value declines, varies widely within ratings, systems In 2017, , employers, Medicare and Medicaid paid St. Louis more than $9.9 billion for inpatient and outpatient hospital care, up 2.2% compared to the prior year adjusted for inflation. The Average Payment Adjusted for Mix across all payers was $5,312, slightly below the previous year. The average payment amount varied widely among hospitals and within systems, as shown in the table below. Barnes-Jewish Hospital garnered the largest average payment while OSF Saint Anthony's Health Center (Alton) received the lowest.

The four largest hospital systems - BJC, SSM, Mercy and St. Luke's - accounted for approximately 91% of overall patient revenue in the St. Louis hospital market in 2017. However, exercise caution when comparing average payments among hospitals within each system and across the region. Patient volumes vary considerably at the individual hospital level. As mentioned earlier in the report, Medicare star ratings and average payments provide a starting point for consumers when planning ahead for hospital care for themselves and their families. Choosing a hospital is a complex and personal decision that reflects individual needs and preferences. People should consider a variety of factors when choosing a hospital, such as physician guidance about care needs and other sources of information specific to a patient's medical condition or procedure, such as rates of complications and patients' experiences. Based on this information, patients have a better opportunity to find the best value hospital that meets their health care needs. St. Louis Area Non-Profit Hospitals Value Comparison, 2016 - 2017 Quality Financial Average Payment 1 Medicare Star Adjusted for Patient % Operating System Name (market share ) 1 (Excludes Pediatric, Critical access and Rural Hospitals) Rating Mix (All-Payer) Change Margin 2016 2017 2016 2017 2016 2017 BJC HealthCare (35.59%) Alton Memorial 2 1 $4,931 $4,108 -16.7% 5.76% -0.63% Barnes-Jewish Hospital 2 2 $7,790 $7,919 1.7% 2.82% 3.26% Barnes-Jewish - St. Peters 2 2 $5,231 $4,889 -6.5% 10.75% 8.22% Barnes-Jewish W. County 5 3 $4,853 $4,527 -6.7% 13.26% 12.28% Christian Hospital 2 1 $4,914 $4,843 -1.4% -3.64% -12.60% Memorial Hospital 3 2 $5,437 $5,727 5.3% 0.86% 2.42% Memorial Hospital East 3 $4,711 -34.18% Baptist Med. Ctr. 4 4 $5,769 $5,753 -0.3% 7.33% 5.87% Progress West Hospital 3 4 $5,489 $5,500 0.2% 6.83% 2.58% SSM Health (26.45%) DePaul Hospital 2 2 $5,214 $5,205 -0.2% 11.18% 9.93% St. Clare Hospital 3 4 $5,888 $5,720 -2.8% 2.44% 4.01% St. Joseph Hospital (St. Charles)2 2 2 $4,847 $4,575 -5.6% 3.71% 2.13% St. Joseph Hospital-West 3 4 $4,437 $5,237 18.0% 11.25% 6.51% Saint Louis University Hospital 1 1 $9,052 $7,691 -15.0% 5.70% -6.65% St. Mary's Hospital 3 2 $4,939 $5,452 10.4% 3.65% 2.41% Mercy (22.15%) Mercy Hospital Jefferson 2 3 $5,299 $4,493 -15.2% 7.57% 7.95% Mercy Hospital St. Louis 5 5 $5,831 $6,206 6.4% 16.64% 15.50% Mercy Hospital 5 4 $4,110 $4,779 16.3% 15.93% 12.68% Mercy Hospital South3 2 1 $4,573 $4,187 -8.4% -1.18% -13.79% St. Luke's Hospital (4.91%) St. Luke's Des Peres Hospital4 2 2 $6,325 $6,244 -1.3% -1.60% -3.05% St. Luke's Hospital 5 5 $5,672 $5,979 5.4% 2.98% 4.38% Hospital Sisters (3.22%) St. Elizabeth's Hospital 3 3 $4,553 $4,887 7.3% -33.10% -20.27% Non-Merged Anderson Hospital (2.41%) 3 3 $4,363 $4,118 -5.6% 1.93% 5.08% Jersey (0.23%) 3 4 $3,724 $4,000 7.4% 3.33% 1.66% OSF Saint Anthony's Health Ctr. (0.98%) 3 3 $3,899 $3,928 0.7% -11.92% -8.08% Hospitals' Payment Average, not adjusted by volume5 $5,337 $5,312 -0.5%

1 Market share percentages for each network are based on total number of discharges for the hospitals in the network. configurations are current as of 2019. The Average Payment Adjusted for Patient Mix reflects inpatient and outpatient hospital care for all-payers and is Medicare case-mix adjusted. In 2017, the percentage payments attributed to outpatient care increased slightly to 53% of hospital revenue. 2 St. Joseph Health Center & St. Joseph Hospital-Wentzville report on a combined basis. 3 Mercy acquired of St. Anthony's Medical Center in June 2017 and renamed it Mercy Hospital South. 4 St. Luke's Hospital acquired Des Peres Hospital in 2018 and renamed it St. Luke's Des Peres Hospital. 5 Based on all-payer average payments 'per adjusted discharge and patient mix for 29 St. Louis hospitals.