154 1161 1169 1176 Miscellaneous Products 0833 1192 1197 1202 1211 1220 1227 1233 1243

Other Services 11050 1239 1250 1260 1274 1291 1304 1317 1333 Business Services 3845 1240 1247 1255 1269 1293 1305 1317 1335 Computer and Data Processing 1992 1350 1368 1389 1411 1435 1459 1487 1512 Transportation and Shipping 1233 1233 1263 1265 1285 1292 1317 1322 1342 Telephone 0987 1033 1041 1047 1047 1055 1062 1066 1068 Blood Services 0586 1139 1138 1137 1154 1168 1166 1165 1188 Postage 0372 1319 1319 1319 1319 1319 1319 1319 1319 Other-Labor Intensive 1233 1230 1237 1253 1268 1278 1283 1298 1314 Other-Non-labor Intensive 01100 1270 1281 1291 1300 1307 1320 1331 1340

1Fordata sources used to estimate the Input price index relative weights and choice of price proxies see the Federal Reglster(1990)2Category weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and t994are forecasted a designates quarter of year SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-Hitt

Health Care Financing ReviewSpring 1993lvolume 14 Number3 267

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 10 Percent Change in Four-Quarter Averages In the Skilled Nursing Facility Input Price Index

by Expense Category 1991-94

Expense Category2

Base Year

Weights 19772

Four Quarters Ending

1991 01

1991 02

1991 1991 1992 1992 03 04 01 02

1992 Q3

1992 04

Total 100000 60 55 50 43 39 37 36 36

Wages and Salaries 63020 62 55 50 44 40 39 38 41 Employee Benefits 7600 58 64 68 70 67 61 55 50 Food 9740 38 30 22 16 14 12 12 12

Direct Purchase 4930 32 20 07 oo -06 -05 oo 02 Contract Service 4810 43 38 34 30 30 27 23 20

Fuel and Other Energy 4270 74 73 57 07 -13 -19 -14 07 Electricity 1210 25 26 32 38 33 32 27 20 Natural Gas 0910 02 06 11 11 04 04 09 22 Fuel 011 and Coal 1660 160 151 100 -38 -83 -97 -85 -33 Water and Sewerage Maintenance 0490 65 66 69 73 76 76 71 68

All Other 15370 59 59 56 51 47 44 41 40 Drugs 1500 84 81 83 84 83 79 71 65 Supplies 3280 54 55 51 42 36 32 30 30 Health Services 1210 73 69 65 60 57 59 61 63 Other Business Services 4590 53 53 52 48 46 43 39 38 Miscellaneous 4790 54 55 51 42 36 32 30 30

Base Year

Four Quarters Ending

Total

Weights 19772

1993 01

1993 02

1993 1993 1994 1994 Q3 04 01 02

1994 03

1994 04

100000 40 42 45 47 47 47 46 45

Wages and Salaries 63020 43 46 50 51 53 53 52 50 Employee Benefits 7600 47 46 47 47 46 44 41 39 Food 9740 14 17 21 25 27 29 28 28

Direct Purchase 4930 07 10 15 20 23 25 25 24 Contract Service 4810 20 22 26 29 31 31 31 31

Fuel and Other Energy 4270 31 41 44 44 37 32 32 36 Electricity 1210 19 14 11 08 06 07 08 10 Natural Gas 0910 47 62 68 54 34 18 09 15 Fuel 011 and Coal 1660 17 38 45 57 52 49 54 58 Water and Sewerage Maintenance 0490 67 67 67 65 82 59 58 58

All Other 15370 39 39 39 39 39 39 39 40 Drugs 1500 61 61 63 64 66 67 67 68 Supplies 3280 31 30 30 30 30 30 30 30 Health Services 1210 63 61 61 60 61 62 62 62 Other Business Services 4590 36 35 35 35 35 35 34 34 Miscellaneous 4790 31 30 30 30 30 30 30 30

1Fordata sources used to estimate the Input price Index relative weights and choice of price proxies see the Fedetal Register (1991)2Categorywelghts may not sum to total because of rounding

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q designates quarter of year Percent change data shown are four-quarter moving averages The following Is an example of how a percent change Is caLculated Use the quarterly Index levtls shown In Tables 9 11 and 13 Choose the four quarter period ending for which you would like to calculate the percent change (eg yearend 1993 Quarter 3) Count back three quarters so that you have a total of four(eg 1993 Quarter 3 1993 Quarter 2 1993 Quarter 1 1992 Quarter4) Average these four quarters (add the Index tevetsand divide by 4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averages

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics DiviSion of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Resources lncJMcGraw-HIU

Health care Financing RevlewiSprlng 1993volume 14 NumberS 268

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 11 Quarterly Index Levels In tho Skilled Nursing Facility Input Price Index by Expense

Category 1989middot92 Expense category1

Year Weights 1977

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

Total

Wages and Salaries Employee Benefits Food

Direct Purchase Contract Service

Fuel and Other Energy Electricity Natural Gas Fuel Oil and Coal Water and Sewerage Maintenance

All Other Drugs Supplies Health Services Other Business Services Miscellaneous

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2276

2284 2355 1844 1854 2039 2290 2127 2298 2306 2617 2472 3206 2225 2862 2564 2225

2291

2302 2392 1851 1651 2055 2197 2129 2250 2077 2676 2499 3297 2239 2894 2592 2239

2311

2323 2422 1851 1637 2070 2217 2145 2261 2086 2756 2523 334~ 2254 293~ 2618 2254

2332

2343 2449 1864 1648 2084 2256 2170 2298 2141 2n9 2547 3389 2274 2907 2641 2274

2356

2373 2491 1864 1644 2090 2204 2168 2261 2019 2813 2575 3454 2290 3030 2668 2290

2374

2390 2511 1871 1654 2093 2228 2185 2280 2045 2859 2602 3512 231)9 3081 2692 2309

2397

2415 2532 1873 1647 2105 2277 2191 2331 2118 2928 2621 3544 2324 3121 2711 2324

2430

2453 2561 1887 1656 2124 2314 2199 2432 2141 2902 2646 3590 2343 3153 2736 2343

Year Weights 1977

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

63020 7600 9740 4930 4810 4270 1210 0910 1880 0490

15370 1500 3260 1210 4590 4790

2459

2497 2605 1900 1667 2139 2331 2200 2448 2160 3014 2675 3667 2360 3213 2761 2360

2485

2525 2831 1914 1678 2155 2347 2202 2454 2185 3057 2701 3736 2377 3262 2785 2377

2515

2560 2654 1927 1689 2171 2384 2205 2456 2209 3109 2725 an~ 2394 3309 2809 2394

2544

2592 2677 1941 1700 2188 2378 2209 2445 2241 3137 2749 3829 2412 3347 2832 2412

2574

2626 2715 1955 1710 2206 2400 2215 2455 2274 3186 2780 3921 2430 3414 2855 2430

2600

2853 2735 1968 1719 2223 2425 2221 2478 2306 3231 2807 3982 2449 3464 2879 2449

2628

2883 2756 1981 1729 2240 2453 2228 2500 2343 3293 2632 4022 2468 3511 2904 2468

2653

2709 2776 1995 1739 2257 2477 2237 2522 2379 3320 2860 4098 2487 3551 2929 2487

1For data sources used to estimate the input price Index relative weights and choice of price proxies see the Federal Reglster(1991) 2categol) weights may not sum to total because of rounding NOTES Data for 1991 are historical Data for 1992 are partly historical and parity forecasted Q designates quarter of year SOURCES Health Care Financing Admlnstration Office of the Actuary Data from the Office of National Health Statistics Division of Health COst Analysis Third quarter 1992forecasts were made by Data Resources incJMcGrawmiddotHili

Health Care Financing ReviewSpring 1913volume 1-4 Numbera 269

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 12 Percent Change in Four-Quarter Averages in the Home Health Agency Input Price Index by

Expense Category 1991middot94

Expense category

Base Year

Weights 19762

1991 01

1991 02

Four Quarters Ending

1991 1991 1992 1992 03 04 01 02

1992 03

1992 Q4

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract Services

I

100000

65140 7900 4870 2790 1350 1170 2810 6870 7100

50

48 58 58 53 42 75 49 50 54

53

51 64 65 53 41 74 47 53 55

56 57 57 51

56 60 63 58 68 70 67 61 57 28 14 10 52 48 46 43 39 35 33 29 58 07 -13 -19 47 50 55 52 56 57 57 51 51 42 36 32

44

48 55 10 39 26

-14 49 44 30

41

44 50 21 38 25 07 41 41 30

Ye Weights 197amp2

Four Quarters Ending

1993 01

1993 Q2

1993 1993 1994 1994 Q3 Q4 01 02

1994 Q3

1994 Q4

100000

65140 7900 4870 2790 1350 1170 2810 6870

40

42 47 27 36 22 32 31 40

43

45 46 31 35 22 42 32 43

46 48 50 50

50 52 54 54 47 47 46 44 33 36 40 41 35 35 35 35 23 23 24 27 45 45 38 33 34 37 42 41 46 48 50 50

50

55 41 44 34 31 33 41 50

51

56 39 45 34 40 37 40 51

may not sum to total

NOTES Data for 1991 are historical Data for 1992 are partly historical and partly forecasted Data for 1993 and 1994 are forecasted Q dasignates quarter of year Percent change data shown are four quarter moving averampQes The following Is an e)(ample of how a percent change Is calculated Use the quarterly tnde)( levels shown In Tablas 9 11 and 13 Choose the four-quarter period ending for which you would like to calculate the percent change (eg yearernl1993 Quarter 3) Count back three quarters so that you hevea total of four(eg 1993 Ouarter3 1993 Quarter 2 1993 Quarter 1 1992 Ouarter 4) Average these four quarters (add the lnde)( levels and divide by4) Now take the four quarters previous to the four quarters that you just used (eg 1992 Quarter 3 1992 Quarter 2 1992 Quarter 1 1991 Quarter 4) Average these four quarters Finally compute a percent change using the two averampQes

SOURCES Health Care Financing Administration Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992 forecasts were made by Data Aellourcas IncMcGraw-Hill

Health Care Financing Revlew1Sprlng19931Voluma 14 Number 3 270

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 13 Quarterly Index Levels of the Home Health Agency Input Price Index

by Expense Category 1991middot94 Expense Category 1

Year Weights 19762

1991 01

1991 02

1991 03

1991 04

1992 01

1992 02

1992 03

1992 04

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent Non-Rental Space Occupancy Medical and Nursing Supplies Contract Services Miscellaneous

Total

Wages and Salaries Employee Benefits Transportation Office Costs Rent NonmiddotRental Space Occupancy Medical and Nursing Supplies Contract SeiVices

1

100000

65140 7900 4870 2790 1350 1170 2610 6870 7100

2696

2797 2617 2248 2761 2315 2579 2336 2696 2389

2744

2859 2659 2234 2791 2335 2474 2392 2744 2384

2788

2911 2692 2245 2819 2355 2497 2410 2788 2400

2811

2933 2722 2265 2844 2370 2541 2446 2811 2421

2832

2954 2769 2257 2873 2385 2482 2481 2832 2438

2848

2967 2791 2290 2899 2394 2510 2485 2848 2458

2888

3016 2815 2305 2919 2405 2566 2498 2688 2474

2928

3063 2847 2327 2946 2423 2608 2516 2928 2495

Base Year

Weights t9762

1993 01

1993 02

1993 03

1993 04

1994 01

1994 02

1994 03

1994 04

100000

65140 7900 4870 2790 1350 1170 2810 6870

2958

3095 2896 2324 2973 2434 2629 2536 2958 2513

2988

3125 2924 2380 2999 2450 2648 2589 2988

3031

3179 2950 2395 3025 2465 2667 2602 3031

3070

3225 2975 2421 3049 2474 2684 2625 3070

3108

3267 3018 2435 3074 2500 2710 2644 3108

3136

3295 3040 2483 3100 2531 2738 2687 3136 2607

3186

3357 3063 2492 3127 2575 2771 2708 3186 2627

3230

3409 3086 2529 3154 2613 2798 2727 3230

I rounding

NOTES Data lor 1991 are historical Data for 1992are partly historical and partly forecasted Data lor 1993 and 1994 are forecasted Q designates quarter of year

SOURCES Health Care Financing Adminstratton Office of the Actuary Data from the Office of National Health Statistics Division of Health Cost Analysis Fourth quarter 1992forecasts were made by Data ResourceslncJMcGraw-HIII

Health Cere Financing ReviewSpring 1993Jvolume 14 Number3 271

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 14 Selected National Economic Indicators 1989-92

Calendar Year 1969 1990 1991 1991 1992 1992 1992

Indicator 1989 1990 1991 03 03 03 04 01 02 03

Gross Domestic Product Billions of Dollars $5251 $5522 sssn $5279 $5560 $5713 $5753 $5840 $5902 $5982 Billions of 1987 Dollars $4838 $4878 $4821 $4839 $4883 $4832 $4838 $4874 $4892 $4939 Implicit Price Deflator (1987 = 1000) 1085 1132 1178 1091 1139 1182 1189 1198 1206 1211

Employment Hours and Earnings Unemployment Rate All Workers 53 55 68 53 56 66 70 72 75 76

Private Non-Agricultural Workers Total Employment in Thousands 90550 91478 89930 91413 92348 90649 90314 88256 89982 90665 Average Weekly Hours 346 345 343 346 348 346 345 341 344 346 Average Hourly Earnings $965 $1001 $1033 $967 $1004 $1034 $1046 $1052 $1054 $1058

Health Services Workers Total Employment in ThOusands 7484 7831 8177 7535 7896 8239 8307 8357 8432 8510 Average Weekly Hours 325 325 325 326 328 327 326 328 326 329 Average Hourly Earnings $982 $1040 $1096 $990 $1046 $1104 $1115 $1123 $1130 $1144

Personal Income and Savings Income in Billions $4380 $4664 $4828 $4389 $4693 $4846 $4907 $4981 $5029 $5060 Disposable Income In Billions $3787 $4043 $4210 $3795 $4065 $4228 $4285 $4361 $4412 $4431 Savings In Billions $152 $176 $200 $129 $157 $191 $219 $215 $232 $201 Personal Savings Rate 40 44 47 34 39 45 51 49 53 45

Prlces1

Gross Domestic Product FixedmiddotWeight Price Index (1987 = 101JO) 1086 1135 1181 1092 1142 1186 1193 1204 1213 1220

Consumer Price Index All Items 1240 1307 1362 1247 1316 1367 1377 1387 1398 1409 All Items Less Medical Care 1224 1288 1338 1231 1296 1343 1351 1360 1370 1380

Apparel and Upkeep 1186 1241 1287 1167 1233 1280 1317 1305 1325 1309 Energy 943 1021 1024 971 1038 1031 1018 993 1026 1058 Food and Beverages 1249 1321 1368 1256 1327 1368 1369 1383 1385 1387 Housing Shelter 1328 1400 1463 1339 1419 1472 1479 1498 1505 1520

Medical Care 1492 1628 1770 1507 1648 1787 1817 1859 1887 1915

Producer Price lndex2 Finished

lnde~

NOTES Q designates quarter of year Quarterly data are not seasonally adjusted SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1989-November 1992 US Department of Labor Bureau of Labor Statistics Employment and Earnings Washington US Government Printing Office Monthly reports for January 1989-0ecember 1992

Health Care FJnancJng RelewiSpring 1993volume 14 N~~mber3 272

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Table 15 Percent Change in Selected National Economic Indicators 1989middot92

Indicator

Calendar Year 1989 Q3

1990 Q3

1991 Q3

1991 Q4

1992 Q1

1992 Q2

1992 Q3 1969 1990 1991

Gross Domestic Product Billions of Dollars Billions of 1987 Dollars Implicit Price Deflator (1987 =

1000)

Employment Hours and Earnings Unemployment Rate All Workers1

Private Non-Agricultural Workers Total Employment Average Weekly Hours Average Hourly Earnings

Health Services Workers Total Employment Average Weekly Hours Average Hourly Earnings

Personal Income and Savings Income Disposable Income Savings Personal Savings Rate1

Prices2

Gross Domestic Product Fixedmiddot Weight Price Index (1987 = 1000)

Consumer Prlce Index All Items All Items Less Medical Care

Apparel and Upkeep Energy Food and Beverages Housing Shelter

Medical Care

Producer Prlce lndex3 Finished Consumer Goods

Annual Percent Change

72 52 28 25 08 -12

45 43 40

-02 03 12

27 10 -17 -03 -03 -06

40 37 31

51 48 44 01 03 -00 67 59 53

75 65 35 67 68 41

-23 155 137 -03 03 04

45 45 40 48 54 42 46 52 39 28 46 37 57 82 04 57 58 36 45 54 45 77 91 87

56 55 19

Percent Change

67 53 22 09

44 44

-02 03

24 10 -02 -01

41 38

49 48 03 05 69 57

70 69 62 71

-153 219 -09 05

44 48 47 55 44 53 20 57 57 68 52 58 46 60 77 93

49 54

From the Same

28 35 -10 01

38 34

12 10

-18 -14 -06 01

30 30

43 43 -03 02

55 51

33 33 40 38

214 159 06 05

39 34 39 30 36 26 39 37

-07 -81 31 24 37 38 85 80

17 -11

Period of Previous

46 43 16 16

29 27

08 07

-06 01 08 04 29 24

40 37 13 03 46 36

48 46 54 53

113 189 02 06

32 31 29 31 26 28 34 28

-37 09 16 08 36 35 78 77

-02 11

Year

47 22

24

08

00 01 24

33 06 36

44 48 52 00

29 31 26 22 26 14 33 72

16 Chaoge In rate rather than percent chaoge

2Base period = 1982a4 unless noted 3Fonnerly called the Wholesale Price Index

NOTE Q designates quarter of year SOURCES US Department of Commerce Bureau of Economic Analysis Survey of Current Business Washington US Government Printing Office Monthly reports for January 1988-November 1992 US Department of Labor Bureau of Labor Statistics Employment tmd Earnings Washington US Government Printing Office Monthly reports for January 1988-December 1992

Health Care Financing RevlewiSprlng 19931votumet4Numbampr3 273

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Figure 1 Percent Change In Inpatient Days and Outpatient Visits From Same Period of Previous Year

1983-92

15 ---- OUipatlentVislts -- Inpatient Days

10

5 bull ~ v bull

0 f

~ -5

-10

1983 1984 1985 1986 1987 1988 1989 1990 1991 1992

Quarters

SOURCE American Hospital Association NiltiQnalHospital P6n81Survey Repqrl$ Chicago Monthly reports for January 1982shySeptember 1992

Health care Financing ReviewSpring 1993Volume 14 Numbef3 274

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Flgure2

Percent Change In Beds and Level Change In Occupancy Rates From Same Period of Previous Year 1983-92

2

rJ

v

---- Level Change in Occupancy Rates -- Percent Change in Beds r-- I

1983 1984 1985 1999 1997 1988 1999 1990 1991 1992

Quarters

SOURCE American Hospital Association N81ftmafHospital Psn81 SutvBy Repmts Chicago Monlhtj reports for January 1982middot September 1992

Heallh Care Financing RevlewiSpring 1993volume 14 Number3 275

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Flgure3 Percent Change In Employment From Sama Parlod of Previous Year 1983-92

8 ---- Heallh Servke Total Employmeot --All Private Total Employmeot

6

4

1983 1984 1985 1998 1987 1988 1989 1990 1991 1992

Qua

SOURCE US Department of Labor Bur8MJ ol Labor Statistics EmpoymMitandampmings Washington US Government PrinUng Office Monlhly 1t1porl$for January 1982middotDecember 1992

Health Care Financing ReviewSprlng19931volume 1bull Numbet 3 276

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Flgure4 Percent Change for Non-supervisory Payroll From the Same Period of Previous Year 1983-92

14 ----All Private Non-Agricultural

-- Private Heahh Establishments

12 r

I 10 f

8 l ~ _ A_ _t v

~ bull I ---

_ 4 - rshy I

2 I L_

0

1983 1984 1985 1888 1987 1888 1968 1990 1991 1992

Quarters

SOURCE US Department of Labor Burvau of labor Statistics Employtnt1ftl sndEaming$ Washington US Government Ptinling Office MonlhiY reports forJanuafy 1982-December 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 277

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Figure 5 Percent Change for Non-supervlsory Work Hours From the Same Period of Previous Year 1983-92

8 ---- All Private Non-Agricultural --Private Health Establishments I bull

I

I --J

1983 1984 1985 1998 1997 1998 1989 1990 1991 1992

oua SOURCE US Deptlflment of Labor Bul88u of Labor statistics EmpoylnenlandEamings WashillglOn US Govemrnent Printing Office Monthly reports for January 1982middotDecember 1992

Health Care Financing ReviewiSpring 1993votume 14 Number 3 278

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Figure 6 Percent Change In Moosures of Price Inflation From tho Same Period of Previous Veer 1983-92

12 middotmiddotmiddotmiddotmiddotmiddotmiddotmiddotGross Domestic Product Fixed-Weight Price Index

---- Consumer Price Index - MedcaJ care --Consumer Price Index - AI Items 10 --

- r shy - r_ _bull - --

---- __ _ I shy---

---shyr 0 bull bull - bullbullv bull bull bull bull- bull bull- bullbull bull middot4 middotmiddot--shy

2

1983 1964 1985 1988 1987 1988 1989 1990 1991 1982

shy

SOURCES US Depanmlnt of Labor Bureau of Labor Statli1ies CP1 De1aHlaquo1R8polt WashingtOn US GowrM1ent Printing Otftoe MoNtlly lepOft$ for January 1982-$eplembel 1992 us Depamnentol Commeloe Bunlau ol Economic Analysis SulwyofCUmlntBusnes$ Washington US Govemmant Printing Office Monlhly 18p01t8 for JanuaJy 1982-November 1992

Health Care Ananclng ReviewSpring 19931volume 14 NumberS 279

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

Figure 7

Percent Change In Measures of Price Inflation From the Same Period of Previous Year 1982-92

14shy

12shy

I 10shy

f middotshymiddotshy

----Medical care SeMces middotbullbullbullbull bullbullmiddot Medical Care Commodities

SOURCES US Departmenl Ql Labor Bureau of Labor Slallslics 0P1DetaiiBdRepolt Washington US Govemment Printing Office Monlhly reports for January 1982-8eptember 1992 US Department of COmmerce Bureau of Economic AnalysiJ SurYsyofCflmlf1f Buslness Washington US Government Printing Office Monthly reports for January 1982-November 1992

Health Care Financing ReviewSpring 1993volume 14 Number3 280

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281

FigureS Percent Change In lndlcatora of National Economic Activity From the Same Period of Previous Year

1983-92

12shy

10shy

middotshymiddotshy2 shy

----Unemployment Rate Level

bullbullbullmiddot bullmiddot middot middot Real Gross Domestic Product

~ - ---------shy -shy -_ -----shy -shy _________

-middot middot middot

bull 8 bullbullbull bull bullbullbull

bull middotmiddotmiddot middot - bullmiddot

middotmiddotmiddotmiddotmiddot---~-- middotmiddotbull

-middotmiddotmiddotmiddot bull-~middotmiddot middotmiddot middotmiddotmiddotmiddotmiddotmiddot- o-t----------------------------------~~--~---

__ middot2shy middot-middotmiddotmiddotmiddot

1983 1984 1985 1988 1987 1988 1988 1990 1991 1992

SOURCES US DepMrnent of COmrnelce Bureau of Economic Analysis SliMyo1CUiftlnlBuslntw Wullngkln us Govemmenl PrinllngOffice Monthly reports of January 1982-Novelnbel 1992 us DepaMienl of Labor Bureau of Labor Stalistlca EmploymtlfltlltldEwning$ Washlnglon US Government Printing Office Monthly repotts for Januaty 1982shyDecember 1992

Htth Care Financing RevlewiSprlng 1tll31voltlme1-4Numbw3 281