As managed care's share of a metropolitan market grows, hospitalization costs are more tightly controlled and hospital lengths of stay come down. That's what common sense suggests, and that's what a recent study bears out. But there are anomalies. In Milwaukee and Miami, for example, higher-than-average hospital costs coexist with fairly heavy managed care penetration. The maps below show how 20 of the nation's largest metropolitan areas fared in the study, which drew on a data base of 11.7 million patients discharged from 3,700 acute care hospitals.
Hospital costs by metropolitan area, vs. national average
| ATLANTA | -2.41 |
| BALTIMORE | +0.38 |
| BOSTON | -6.45 |
| CHICAGO | +6.34 |
| CLEVELAND | +1.02 |
| DALLAS | +3.94 |
| DETROIT | -2.66 |
| HOUSTON | +32.82 |
| LOS ANGELES | -16.15 |
| MIAMI | +10.47 |
| MILWAUKEE | +13.60 |
| MINNEAPOLIS-ST. PAUL | -3.61 |
| NEW YORK | -9.28 |
| PHILADELPHIA | +0.23 |
| PITTSBURGH | +2.67 |
| ST. LOUIS | +7.49 |
| SAN DIEGO | -10.00 |
| SAN FRANCISCO | -32.24 |
| SEATTLE | -18.46 |
| WASHINGTON | +6.21 |
Hospital lengths of stay by metropolitan area, vs. national average
| ATLANTA | -7.70 |
| BALTIMORE | -2.77 |
| BOSTON | -2.41 |
| CHICAGO | -3.76 |
| CLEVELAND | -5.70 |
| DALLAS | -14.13 |
| DETROIT | +4.65 |
| HOUSTON | +2.14 |
| LOS ANGELES | -17.81 |
| MIAMI | -2.81 |
| MILWAUKEE | -0.54 |
| MINNEAPOLIS-ST. PAUL | -18.92 |
| NEW YORK | +50.07 |
| PHILADELPHIA | +11.50 |
| PITTSBURGH | +3.69 |
| ST. LOUIS | -5.06 |
| SAN DIEGO | -26.07 |
| SAN FRANCISCO | -20.32 |
| SEATTLE | -25.54 |
| WASHINGTON | +8.92 |
Percentages are adjusted for severity differences.
SOURCE: KPMG PEAT MARWICK LLP, COSTA MESA, CALIF. (CALL 800-243-1397 FOR A COPY OF THE STUDY'S EXECUTIVE SUMMARY.)