Each chapter begins with an introduction, presenting the key findings.

Section 1: Demographics

We describe the demographics of the chapter’s survey sample. These include organization-size demographics, including organization gross revenue, number of hospitals/buildings, number of satellite facilities, number of beds, staff, and number of specialties.
We continue with financial demographics, including net patient revenue, operational budget, capital budget, personnel budget, and technology budget.
This section concludes with patient volume metrics, which include admissions per year, outpatient visits per year, ER visits per year, and telehealth classes per year.

Section 2: Basic Performance Metrics

This section provides an overview of essential performance indicators used to assess operational efficiency and workforce management in healthcare organizations. We also calculate the utilization rates of medical imaging and perioperative technologies. Together, these metrics offer a comprehensive view of how effectively healthcare facilities manage patient care delivery, optimize resource use, and maintain workforce stability. It includes the following metrics:

• Emergency room wait time
• Length of patient stay
• Bed occupancy rate
• Bed turnover time
• Perioperative and imaging technologies utilization rates
• Medical inventory turnover time
• Staff overtime hours per week
• Staff voluntary turnover
• Time in days to hire staff
• Contingency workers as a percentage of medical staff

Section 3: Financial Metrics

This section focuses on the economic dimensions of healthcare delivery. Financial metrics provide critical insights into how effectively organizations convert resources into value, manage costs, and maintain long-term viability. We examine measures such as revenue per bed, per patient, and per staff member, alongside cost per discharge, to assess productivity and cost efficiency. We also analyze budget allocations by category as an average share of operational spending, as well as technology investments expressed as a percentage of revenue, operating expenses, and on a per-staff basis. The section comprises the following metrics:

• Net patient revenue per bed
• Net patient revenue per patient
• Net revenue per staff member
• Revenue vs. cost per encounter
• Budget categories as average percentage of total operational spending
• Technology spend as a percentage of revenue
• Technology spend as a percentage of total operational budget
• Technology spend per staff member

Section 4: Staffing Metrics

This section provides staffing metrics and composition trends for all healthcare providers. The total head count includes clinical and nonclinical personnel, with further breakdowns by role type such as physicians, nurses, administrative staff, and support services. In addition to overall staffing numbers and percentage distributions, this section also examines the staff-to-bed ratio—a useful indicator of resource allocation and operational capacity. It includes the following metrics:

• Total staff by type
• Total staffing mix
• Doctors staffing mix
• Nurses staffing mix
• Allied health staffing mix
• Support personnel staffing mix
• Staff per bed

Section 5: Revenue Cycle Management Metrics

This section focuses on financial processes that govern how healthcare organizations capture, manage, and collect revenue from patient services. Revenue cycle management (RCM) metrics provide visibility into the efficiency and accuracy of billing, claims submission, and reimbursement workflows. These are:

• Total claims submitted
• Distribution of claims by category
• Submission rates for electronic claims
• Percentage of claims seeking prior authorization
• Percentage of fully electronic prior authorization claims
• Prior authorization approval rate
• Time from submission to approval
• Claims denial rate
• Average time to reimbursement for all claims
• Average time to reimbursement by type
• Length of time in accounts receivable (A/R)
• Clean claims rate
• Average resubmissions/amendments for unclean claims
• Value of write-offs
• Reasons for write-offs

Section 6: Compliance and Error Rate

This section examines key indicators that reflect the quality, safety, and regulatory adherence of healthcare organizations. Compliance and error-related metrics are essential for evaluating patient safety, operational reliability, and adherence to industry standards. It covers the following:

• Total HIPAA breaches
• Percentage of HIPAA breaches by tier
• Medication error rate
• Medication adherence rate
• Vaccination compliance rate
• Hospital-acquired infection rate
• Readmission rate

Section 7: Technology and Vendor Adoption

This section explores the adoption of key technology platforms and vendor solutions across healthcare organizations. It includes data on the most commonly used Electronic Health Record (EHR) systems, the degree to which these systems are embedded within the organization (EHR system residency), and the current status of clinical and operational technologies. It includes:

• EHR solutions in use across organizations
• EHR system data residency
• Current technology status for clinical and operational use

APPENDIX

The Appendix includes common terms and definitions used in our annual survey and in this study. It also includes a detailed definition for all healthcare provider spending and staffing categories. The Appendix concludes with a brief discussion of the statistics used in this study.

• Common Terms and Definitions
• Spending Category Definitions
• How We Define Staffing Categories
• Statistical Notes