Ambulatory health care services in the United States
Since 1998, the gross output of ambulatory health care services in the United States has steadily increased from 409 billion U.S. dollars to some one trillion U.S. dollars in 2016. In response, employment in this sector has risen from 4.3 million employees in 1998 to almost 7.3 million employees in 2017, with employee compensation of 543 billion U.S. dollars. Other health care services in the United States have also seen increased output over the last decade. The output of nursing and residential care facilities has more than doubled from 102 billion U.S. dollars in 1998 to 251 billion U.S. dollars in 2017. During the same time, hospital output has more than tripled from 290 billion U.S. dollars to nearly 900 billion U.S. dollars.
Ambulatory services mostly do not provide inpatient services. Care from physicians account for approximately half of the sector’s revenue. The sector is highly fragmented and is widespread throughout the country. Large companies have the advantage of being able to offer a wide range of services, have access to latest medical research and supplies, and forming contracts with health insurance companies. On the other hand, smaller companies tend to provide specialized services, and work in a smaller geographical area. Within this sector, firm revenue has been mostly taxable. Taxable firm revenues reached some 886 billion U.S. dollars, while 93 billion U.S. dollars in the industry remained tax-exempt.