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The Evolving Private Psychiatric Inpatient Market

  • Erica C. HutchinsEmail author
  • Richard G. Frank
  • Sherry A. Glied
Article

Abstract

The private psychiatric hospital market has exhibited great volatility over time. From 1976 to 1992, the number of hospitals more than doubled, while in the decade following, the number of facilities dropped by half. Recently, however, the industry has begun to grow again. The evolution of this market reflects the response of a private industry with access to capital markets to changes in both the supply of substitutes and the demand for services. Most recently, the limited supply of facilities and expanded demand for psychiatric services have spurred renewed growth. The two leading firms today, Universal Health Services, Inc., which rode the market crest and downturn since the 1980s, and Psychiatric Solutions, Inc., a newer entrant, have employed different strategies to take advantage of these opportunities. The rapid responsiveness of the private psychiatric hospital market, as exemplified by these two firms, presents significant potential for shaping future mental health policy.

Keywords

Psychiatric Hospital Occupancy Rate Market Leader Behavioral Health Care Prospective Payment System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Gellar J. A history of private psychiatric hospitals in the USA: from start to almost finished. Psychiatric Quarterly. 2006;77(1):1–41.CrossRefGoogle Scholar
  2. 2.
    Fine J, Super KE. Repeal of some States’ CON laws spurs psych hospital construction. Modern Healthcare. 1986;16(21):74–76.Google Scholar
  3. 3.
    Salinsky E, Loftis C. Shrinking inpatient psychiatric capacity: cause for celebration or concern? National Health Policy Forum Issue Brief No. 827. August 1, 2007.Google Scholar
  4. 4.
    Dorwart R. Privatization of psychiatric services. The American Journal of Psychiatry. 1988;145(5):543–553.PubMedGoogle Scholar
  5. 5.
    Frank RG, Koyanagi C, McGuire TG. The politics and economics of mental health ‘parity’ laws. Health Affairs. 1997;16(4):108–119.CrossRefPubMedGoogle Scholar
  6. 6.
    Weithorn L. Mental hospitalization of troublesome youth: an analysis of skyrocketing admission rates. Stanford Law Review. 1988;40(3):773–838.CrossRefPubMedGoogle Scholar
  7. 7.
    Frank RG, Glied SA. Better but not well: mental health policy in the United States since 1950. Baltimore: Johns Hopkins University Press; 2006.Google Scholar
  8. 8.
    Levenson A. Growth of investor-owned psychiatric hospitals. American Journal of Psychiatry. 1982;39(7):902–907.Google Scholar
  9. 9.
    Gellar J. The last half-century of psychiatric services as reflected in psychiatric services. Psychiatric Services. 2000;51(1):41–67.Google Scholar
  10. 10.
    Levenson A. Issues surrounding the ownership of private psychiatric hospitals by investor-owned hospital chains. Hospital and Community Psychiatry. 1983;34(12):1127–1131.PubMedGoogle Scholar
  11. 11.
    Mark TL, Coffey RM. What drove private health insurance spending on mental health and substance abuse care, 1992–1999? Health Affairs. 2003;22(1):165–172.CrossRefPubMedGoogle Scholar
  12. 12.
    Manderscheid RW, Berry J (eds). Mental Health, United States, 2004. U.S. Department of Health and Human Services.Google Scholar
  13. 13.
    Lave J. Developing a Medicare prospective payment system for inpatient psychiatric care. Health Affairs. 2003;22(5):97–105.CrossRefPubMedGoogle Scholar
  14. 14.
    Scotto E. Specialty healthcare services. Needham & Company Industry Report 2003.Google Scholar
  15. 15.
    Kerr P. Charter medical and Texas settle a case. New York Times. January 1, 1993.Google Scholar
  16. 16.
    Nodell B. National medical enterprises persuades wall street. Los Angeles Business Journal. November 22, 1993.Google Scholar
  17. 17.
    Freudenheim M. Hospital Corp. Drops Psychiatric Unit Sale. New York Times. December 21, 1989.Google Scholar
  18. 18.
    Hospital Corporation of America, 2007, Form 10-K, retrieved June 5, 2008, from Edgar Online database, http://www.sec.gov/edgar.shtml.
  19. 19.
    Magellan Health Services, Inc., 2007, Form 10-K, retrieved June 5, 2008, from Edgar Online database, http://www.sec.gov/edgar.shtml.
  20. 20.
    Community Psychiatric Centers (CPC) Company History, retrieved on June 5, 2008, from Thomson ONE Banker database, http://banker.thomsonib.com.
  21. 21.
    Annual Survey: Behavioral Healthcare Delivery Today. National Association of Psychiatric Health Systems.Google Scholar
  22. 22.
    Costa P. The U.S. hospital industry. ABN AMRO Industry Report. 2001.Google Scholar
  23. 23.
    Covall M. Medicare prospective payment comes to psychiatric hospitals: the long-awaited Medicare. Behavioral Health Management. January 1, 2005.Google Scholar
  24. 24.
    Lehrich D. Behavioral health care: ‘Three Pillars’ stand strong. Deutsche Bank Industry Report. June 26, 2006.Google Scholar
  25. 25.
    Lehrich D. Behavioral health care: solid fundamentals remain in place. Deutsche Bank Industry Report. September 5, 2007.Google Scholar
  26. 26.
    Morgan F. Industry update: inpatient psychiatric facility prospective payment system. Jefferies Industry Report. November 25, 2003.Google Scholar
  27. 27.
    Mark TL, Levit KR, Buck JA, et al. Mental health treatment expenditure trends, 1986–2003. Psychiatric Services. 2007;58(8):1041–1048.CrossRefPubMedGoogle Scholar
  28. 28.
    Hough J. The SmartMoney.com EV/EBITDA screen. SmartMoney Magazine. April 16, 2003.Google Scholar
  29. 29.
    Ferris K, Pecherot Petitt B. Valuation: avoiding the winner’s curse. Upper Saddle River: Financial Times Prentice Hall Books; 2002.Google Scholar
  30. 30.
    Universal Health Services, Inc. (UHS), 2007, Form 10-K, retrieved June 5, 2008, from Edgar Online database, http://www.sec.gov/edgar.shtml.
  31. 31.
    Fong T. San Diego-based psychiatric services company to merge with Tennessee firm. Knight Ridder/Tribune Business News. May 7, 2002.Google Scholar
  32. 32.
    Psychiatric Solutions, Inc. (PSYS), 2007, Form 10-K, retrieved June 5, 2008, from Edgar Online database, http://www.sec.gov/edgar.shtml.
  33. 33.
    Universal Health Services, Inc. (UHS), 2008, Q1 2008 Earnings Call, 25 April, retrieved June 6, 2008, from Thomson ONE Banker database, http://banker.thomsonib.com.
  34. 34.
    Kershaw S. The Murky politics of mind–body. New York Times. March 30, 2008.Google Scholar
  35. 35.
    Jeffrey S. Mental health parity bill passes house, but differs from senate bill. Medscape Medical News. March 7, 2008.Google Scholar
  36. 36.
    Universal Health Services, Inc. (UHS), 2008, Q4 2007 Earnings Call, 29 Feb, retrieved June 6, 2008, from Thomson ONE Banker database, http://banker.thomsonib.com.
  37. 37.
    President’s New Freedom Commission on Mental Health. Achieving the promise: transforming mental health care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD: 2003; 79–85.Google Scholar
  38. 38.
    U.S. Department of Health and Human Services. Mental health: a report of the surgeon general—executive summary. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999; 171, 258, 287–288.Google Scholar

Copyright information

© National Council for Community Behavioral Healthcare 2009

Authors and Affiliations

  • Erica C. Hutchins
    • 2
    Email author
  • Richard G. Frank
    • 3
  • Sherry A. Glied
    • 1
  1. 1.Department of Health Policy and Management, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  2. 2.New YorkUSA
  3. 3.Department of Health Care PolicyHarvard Medical SchoolBostonUSA

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