Hospitals

Types of Hospitals

Generally speaking, there are seven types of hospitals in the United States:

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• Academic medical centers (AMCs) are hospitals intimately affiliated with medical schools. Such facilities typically have teaching and research missions in addition to providing clinical inpatient care. Clinical services in such centers usually include a complete array of services and the ability to provide care to individuals who have the most rare physical problems. These facilities are usually owned by the associated academic institution.
• Veterans Administration (VA) hospitals are facilities across the United States designed and maintained to provide care to veterans of the various U.S. uniformed services who seek care through these institutions. Clinical services in these hospitals are designed to meet the needs of veterans and do not include obstetric, newborn, or pediatric care. Physicians affiliated with VA facilities typically are employed by the institute either on a full-time or part-time basis. These hospitals are owned by the Veterans Administration.
• Public hospitals are typically large, inner-city facilities that are supported by local taxes. Such institutions frequently are affiliated with medical schools that provide the majority of the institution's medical staff. These facilities were originally developed to provide charity care to individuals with limited financial resources. Public hospitals are usually owned by local government.
• Not-for-profit community hospitals are the most common type of facility. These facilities agree to provide a minimal level of community service in exchange for notfor-profit status, which excludes these facilities from property and business taxes. Most not-for-profit community hospitals have open medical staffs. Physicians who practice medicine in the community apply for clinical privileges at the community hospital and are granted such privileges after review of their training credentials and experience. Not-for-profit hospitals are tax exempt and are owned by their respective not-for-profit foundations.
• For-profit community hospitals are basically the same as not-for-profit institutes except for their tax status. These institutions have access to public markets in order to raise capital, as opposed to bond markets, which are used by notfor-profits. Medical staff in for-profit facilities typically are physicians in the community who apply for privileges based on their training and experience. For-profit facilities are owned by a public company.
• Rural hospitals are facilities located in counties outside standard metropolitan statistical areas. These facilities may be for-profit or not-for-profit and attract medical staff from their area to apply for privileges based on their training and experience. Rural hospitals are so designated by the U.S. Public Health Services and are recipients of federal support to assure their continuation. Rural hospitals may be not-for-profit or for-profit and owned either by a not-for-profit foundation or a for-profit company, respectively.
• Specialty hospitals have existed in the fields of obstetric/newborn, pediatric, and orthopedic care for many years. These facilities may be not-for-profit or for-profit, and services are limited to their particular area. Medical staffs are typically specialists in the hospital's fields who practice in the community and apply for privileges based on their training and experience. Recently, other types of specialty hospitals have emerged. These have been heart hospitals or other specialty areas that are owned, in part, by physicians. These hospitals' medical staff typically is composed of physicians who have an equity position in the facility. Pediatric hospitals in the United States tend to be affiliated with medical schools and may be owned by the academic center. Ownership of other specialty facilities may vary as suggested earlier.

Scope of Service

The scope of service at America's hospitals varies considerably. Generally most academic medical centers offer essentially all approved services. These facilities also tend to participate in significant numbers of research programs, thereby offering some treatments that have not yet received FDA approval.

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