Hospitals receive their revenues from different sources for the services they provide to patients. At the end of the first decade of the 2000s and in the early 2010s, the largest source of income to community hospitals came from Medicare and Medicaid programs. According to data released in January 2009 by the Centers for Medicare and Medicaid Services, of the $2.24 trillion spent on health care in 2007, government funds provided 46.2 percent, or $1.04 billion. Specifically, Medicaid accounted for 19.2 percent of funding; Medicare, 14.7 percent; and other government funding, 12.3 percent. Private insurance paid 34.6 percent, or over $775 billion; out-of-pocket expenses accounted for 12 percent, or $268.9 billion; and the remaining 7.2 percent came from other sources.
Hospital expenses are strongly affected by legislation, costs of medical technology, and trends in medical practice. As these expenses rose throughout the first decade of the 2000s, on-site administrative, food service, maintenance, and laundry support often were streamlined or contracted out in response. To counteract rising costs, many hospitals also attempted to expand their revenues by increasing their role in community health maintenance efforts beyond traditional emergency, obstetrics, and inpatient care to include disease prevention and patient education programs, such as weight reduction, drug rehabilitation, prenatal care, and pediatric wellness.