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Insurance and public payers have pushed to make more care outpatient or delivered at less intensive facilities.

Occupancy rates have declined even as the number of licensed beds has gone down (with population increasing substantially, so the per capita effect is even bigger):

https://www.cdc.gov/nchs/data/hus/2015/089.pdf

Especially look at small hospitals, which Medicare pays using a different formula to help keep them open (which isn't a bad thing, it increases access to care for lots of people).




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