Top California hospitals ranked by inpatient metrics reveal Southern California dominance

The recent meeting of the Health Care Affordability Advisory Committee, held on February 13, 2025, focused on critical metrics regarding hospital performance in California. The discussions highlighted significant disparities in hospital financial health and operational efficiency, which have implications for health care affordability across the state.

The committee presented data on five key metrics, excluding certain types of hospitals such as critical access and psychiatric facilities. The analysis revealed that the average inpatient net patient revenue (NPR) per case mix adjusted discharge (CMAD) for the top 30 hospitals ranged from $54,000 to $18,000, with a statewide median of approximately $13,000. This stark contrast underscores the financial challenges faced by many hospitals, particularly those serving vulnerable populations.

In terms of commercial inpatient NPR, the top hospitals averaged between $57,000 and $28,000, with a median of $18,000. The growth metric for inpatient NPR showed a wide range, from a high of 66% to a low of 7%, with a statewide median growth rate of just 2%. This indicates that while some hospitals are experiencing significant revenue growth, many others are stagnating, raising concerns about sustainability and access to care.

The average operating margin for the top hospitals varied significantly, from 39% to 12%, with a statewide median of only 3%. This low median suggests that many hospitals are operating on thin margins, which could impact their ability to invest in services and infrastructure.

Geographically, the data revealed a concentration of high-performing hospitals in Los Angeles County and the Bay Area, with many of the top hospitals also designated as teaching or academic medical centers. This concentration raises questions about equitable access to quality health care across different regions of California, particularly in underserved areas.

The committee's findings emphasize the need for ongoing monitoring and strategic interventions to address disparities in hospital performance. As the state grapples with health care affordability, these metrics will be crucial in guiding policy decisions and ensuring that all Californians have access to high-quality care.

Looking ahead, the committee plans to continue its analysis and engage with stakeholders to develop actionable strategies aimed at improving hospital performance and health care affordability statewide. The discussions from this meeting highlight the critical intersection of hospital financial health and community health outcomes, underscoring the importance of addressing these issues in future policy initiatives.