louisville's health-related economy

Louisville’s Health-Related Economy

byPaul Coomes, Ph.D.

Professor of Economics, and National City Research Fellowand

Margaret Maginnis,Senior Research Analyst

for Angle Technologies and the Health Enterprises NetworkMay 2006

ContentsExecutive summaryHow big is the industry?Health care industry: establishments, jobs, pay, salesHealth care occupationsManufacturingCorporate headquartersScientific research and developmentUniversity research activity Small business innovation and technology grantsPatent activityNotes

2Louisville’s Health-Related Economy, 2006

Executive SummaryThis is an update of the benchmark report, “Louisville’s Health-Related Economy: Size, Character, and Growth”, produced for

the Health Enterprises Network, May 2001 http://monitor.louisville.edu/healthcare/health.htm We have organized the latest economic data for the various dimensions of health enterprises, and provided them here in a graphical format. As with our earlier study, we have compared activity in Louisville to that of fifteen other metropolitan areas. A summary table of rankings is on the next slide. Among the most interesting and important findings of our latest research are:

We have identified nearly 2,500 health-related establishments in the Louisville area. Collectively they employ about 85,000 persons, with an annual payroll of $3.5 billion. They generate over $430 million annually in state and local taxes. All major components of the industry posted growth over the last five years, particularly hospitals and ambulatory care facilities. Also, we have been able to document much more educational, nonprofit, and governmental activity than in our previous study.

Health care remains one of the largest employers in the Louisville area, accounting for 10 percent of all jobs and compensation. Employee compensation grew by over 7 percent per year during the last two years for which data are available. On a per capita basis, most health care economic measures indicate that Louisville ranks in the middle or above compared to other similar metro areas, and is consistently above the national average in terms of revenues, payrolls, and jobs.

Louisville is home to two of the fourteen Fortune 1000 headquarters of health-related companies located in the sixteen comparison metros: Humana and Kindred. Only the Nashville (7) and Indianapolis (3) metros have more major headquarters. Nashville continues to rise in national prominence, gaining the most headquarters since our last study. In another headquarters listing, by Reference USA, Louisville stands out in the health insurance, nursing home, and home health industries.

The University of Louisville continues to soar up in the rankings of federally-funded research. It jumped from 204th to 103rd

among all institutions in funding from the National Institutes of Health in the last eight years, by far the greatest growth among any of the institutions among the competitor metros. UL now brings in over $50 million annually in federal research funds in health-related fields, a growth of tenfold over the last decade.

Louisville continues to rank near the bottom in private research and development activity and, as we observed in our last study, has no pharmaceutical companies.

Louisville ranks higher in health-related patent activity than in our last study (10th rather than 14th), posting the third highest growth rate this decade – behind only Birmingham and Raleigh.


http://monitor.louisville.edu/healthcare/health.htm

The table summarizes Louisville’s ranking in key measures for the 2001 and 2006 studies.

Louisville posted some gains, particularly in university research, small business technology grants, and patents.

Health Enterprise Component2001

Study2006

StudyChange in Rank

Health Care DeliveryHealth care delivery sales per capita - total 6 5 1Health care delivery payroll per capita - total 3 4 -1

ambulatory sales per capita 6 7 -1ambulatory payroll per capita 5 9 -4

hospital sales per capita 11 9 2hospital payroll per capita 10 11 -1

nursing and residential care sales per capita 1 3 -2nursing and residential care payroll per capita 1 3 -2

Manufacturingpharmaceutical establishements 16 16 0

medical equipment and supplies establishments 11 9 2Corporate headquarters

Fortune 1000 2 2 0Dun& Bradstreet/ Reference USA 3 3 0

Scientific research & development (outside universities)establishments per capita 15 16 -1

University research & developmentall federal funding of R&D in the life sciences 8 8 0

National Institutes of Health funding - UL total 11 10 1National Institutes of Health funding - Medical School only 11 9 2

journal articles published by medical school faculty 9 8 1licenses and options executed 14 13 1adjusted gross license revenue 14 14 0

Small business innovation and technology grantsSBIR-STTR awards granted 8 5 3value of SBIT-STTR awards 6 5 1

Patentsutility patents granted 14 10 4

Louisville's Rank among Sixteen Comparison Metropolitan Areas

Note that there have been several definitional changes between the two study periods, and these can affect rankings independently of economic activity. Metropolitan areas were redefined after the 2000 Census. The Louisville MSA, for example, now includes 13 rather than 7 counties. Also, all industry data is now reported on a NAICS (North American Industrial Classification System), rather than the old SIC (Standard Industrial Classification) system. Finally, the US Bureau of Economic Analysis has changed the way it reports payroll and other earnings data, now excluding earnings by industry for proprietors, but including fringe benefits in a measure of compensation by industry. Where possible, we have adjusted for the changes in definitions.


How Big?The health enterprises network comprises a range of operations across many industrial classifications.

There is no ‘industrial code’ for the cluster of operations linked to health care. Rather, they span many industries, including health care delivery, manufacturing of medical equipment and supplies, insurance, management, research and development, education, and nonprofit and governmental support.

In the first slide, we make an estimate of the size of the network in the Louisville metropolitan area, adding pieces from several industries. It includes all of the core health care delivery activities, but only pieces of the linked industries. Standard industrial classifications count legal, IT, advertising and other firms that thrive by selling services to health care firms as part of other (non-health-related) industries. For example, SHPS is a major health-related company in Louisville, but is counted under ‘business services’ in most databases. In subsequent slides we show details for individual industries, and compare these to measures for other metro areas.

Two trend slides are also included for Louisville. Total compensation of employees and proprietors in the health care sector (NAICS 62) is shown for the past three decades, revealing the strong overall growth pattern. The total is about $3.2 billion. And we were able to put together a fifteen year history of jobs in the supersector “Health and Education Services”, one dominated by health care. According to the US Bureau of Labor Statistics, the number of jobs in the sector has risen from 53,000 to 77,000 since 1990 (and by 10,000 so far this decade).

Estimates for latest yearCompared to other industries

Jobs in health careEmployee Compensation in health careCompensation per job in health care

Health care links to other industriesTrend: compensation in health careTrend: jobs in health care (and education) services


Number of Establish -

mentsRevenues or

Expenditures Jobs Payroll State Taxes* Local Taxes**Health Care Delivery

Ambulatory (offices of physicians, outpatient centers, labs) 2,050 $2,570,176,139 25,060 $1,133,066,199 $90,871,909 $20,905,071Hospitals 25 $3,241,948,961 26,078 $1,313,428,238 $178,280,796 $24,232,751

Nursing & residential homes 254 $644,903,269 13,711 $309,212,909 $35,117,328 $5,704,978Related Enterprises

Manufacturing of medical equipment & supplies 40 $92,800,000 765 28,735,000 $2,304,547 $589,068Health insurance carriers 2 na 7,537 $326,210,000 $26,162,042 $6,687,305

Management, real estate, and support companies 5 na 2,352 $70,560,000 $5,658,912 $1,446,480Private research and development, including life sciences 27 $52,162,000 500 $35,210,000 $2,823,842 $721,805

Education and academic research (health science schools) 17 $267,465,910 4,530 $208,957,742 $16,758,411 $4,283,634Nonprofit service and support organizations 63 $198,588,995 3,095 $93,169,545 $7,472,197 $1,909,976

Government - EMS, health departments 14 $65,419,738 1,526 $45,793,817 $3,672,664 $938,773Total 2,497 $7,133,465,013 85,155 $3,564,343,450 $369,122,649 $67,419,841

na: not applicable (under insurance carriers, for example, Humana system-wide revenues in 2005 were $14.4 billion; the jobs and payroll shown are those captured in Louisville)Estimates of revenues, jobs, and payrolls for health care delivery are extrapolated from the 2002 Economic Census, using compound growth rates calculated from historical data.Estimates for manufacturing from 2002 Economic Census.Estimates for insurance carriers include only Humana and Anthem. Estimates for management companies refer only to SHPS. Data not available for many smaller companies.Estimates for manangement, real estate, and support companies included for: SHPS, Ventas, Trover, Yellow Ambulance, META.

Estimates for nonprofit support organizations obtained by identifying agencies from telephone directory and internet. Direct job and payroll information was available for some; estimates for others Estimates for government agencies calculated from published budget data from Louisville City-County government and Kentucky State government, with 15% blowup factor as estimate for souther* KY and IN income and sales taxes, plus KY hospital tax of 2.5%, KRS 142.303 (assume 90% of NPR from KY hospitals), plus KY nursing home tax of 2% (assume 80% of revenues in KY).** Local occupational tax only for Jefferson County: 1.25% City/ County, plus .20% TARC, plus .75% x .8 to JCPS; assume 90% of MSA activity in Jefferson.

The Health-Related Industry in Louisville(estimates for latest year, metro area)

Estimates for educational institutions include direct 2005 budgetary data from a few schools, with estimates for other made from data on degrees completed.Estimates for private R&D based on 2002 Economic Census, which provided a count of establishments. Revenues, jobs, and payroll estimated from national ratios.



Jobs by Industry, Louisville MSA, 2003

4,087

6,526

9,307

12,389

12,668

17,461

23,022

29,883

36,078

38,033

38,643

40,382

42,400

44,198

47,507

47,806

71,238

80,274

83,690

0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000

Military

Management of companies and enterprises

Federal government, civilian

Educational services

Information

State government

Real estate and rental and leasing

Wholesale trade

Professional and technical services

Finance and insurance

Transportation and warehousing

Administrative and waste services

Other services, except public administration

Construction

Accommodation and food services

Local government

Health care and social assistance

Retail Trade

Manufacturing

Source: US Bureau of Economic Analysis, May 2005; estimates for 'super sectors' only.

There were 727,000 jobs in the Louisville metro in 2003; health care accounted for 9.8% of total.

Other health-related jobs are counted under industries like insurance and manufacturing.

8

Compensation by Industry, Louisville MSA, 2003

$137,941,000

$225,875,000

$278,078,000

$537,775,000

$558,702,000

$679,883,000

$740,495,000

$758,312,000

$783,563,000

$810,676,000

$1,401,232,000

$1,408,811,000

$1,644,627,000

$1,771,004,000

$1,966,353,000

$1,974,595,000

$2,021,173,000

$2,706,372,000

$5,259,388,000

$0 $1,000,000,000 $2,000,000,000 $3,000,000,000 $4,000,000,000 $5,000,000,000 $6,000,000,000

Military




Information


State government





Construction

Wholesale trade

Retail trade



Local government


Manufacturing


Louisville’s Health-Related Economy, 2006

Employee compensation was $2.6 billion in the

Louisville metro in 2003; health care

accounted for 10.3% of total.

Annual Compensation per Job by Industry, Louisville MSA, 2003

$12,079

$15,962

$18,232

$18,480

$20,075

$22,062

$31,875

$33,751

$37,991

$38,839

$42,279

$42,409

$44,103

$50,885

$51,918

$55,036

$62,844

$73,051

$82,405

$0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000






Retail trade

Construction

Military



Local government

State government

Information



Wholesale trade

Manufacturing




Average annual employee

compensation in 2003 was $38,000.


SectorTotal

Purchases

Purchases from Louisville MSA

FirmsREAL ESTATE $67,500 $66,100DRUGS $28,130 $5,330OTHER BUSINESS SERVICES $17,270 $7,430MGT. CONSULT. AND PUBLIC REL. $15,330 $6,780INDUSTRIAL CHEM. INORG & ORG $14,430 $10,710MISC. PLASTIC PRODUCTS $12,750 $3,970WHOLESALING: NONDURABLE GOODS $10,480 $7,690ELECTRIC UTILITIES $9,440 $4,180SURGICAL APPLIANCES & SUPPLIES $9,180 $2,130EATING & DRINKING PLACES $8,010 $7,210MAINT & REP: NON-RES. BLDGS. $7,640 $7,640PERSONNEL SUPPLY SERVICES $7,570 $7,110COMMUNICATIONS EXC RADIO & TV $7,390 $4,160COMPUT. & DATA PROC. SERVICES $6,500 $850PHOTOGRAPHIC EQUIP. & SUPPLIES $6,220 $0RETAIL: MISCELLANEOUS STORES $5,560 $3,460PETROLEUM REFINING $5,230 $0TRUCKING & WAREHOUSING $4,610 $3,230X-RAY & OTHER ELECTROMED. EQUI $3,920 $870APPAREL FROM PURCHASED MATLS. $3,540 $110MED. & HEALTH SRVCS. FAC. NEC $3,410 $3,250COMMERCIAL PRINTING $3,110 $2,400DETECTIVE & PROTECTIVE SRVCS $3,010 $1,280INSURANCE CARRIERS $2,880 $1,430SURGICAL & MEDICAL INSTRUMENTS $2,760 $0WHOLESALING: DURABLE GOODS $2,530 $2,260RESEARCH & TESTING SERVICES $2,500 $480POSTAL SERVICE $2,350 $2,130FABRICATED RUBBER PROD NEC $2,190 $130ACCOUNTING MISC. SERVICES NE $2,140 $630HOUSEFURNISHINGS NEC $2,100 $1,290AIR TRANSPORTATION $2,030 $470GAS UTILITIES $1,970 $250SOAP & OTHER DETERGENTS $1,830 $1,510MEAT PACKING PLANTS $1,770 $1,360MISC REPAIR SHOPS $1,670 $420SERVICES TO BUILDINGS $1,530 $330Subtotal $290,480 $168,580Sum of Purchases from 200 Other Industries $38,620 $14,810Total Purchases of Goods and Services $329,100 $183,390Source: Regional Science Research Institute, PCIO Model of Louisville MSA, Version 6.10, May 1

Hospital Purchases from Other Industriesper $1 Million in Hospital Output

The table provides estimates of the value of vendor purchases per $1 million in hospital sales.

The first column shows how much is purchased from other industries, and the second column shows how much can be provided locally.



Vendor Purchases per $1 Million Hospital Revenues

24 Largest Supplying Industries

$2,760

$2,880

$3,010

$3,110

$3,410

$3,540

$3,920

$4,610

$5,230

$5,560

$6,220

$6,500

$7,390

$7,570

$7,640

$8,010

$9,180

$9,440

$10,480

$12,750

$14,430

$15,330

$17,270

$28,130

$0 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000

Surgical and medical instruments

Insurance carriers

Detective and protective services

Commercial printing

Medical & health services facilities, nec

Apparel from purchased materials

X-ray & other electromedical equipment

Trucking and warehousing

Petroleum refining

Misc Retail Stores

Photographic equipment and supplies

Computer and data processing services

Communications, excluding radio and TV

Personnel supply services

Maintenance and repair

Eating and drinking places

Surgical appliances and supplies

Electric utilities

Wholesale nondurable goods

Misc plastic products

Industrial chemicals - inorganic and organics

Management consulting and public relations

Other business services

Drugs

Source: Regional Science Research Insistute, PCIO input-output model, 1994. Total purchases from vendor = $329,000 per $1 million in revenues.

The chart summarizes the data in the first column of the previous table.

This gives an idea of the economic development opportunities generated as inpatient health care grows over time.

Estimated Labor and Proprietors' Earnings per Capita, Louisville MSAHealth Services/ Health Care and Social Assistance Industry

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

1969

1971

1973

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

Source: US Bureau of Economic Analysis. We have spliced data across industrial classification systems, using Labor and Proprietors Earnings for SIC 80 (Health Services) data through 2000, and Employee Compensation NAICS 62 (Health Care and Social Assistance) after 2000 (blown up by the historical ratio of labor and proprietors' earnings to employee compensation.

in 2004, total labor and proprietors' earnings in Louisville was about $3.2 billion, or $2,647 per capita

Total employee and proprietors’ earnings have grown by an

average rate of 5.3% per year over

the last decade.


Relative Labor and Proprietors' Earnings per Capita, Louisville MSAHealth Services/ Health Care and Social Assistance Industry

0.80

0.90

1.00

1.10

1.20

1.30

1969

1971

1973

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

N ational average

Louisville MSA

Source: US Bureau of Economic Analysis. We have spliced data across industrial classification systems, using Labor and Proprietors Earnings for SIC 80 (Health Services) data through 2000, and Employee Compensation NAICS 62 (Health Care and Social Assistance) after 2000. The relative decline for Louisville occurred in 2000.

Louisville surged in its health care

concentration during the 1970s, 1980s and 1990s.


Jobs in Health and Education ServicesLouisville Metropolitan Statistical Area, 1990 to 2005

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Ambulatory Care (offices of doctors, dentists, outpatient centers, labs, home health, etc) grew by 87 percent.

Hospitals, Nursing Homes, Social and Educational Services: grew by 33 percent.

Source: US Bureau of Labor Statistics, annual average of monthly wage and salary jobs.


Detailed Health Care Industry Data for Louisville and Comparison Metro Areas

Total Health Care and Social Assistance (supersector NAICS 62)Sales per capita, 2002Payrolls per capita, 2002Jobs per 100 Residents, 2002

Ambulatory care (NAICS 621)Establishments by type, Louisville MSASales per capita, 2002Payrolls per capita, 2002

Hospitals (NAICS 622)NarrativeHospitals in the Louisville MSA – Beds, Discharges, Gross Revenues, 2006General Medical and Surgical Hospitals (NAICS 6221), Sales per Capita, 2002General Medical and Surgical Hospitals (NAICS 6221), Payroll per Capita, 2002General Medical and Surgical Hospitals (NAICS 6221), Jobs per 100 Residents, 2002American Hospital Association: inpatient days per capita, 2004American Hospital Association: expenses per inpatient day, 2004American Hospital Association: total expenses per capita, 2004American Hospital Association: payroll expenses per capita, 2004

Nursing and residential care (NAICS 623)Sales per capita, 2002Payrolls per capita, 2002Jobs per 100 Residents, 2002



Health Care and Social AssistancePer Capita Sales 2002

$3,754

$3,898

$3,975

$4,336

$4,419

$4,462

$4,617

$4,633

$4,956

$4,993

$5,435

$7,189

$4,303

$4,695

$0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000

Greensboro

Raleigh

Charlotte

Richmond

Jacksonville

Memphis

Kansas City

Columbus

Louisville

Dayton

Birmingham

Indianapolis

Lexington

US

Source: Census of Service Industries, 2002. The Census Bureau, US Department of Commerce.

$5.62 billion in revenues in Louisville MSA; on per capita basis, very similar to its peers; slightly higher than national average.

Lexington highest: it is a regional health care center, and smallest population of comparison metros. Data not disclosed for Cincinnati, Nashville, Memphis.


Health Care and Social Assistance Per Capita Payroll 2002

$1,684

$1,696

$1,714

$1,740

$1,770

$1,797

$1,885

$1,898

$1,976

$2,103

$2,177

$2,554

$1,767

$2,017

$0 $500 $1,000 $1,500 $2,000 $2,500 $3,000

Jacksonville

Raleigh

Charlotte

Greensboro

Richmond

Memphis

Columbus

Kansas City

Birmingham

Louisville

Dayton

Indianapolis

Lexington

US


$2.4 billion in payrolls in Louisville MSA; among highest on per capita basis.


Health Care and Social Assistance Jobs Per Capita 2002

4.79

5.01

5.02

5.12

5.14

5.51

5.56

5.62

5.64

6.25

6.44

7.52

5.37

5.97

0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00 8.00

Charlotte

Greensboro

Raleigh

Memphis

Jacksonville

Richmond

Kansas City

Birmingham

Columbus

Louisville

Dayton

Indianapolis

Lexington

US


70,600 jobs in Louisville MSA; among highest on per capita basis.

Ambulatory Care Establishments, by Type, Louisville MSA, 2002

Offices of optometrists

Offices of mental health practitioners (except physicians)

Offices of physical, occupational & speech therapists, and audiol

Offices of all other health practitioners

Outpatient mental health & substance abuse centers

Other outpatient care centers

Medical & diagnostic laboratories

Home health care services

Ambulance services

All other ambulatory health care services

Offices of chiropractors

Offices of dentists

Offices of physicians

Source: US Census Bureau, 2002 Economic Census; there were a total of 2,050 establishments in the Ambulatory Health Care Services industry (NAICS 621).

890515


Per Capita Sales, Ambulatory Health Care Services, 2002

$1,613

$1,723

$1,737

$1,802

$1,812

$1,869

$1,919

$1,989

$2,026

$2,244

$3,108

$1,742

$1,863

$1,875

$1,200 $1,400 $1,600 $1,800 $2,000 $2,200 $2,400 $2,600 $2,800 $3,000 $3,200

Richmond

Charlotte

Memphis

Greensboro

Raleigh

Louisville

Indianapolis

Kansas City

Jacksonville

Columbus

Dayton

Birmingham

Lexington

US

Source: Census of Service Industries, 2002. The Census Bureau, US Department of Commerce. Cincinnati, Nashville and Omaha are not calculated due to disclosure issues.

$2.2 billion in revenues in Louisville MSA; on per capita basis, very similar to its peers; slightly higher than national average.

Lexington highest, since it is a regional health care center and is the smallest metro in terms of population.


21

Per Capita Payroll, Ambulatory Health Care Services, 2002

$745

$749

$784

$792

$792

$812

$817

$858

$865

$881

$978

$994

$725

$821

$600 $700 $800 $900 $1,000 $1,100

Memphis

Richmond

Indianapolis

Jacksonville

Charlotte

Raleigh

Kansas City

Louisville

Greensboro

Dayton

Columbus

Birmingham

Lexington

US

Source: Census of Service Industries, 2002. The Census Bureau, US Department of Commerce. Cincinnati, Nashville and Omaha are not calculated due to disclosure issues.


$972 million in payrolls in Louisville MSA; on per capita basis, very similar to its peers; higher than national average.

HospitalsThere are more data available on hospital activity than in any other component of the health

enterprises network. We present several measures here, accumulated from multiple sources. Together, they paint a picture of the size and scope of the hospital industry in Louisville.

We identified 25 hospitals in the metropolitan area, 17 of which are classified as short-term acute care. Other categories include psychiatric, rehabilitation, and long-term care. Most are owned and operated by nonprofit corporations, though Louisville also has three investor-owned hospitals, two owned by state government, two by local governments, and one by the federal government. They support a total of over 4,000 beds, with over 175,000 patient discharges annually.

The Census Bureau provides estimates of activity by ‘general medical and surgical hospitals’, or industrial code 6221. Data for 2002 were disclosed for most of the comparison metro areas and is summarized in the slides below. Louisville generally ranks in the middle of the comparison metros in terms of hospital revenues, payrolls, and jobs per capita.

We also include some economic data from the American Hospital Association. Their database includes measures on 20 ‘community hospitals’ in Louisville, which while not comprehensive gives another comparison. Louisville ranks a bit higher in these rankings, particularly in terms of inpatient days. (Community hospitals are defined as all nonfederal, short-term general, and other special hospitals. Other special hospitals include obstetrics and gynecology; eye, ear, nose, and throat; rehabilitation; orthopedic; and other individually described specialty services. Community hospitals include academic medical centers or other teaching hospitals if they are nonfederal short-term hospitals. Excluded are hospitals not accessible by the general public, such as prison hospitals or college infirmaries.)


Name of facility Location Primary type of care

Type of ownership &

controlHospital

BedsTotal

DischargesPatient Days

Gross Patient Revenue ($000)

1 Baptist Hospital East Louisville Short term acute care N 356 25,928 110,098 $603,378,1972 Baptist Hospital Northeast La Grange Short term acute care N 90 3,114 13,509 $60,163,0003 Central State Hospital Louisville Psychiatric S 172 1,299 39,374 25,739,2044 Clark Memorial Hospital (JHHN) Jeffersonville Short term acute care N 169 8,888 46,375 $310,117,7025 Flaget Memorial Hospital Bardstown Short term acute care N 40 2,824 8,236 $82,650,1326 Floyd Mem Hosp & Hlth Servs New Albany Short term acute care N 191 10,484 37,776 $275,083,8997 Harrison County Hospital Corydon Short term acute care L 51 1,708 6,869 $62,668,4388 Jewish Hospital - downtonwn (JHHN) Louisville Short term acute care N 442 21,695 124,988 $1,359,902,8789 (Jewish) Frazier Rehabilitation Institute Louisville Physical rehabilitation N

10 Jewish Hospital-Shelbyville (JHHN) Shelbyville Short term acute care N 70 2,835 14,239 $112,129,67811 Kindred Hospital-Louisville Louisville Long term P 367 621 30,412 $149,660,61512 Med Center of Southern Indiana Charlestown Short term acute care P 78 1,314 4,349 $32,199,89113 Norton Hospital Louisville Short term acute care N 1,175 64,117 311,086 $2,368,059,51914 Norton Audubon Hospital Louisville Short term acute care N15 Norton Suburban Hospital Louisville Short term acute care N16 Norton Southwest Hospital Louisville Short term acute care N17 (Norton) Kosair Children's Hospital Louisvillle Short term acute care N18 Sts. Mary&Elizabeth Hospital (JHSMH) Louisville Short term acute care N 442 14,226 118,206 $419,409,37219 Our Lady of Peace (JHSMH) Louisville Psychiatric N20 Southern Indiana Rehab Hosp New Albany Physical rehabilitation N 60 974 13,070 $36,372,36821 Ten Broeck Hospital-Dupont Louisville Psychiatric P 66 1,771 22,479 32,887,75922 Ten Broeck Hospital-KMI Louisville Psychiatric P 94 1,732 33,103 $46,364,68523 Univ of Louisville Hospital Louisville Short term acute care S 283 14,033 90,388 $743,896,47724 Veterans Administration Hospital Louisville Short term acute care F 122 na na $155,980,00025 Washington County Memorial Hospital Salem Critical access L 25 1,066 3,812 $33,430,000

Totals 4,293 178,629 1,028,369 $6,910,093,814Sources: American Hosptital Directory (www.ahd.com); Business First, November 25, 2005;Ownership Codes: (F) Federal government, (G) Local government, (N) Nonprofit corporation, (P) Private corporation, (S) State government/ universityJHCN: Jewish Hospital Healthcare NetworkJHSMH: Jewish Hospital and St. Mary's Healthcare

Hospitals in the Louisville Metropolitan Statistical Area, 2006 (with data for latest year available)


General Medical and Surgical Hospitals (NAICS 6221)Per Capita Sales, 2002

$1,104

$1,430

$1,624

$1,686

$1,897

$1,963

$2,038

$2,043

$3,281

$1,674

$1,926

$2,661

$0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500

Greensboro

Charlotte

Jacksonville

Columbus

Kansas City

Louisville

Richmond

Memphis

Dayton

Indianapolis

Lexington

US

Source: Census of Service Industries, 2002. The Census Bureau, US Department of Commerce. Birmingham, Cincinnati, Nashville, Omaha, and Raleigh are not included in calculation due to disclosure issues.


General Medical and Surgical Hospitals (NAICS 6221)Per Capita Payroll, 2002

$496

$515

$553

$581

$681

$718

$743

$847

$1,175

$649

$782

$980

$0 $200 $400 $600 $800 $1,000 $1,200 $1,400

Greensboro

Jacksonville

Charlotte

Columbus

Richmond

Kansas City

Memphis

Louisville

Dayton

Indianapolis

Lexington

US



General Medical and Surgical Hospitals (NAICS 6221)Jobs per 100 Residents, 2002

1.31

1.45

1.55

1.56

1.83

1.91

2.40

3.29

1.70

1.89

1.98

2.68

0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50

Greensboro

Charlotte

Jacksonville

Columbus

Memphis

Louisville

Kansas City

Richmond

Dayton

Indianapolis

Lexington

US




Per Capita Inpatient Days for US Community Hospitals, by Metro Area 2004

0.51

0.61

0.63

0.63

0.66

0.67

0.70

0.71

0.74

0.75

0.77

0.82

0.86

0.98

1.02

0.84

0.00 0.20 0.40 0.60 0.80 1.00 1.20

Raleigh

Cincinnati

Dayton

Columbus

Jacksonville

Charlotte

Omaha

Kansas City

Nashville

Indianapolis

Richmond

Memphis

Louisville

Greensboro

Lexington

Birmingham

Source: American Hospital Association Hospital Statistics, 2006 & 2004 AHA Annual Survey Database

AHA reports 1 million inpatient days at Louisville area hospitals; near the top on a per capita basis.

Total Expenses Per Inpatient DayUS Community Hospitals, 2004

$310

$327

$345

$356

$363

$373

$375

$377

$387

$427

$427

$443

$454

$455

$597

$435

$0 $100 $200 $300 $400 $500 $600 $700

Columbus

Indianapolis

Omaha

Dayton

Cincinnati

Charlotte

Kansas City

Lexington

Nashville

Raleigh

Jacksonville

Louisville

Memphis

Birmingham

Richmond

Greensboro


AHA reports $2.3 billion in expenses at Louisville area hospitals; near the top on a per patient-day basis.



Total Expenses per Capita, US Community Hospitals by Metro Area 2004

$1,200

$1,434

$1,555

$1,684

$1,700

$1,771

$1,788

$1,847

$1,882

$1,918

$2,034

$2,042

$2,248

$2,281

$2,593

$1,930

Raleigh

Greensboro

Jacksonville

Cincinnati

Richmond

Dayton

Charlotte

Memphis

Kansas City

Nashville

Louisville

Omaha

Columbus

Birmingham

Indianapolis

Lexington


AHA data on expenses (proxy for revenues) reveal similar pattern to payrolls.


Per Capita Payroll Expenses, US Community Hospitals, by Metro Area 2004

$547

$564

$620

$645

$667

$723

$740

$744

$771

$772

$773

$808

$825

$903

$965

$748

Raleigh

Jacksonville

Greensboro

Richmond

Cincinnati

Charlotte

Memphis

Nashville

Louisville

Dayton

Kansas City

Columbus

Omaha

Birmingham

Indianapolis

Lexington


More recent data, from AHA, reveals similar payroll pattern as Census data.

Nursing and Residential Care Facilities, 2002Sales per Capita

$299

$317

$325

$370

$406

$423

$430

$441

$475

$507

$595

$498

$475

$0 $100 $200 $300 $400 $500 $600 $700

Memphis

Birmingham

Lexington

Raleigh

Richmond

Kansas City

Jacksonville

Charlotte

Greensboro

Louisville

Indianapolis

Dayton

US

Source: Census of Service Industries, 2002. The Census Bureau, US Department of Commerce. Cincinnati, Columbus, Nashville and Omaha are not included in calculation due to disclosure issues.


Nursing and Residential Care Facilities, 2002Payroll per Capita

$132

$134

$158

$167

$174

$187

$206

$207

$214

$244

$265

$231

$228

$0 $50 $100 $150 $200 $250 $300

Memphis

Birmingham

Lexington

Raleigh

Richmond

Jacksonville

Charlotte

Kansas City

Greensboro

Louisville

Indianapolis

Dayton

US



Nursing and Residential Care Facilities, 2002Jobs per 100 Residents

0.67

0.70

0.82

0.83

0.87

0.88

0.98

0.98

1.05

1.17

1.24

1.01

1.06

0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4

Memphis

Birmingham

Raleigh

Lexington

Richmond

Jacksonville

Charlotte

Kansas City

Greensboro

Louisville

Indianapolis

Dayton

US



Health-Related OccupationsThe US Bureau of Labor Statistics produces estimates of jobs and pay by occupation

for metropolitan areas. We have organized the latest data on health-related occupations for Louisville and the comparison metros. The data are summarized in the next slide, with the following slide showing our forecasts of job growth by occupation.

In the next slide we plot the number of jobs per capita against pay per job, with the center of the graph representing the average across the sixteen metros. Data was not available for all occupations and all metros, so this is not comprehensive. But it does give an indication of the relative concentration and pay in certain professions. Unfortunately, there are not many occupations for which Louisville has both a high concentration and high pay. Certain occupations, like optometrists and opticians, have a high concentration in Louisville but earn 20-40% less than in comparable markets. A few occupations, like occupational therapist assistants, home health aides and pharmacists, seem have a relatively low presence but high pay. Finally, a set of high-skill occupations have both a low presence and low pay in Louisville: pediatricians, internists, psychiatrists, and physicians’ assistants.

Registered nurses are the biggest health-related occupational category in Louisville, and is also the one projected to grow the most over the next ten years. The average pay is nearly $48,000. Other higher skill, higher pay occupations expected to grow include physicians, surgeons, and physical therapists.


Occupations in the Louisville MSANumber of Workers per Capita and Average Hourly Wage Compared to 16 MSA Average

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

50%

-80% -60% -40% -20% 0% 20% 40% 60% 80% 100% 120%

Relative number

Rel

ativ

e w

age

GPs

Optometrists

Medical equipment preparers

General internists

Medical equipment i

Medical records and health informationt h i i

Pediatricians

Opticians

Occupational therapist assistants

Higher wage, fewer jobs Higher wage, more jobs

Lower wage, more jobs Lower wage, fewer jobs

People employed in these sectors can expect a lower wage and fewer job opportunites in the Louisville MSA.

Home health aides

Most occupations that pay a higher wage than our peer metros (on avergae) and offer more job opportunites are in lower-skill, lower-pay

sectors such as specialized technologists and technicians, pharmacy aides, nursing aides and

orderlies, and physical therapist assistants. The exceptions are RNs and speech

pathologists.

Occupations that fall in this quadrant have more job opportunities but lower wages relative to the average among peer markets.

Cardiovascular technologists & technicians, nuclear medicine technologists, pharmacy techs, radiology technicians, occupational therapists, dieticians, physical therapists, surgical techs

RNsAides, assistants, orderlies

Speech pathologists Medical transcriptionists

Physicians' assistants

Respiratory therapist techs

EMTs Dental lab techs

PsychiatristsChiropractors

Medical secretaries

PharmacistsDietary technicians

Lab techs


Projected Growth in Health Industry Jobs within the Louisville MSA

2002-2012

-500

0

500

1,000

1,500

2,000

2,500

3,000

3,500

Dental

Labo

ratory

Techn

ician

sPod

iatris

tsAud

iolog

ists

Veterin

ary A

ssist

ants

and L

abora

tory A

nimal

Caretak

ers

Occup

ation

al The

rapist

Aides

Medica

l Equ

ipmen

t Rep

airers

Athleti

c Trai

ners

Nuclea

r Med

icine

Techn

ologis

ts

Radiat

ion The

rapist

s

Pharm

acy A

ides

Optometr

ists

Medica

l Equ

ipmen

t Prep

arers

Psych

iatric

Aide

s

Massa

ge The

rapist

s

Chirop

ractor

s

Occup

ation

al The

rapist

Assist

ants

Diagno

stic M

edica

l Son

ograp

hers

Respir

atory

Therap

y Tec

hnicia

ns

Cardiov

ascu

lar Tec

hnolo

gists

and T

echn

ician

s

Speec

h-Lan

guag

e Path

ologis

ts

Physic

al The

rapist

Aide

s

Medica

l Tran

scrip

tionis

ts

Physic

al The

rapist

Ass

istan

ts

Surgica

l Tec

hnolo

gists

Occup

ation

al The

rapist

s

Health

Diag

nosin

g and

Treatin

g Prac

tition

ers, A

ll Othe

r

Medica

l and

Clin

ical L

abora

tory T

echn

ician

s

Respir

atory

Therap

ists

Physic

ian Ass

istan

ts

Radiol

ogic

Techn

ologis

ts an

d Tec

hnici

ans

Physic

al The

rapist

s

Health

care

Practiti

oners

and T

echn

ical W

orkers

, All O

ther

Dental

Hyg

ienist

s

Health

care

Suppo

rt Work

ers, A

ll Othe

r

Medica

l Sec

retari

es

Medica

l Rec

ords a

nd H

ealth

Infor

mation

Techn

ician

s

Emergen

cy M

edica

l Tec

hnicia

ns an

d Para

medics

Dental

Assist

ants

Physic

ians a

nd su

rgeon

s

Home H

ealth

Aide

s

Medica

l Ass

istan

ts

Nursing

Aides,

Orderlie

s, an

d Atte

ndan

ts

Regist

ered N

urses

Source: KentuckianaWorks Occupational Outlook, Projections 2002-2012

$47,680

$21, 430

$23, 330

$19, 910

$122,460

$30,600

The greatest amount of growth will occur in lower-paying sectors such as orderlies, medical and home

health aides, dental and medical assistants, secretaries and information technicians, and EMTs.

Job opportunities for registered nurses will see

the most growth. Physicians and surgeons

will see some growth.


OccupationsLouisville

MSA16 MSA average

Registered Nurses 12,080 1,162.0 1,060.8 9.5% $25.74 $24.88 3.5%Nursing Aides, Orderlies, and Attendants 7,240 696.4 552.3 26.1% $11.12 $10.49 6.0%Licensed Practical and Licensed Vocational Nurses 3,540 340.5 293.0 16.2% $17.06 $17.09 -0.2%Medical Assistants 2,300 221.2 148.1 49.4% $12.09 $12.24 -1.2%Dental Assistants 1,720 165.4 102.5 61.4% $13.38 $14.65 -8.7%Pharmacy Technicians 1,340 128.9 116.4 10.8% $11.09 $11.55 -4.0%Medical Secretaries 1,270 122.2 127.3 -4.0% $12.17 $12.60 -3.4%Home Health Aides 1,260 121.2 201.3 -39.8% $9.88 $9.46 4.4%Healthcare Support Workers, All Other 1,240 119.3 71.3 67.3% $11.12 $12.26 -9.3%Radiologic Technologists and Technicians 980 94.3 90.2 4.5% $20.47 $21.58 -5.2%Pharmacists 900 86.6 97.6 -11.3% $41.63 $40.64 2.4%Medical and Clinical Laboratory Technologists 750 72.1 79.5 -9.3% $21.84 $21.92 -0.4%Medical Records and Health Information Technicians 730 70.2 69.1 1.6% $14.23 $13.50 5.4%Physical Therapists 720 69.3 54.0 28.3% $28.87 $29.74 -2.9%Medical Transcriptionists 650 62.5 44.6 40.3% $13.92 $13.83 0.7%Respiratory Therapists 580 55.8 43.5 28.1% $20.66 $20.73 -0.3%Occupational Therapists 550 52.9 34.3 54.1% $26.11 $27.56 -5.2%Emergency Medical Technicians and Paramedics 540 51.9 57.4 -9.4% $12.10 $13.88 -12.8%Speech-Language Pathologists 530 51.0 37.1 37.4% $26.91 $26.05 3.3%Surgical Technologists 480 46.2 36.5 26.6% $16.02 $16.53 -3.1%Medical and Clinical Laboratory Technicians 400 38.5 65.1 -40.9% $14.77 $14.82 -0.3%Cardiovascular Technologists and Technicians 380 36.6 22.6 61.7% $17.46 $19.07 -8.4%Physical Therapist Assistants 370 35.6 26.8 33.0% $18.84 $18.28 3.1%Medical Equipment Preparers 350 33.7 19.7 70.7% $12.68 $11.86 6.9%Dietitians and Nutritionists 340 32.7 21.2 54.6% $19.84 $20.75 -4.4%Surgeons 340 32.7 27.9 17.2% $91.34 $91.79 -0.5%Health Technologists and Technicians, All Other 340 32.7 27.6 18.5% $18.18 $17.26 5.3%Family and General Practitioners 330 31.7 50.5 -37.1% $70.83 $72.87 -2.8%Opticians, Dispensing 310 29.8 25.7 16.1% $11.28 $13.95 -19.2%Medical Equipment Repairers 240 23.1 11.7 97.2% $18.38 $18.70 -1.7%Healthcare Practitioner and Technical Workers, All Other 210 20.2 25.4 -20.4% $15.67 $18.10 -13.4%Diagnostic Medical Sonographers 190 18.3 19.9 -8.1% $23.49 $25.22 -6.9%Internists, General 180 17.3 26.3 -34.1% $56.85 $75.14 -24.3%Pharmacy Aides 170 16.4 14.2 14.9% $9.26 $9.00 2.9%Dental Laboratory Technicians 160 15.4 16.6 -7.2% $14.95 $16.70 -10.5%

Health-Related Occupations, Employment and Pay in the Louisville MSA, 2004Employment by Occupation Average Hourly Wage

per 100,000 residentsLouisville

MSA16 MSA average

Louisville wage

relative to 16 MSA

average

Louisville concentration

as % of 16 MSA average

concentration

Number in Louisville

MSA

*According to OES website for MSA definitions, the 2004 OES estimates are aggregated to old MSA boundaries with total populations reflecting those boundaries.Source for 2002 US Population estimates <http:/ / www.census.gov/ popest/ archives/ 2000s/ vintage_2002/ NA-EST2002-01.html>Data for another 15 occupations were not available for Louisville; average for 16 metro areas calculated over metros for which data disclosed.


Manufacturing

38

Business establishments, pharmaceutical and medicine, 2002Business establishments, medical equipment & supplies, 2002Number of employees, medical equipment & supplies, 2002Average wages, average salaries, medical equipment & supplies, 2002

There are two manufacturing industries most clearly linked to health enterprises: pharmaceuticals and medicine (NAICS 3254), and medical equipment and supplies (NAICS 3391). Detailed industrial data on sales, payrolls, and jobs are only available every five years when the economic census is taken. The last census covered the year 2002, and results were published in late 2005. We summarize what was published for these two industries in the slides that follow. Due to federal privacy laws, some data for some metro areas are suppressed.

The census revealed no pharmaceutical companies in Louisville (we know of at least one Louisville company, CreoSalus, that manufacturers drugs and has a small but growing payroll). The lead cities were Kansas City, Raleigh, Omaha, Indianapolis, and Cincinnati.

Louisville did have 40 establishments that manufacture medical equipment and supplies, the same number as five years earlier. However, these manufacturers now employ 765 persons, a 33 percent growth over 1997. The companies shipped products valued at $92.8 million, and had an annual payroll of $28.7 million. In Louisville area, the pay was relatively high for production workers and low for supervisory employees, suggesting that most of the top managers in these firms are located outside of Louisville.



N umber of Business Establishments, Pharmaceutical and Medicine Manufacturing, 2002

0 5 10 15 20 25

Richmond

Lexington

Memphis

Greensboro

Charlotte

Columbus

Cincinnati

Indianapolis

Omaha

Raleigh

Kansas City

with 20 or more employees

with less than 20 employees

Source: US Census Bureau, 2002 Economic Census, October 2005.

Louisville has no pharmaceutical businesses. Kansas City, Raleigh, Omaha, Indianapolis, and Cincinnati have most.

40

N umber of Business Establishments, Medical Equipment & Supplies Manufacturing, 2002

0 10 20 30 40 50 60 70 80 90

Lexington

Raleigh

Greensboro

Richmond

Dayton

Birmingham

Louisville

Nashville

Memphis

Jacksonville

Columbus

Charlotte

Cincinnati

Kansas City

Indianapolis

with 20 or more employees

with less than 20 employees

Source: US Census Bureau, 2002 Economic Census, October 2005.


Louisville ranks in the middle in terms of total number of establishments, but has 11 firms with more than 20 employees.

N umber of Employees, Medical Equipment & Supplies Manufacturing, 2002

0 500 1000 1500 2000 2500 3000 3500 4000

Lexington

Birmingham

Nashville

Raleigh

Dayton

Louisville

Omaha

Richmond

Greensboro

Kansas City

Cincinnati

Charlotte

Columbus,

Indianapolis

Memphis

Jacksonville

Source: US Census Bureau, 2002 Economic Census, October 2005. Data for Omaha estimated based on range indicated.

Louisville’s medical equipment and supplies industry employed 765 persons in 2002, 11th

highest among the comparison metros.


Average Pay per Job, Medical Equipment and Supplies Manufacturing

Comparison Metros, 2002

$78,097

$62,918$59,903 $59,525 $59,457

$57,354$54,860 $53,224 $53,002

$50,373 $50,094 $48,810 $47,660$44,325

$39,959

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

Jackso

nville

Greensb

oroChar

lotte

Memph

isColu

mbus,

Raleigh

Indian

apolis

Lexing

tonCinc

innati

Kansas

CityLou

isville

Richmon

dDayt

onNash

ville

Birming

ham

$0.00

$5.00

$10.00

$15.00

$20.00

$25.00

hourly wage of production workers, right scale

annual pay, supervisory and other salaried workers, left scale

Pay for production workers was 2nd highest, behind only Jacksonville; pay for supervisory and other workers was 11th highest.


Corporate Headquarters

43

Market valuation of publicly traded companies headquartered in Louisville, 2000 to 2005Fortune 1000 companies, with revenues, 2004Dun&Bradstreet listings for Louisville MSAReference USA listing, all comparison metro areas February 2006Reference USA listing, continued

There is no publicly available database on company headquarters. We have investigated four privately produced directories to learn about major companies based in Louisville and our comparison metros. There are five publicly traded health-related companies headquartered in Louisville: Almost Family, Humana, Kindred Healthcare, ResCare, and Ventas. At the end 2005, their combined market value was $13.7 billion, a growth of almost fourfold since 2000.

Fortune magazine famously publishes a list each year of the top 1000 companies in terms of sales. We have sorted the list by industry and headquarters location, and reported the results in the next slide. Louisville is home to two of the 79 companies listed under health-related industries nationally - Humana and Kindred Healthcare. Nashville clearly dominates the ranking, followed by Indianapolis and Louisville.

We examined Dun&Bradstreet’s listing for the Louisville metropolitan area. This is the most exhaustive company listing we are aware of, but it would be expensive to acquire it for all the comparison markets. It shows 14 Louisville-based companies in health-related industries with revenues of over $100 million, and another 28 with revenues between $10 and $100 million. Many of these are large Louisville-only operations, such as University Hospital. However, some prominent Louisville-based organizations are not listed (under health-related industries), such as Jewish Hospital, Ventas, Passport, Trover, SHPS, and Yellow Ambulance.

Finally, we examined another database, Reference USA, which lists companies by place and industry. Reference USA is similar to Dun & Bradstreet but can be accessed without charge via licensed sites such as publiclibraries. It has limitations, including the occasional use of ranges rather than discrete numbers for employment and sales, some discrepancies in business type when compared to Dun&Bradstreet (headquarters, branch, single site, subsidiary) and the inability to access more than 50 records at a time. The database is updated twice yearly.


company ticker 2000 2001 2002 2003 2004 2005

change 2000 to

2005percent change

Almost Family AFAM $11.2 $39.2 $15.7 $20.6 $34.1 $37.3 $26.2 234.7%Humana HUM $2,555.6 $1,990.0 $1,672.8 $3,681.0 $4,731.8 $8,843.2 $6,287.5 246.0%Kindred Healthcare KND $3.6 $811.5 $320.3 $928.5 $1,111.0 $1,004.4 $1,000.8 27928.6%ResCare RSCR $109.4 $215.7 $88.6 $199.8 $388.2 $462.1 $352.7 322.3%Ventas VTR $384.9 $791.7 $797.7 $1,762.3 $2,312.0 $3,302.8 $2,917.9 758.2%sum $3,064.7 $3,848.1 $2,895.1 $6,592.2 $8,577.0 $13,649.8 $10,585.2 345.4%from Compustat database University of Louisville, May 17, 2006

Market Value, Publicly Traded Companies Headquartered in Louisvilleyear ending December 31, in millions


Company IndustryRevenues (mil)

2005 City MetroCaremark Rx Health Care: Pharmacy and Other Services $32,991 Nashville NashvilleHCA Health Care: Medical Facilities $24,455 Nashville NashvilleWellpoint Health Care: Insurance $45,136 Indianapolis IndianapolisEli Lilly Pharmaceuticals $14,645 Indianapolis IndianapolisHumana Health Care: Insurance $14,418 Louisville LouisvilleOmnicare Health Care: Pharmacy and Other Services $5,293 Covington CincinnatiGuidant Medical Products & Equipment $3,551 Indianapolis IndianapolisKindred Healthcare Health Care: Medical Facilities $3,979 Louisville LouisvilleCommunity Health Sys. Health Care: Medical Facilities $3,789 Brentwood NashvilleVanguard Health Systems Health Care: Medical Facilities $2,269 Nashville NashvilleLifepoint Hospitals Health Care: Medical Facilities $1,903 Brentwood NashvilleIasis Healthcare Health Care: Medical Facilities $1,524 Franklin NashvillePSS World Medical Health Care: Wholesalers $1,474 Jacksonville JacksonvilleRenal Care Group Health Care: Medical Facilities $1,570 Nashville NashvilleSource: Fortune Magazine, April 17, 2006; www.fortune.com.

H ealth-Related Fortune 1000 Companies, H eadquartered in Comparison Metros

Louisville is home to two of the 79 Fortune 1000 companies classified as health-related: Humana and Kindred Healthcare. Among the comparison metros, Louisville ranks behind only Nashville (7) and Indianapolis (3).


Company Name City SalesEmployment

HereEmployment

Total Line of BusinessHumana Inc. Louisville $13,104,325,000 1,100 13,700 PROVIDES HMOS & PPOS SUPPLEMENTAL HEALTH INSURANCE & PROKindred Healthcare Inc Louisville $3,531,223,000 50 50,840 HOSPITALS NURSING CENTERS & INSTITUTIONAL PHARMACIESHumana Health Plan, Inc Louisville $2,199,657,000 4 3,000 HEALTH INSURANCE CARRIER & HMOBaptist Healthcare System Louisville $1,283,966,000 224 8,996 HOSPITALS AND MEDICAL CLINICS HOSPITAL MANAGEMENTRES-Care Inc Louisville $1,009,016,000 300 30,000 INTERMEDIATE CARE FACILITY & JOB TRAINING/ RELATED SVCKosair Children's Hospital Louisville $779,264,000 1,200 1,500 GENERAL HOSPITALAnthem Health Plans of KY Louisville $698,700,000 200 1,800 HEALTH CARE PLANNorton Audubon Hospital Louisville $580,000,000 1,100 1,242 GENERAL MEDICAL SURGICAL HOSPITALNorton Healthcare, Inc Louisville $312,700,000 950 9,300 MANAGEMENT SERVICES GENERAL HOSPITALUniversity Medical Center Inc Louisville $290,676,000 1,955 2,000 GENERAL MEDICAL & SURGICAL HOSPITALHumana Mlitary Healthcare Svcs Louisville $269,800,000 190 700 HEALTH CARE SERVICESFloyd Mem Hosp & Hlth Svcs New Albany $240,488,000 1,100 1,200 GENERAL HOSPITAL MEDICAL DOCTOR'S OFFICEAtria Senior Living Group Louisville $183,600,000 120 7,500 ASSISTED LIVINGClark Memorial Hospital Jeffersonville $109,656,000 1,498 1,500 GENERAL HOSPITALDelta Dental of Kentucky Inc Louisville $91,430,000 0 89 HOSPITAL/ MEDICAL SERVICE PLAN INSURANCE AGENT/ BROKERAlmost Family Inc Louisville $86,827,000 40 3,182 HOME HEALTH CARE SERVICES AND ADULT DAY CARE CENTERSeven Counties Services Inc Louisville $78,504,000 0 1,300 SOCIAL SERVICE MEDICAL DOCTORS OFFICE SPECIALTY OUTPATIENNorton Hospitals, Inc Louisville $69,800,000 50 1,500 HOSPITALS PHYSICIAN GROUPS SPECIALTY CARE CENTERSSpectracare Inc Louisville $64,987,000 300 1,400 HOME HEALTH CARE SERVICESTrilogy Health Services LLC Louisville $62,727,000 25 2,000 NURSING/ PERSONAL CARE NONRESIDENTIAL CNSTN MANAGEMENNorton Hospital Louisville $57,600,000 1,150 1,242 GENERAL SURGICAL HOSPITALHealthessentials Solutions Inc Louisville $53,102,000 250 684 GERIATRIC MEDICAL CAREChristian Care Community Inc Louisville $48,386,000 40 1,300 RESIDENTIAL CARE SERVICE MANAGEMENT SERVICES INTERMEDIAVencare Rehab Services Inc Louisville $45,800,000 115 2,000 EXTENDED CARE FACILITY FOR THE ELDERLYVencare Kentucky, Inc Louisville $44,300,000 82 900 SPECIALTY HOSPITALUnited Rehab LLC Louisville $41,000,000 25 2,200 NURSING CARE FACILITYBaptist Hlthcare Affliates Inc Louisville $34,898,000 10 415 GENERAL HOSPITALCompdent Corporation Louisville $30,700,000 64 79 DENTAL BENEFIT PLANDr Bizer's Visionworld Clarksville $25,000,000 30 500 OPTOMETRIST & OPTICIANSPresbyterian Homes Svcs of KY Louisville $19,793,000 12 382 INDEPENDENT LIVING & SKILLED CARE NURSING HOMESChristian Ch Campus of Wstn KY Louisville $18,800,000 30 850 NURSING FACILITY HOUSING FOR THE ELDERLYLifespring, Inc Jeffersonville $18,280,000 150 291 OUT PATIENT COMMUNITY MENTAL HEALTH & SUBSTANCE ABUSE CMasonic Homes of KY Inc Masonic Home $16,846,000 230 375 CIVIC/ SOCIAL ASSOCIATION SKILLED NURSING CARE FACILITYTransitional Hospitals Corp Louisville $16,300,000 150 368 OPERATES LONG TERM ACUTE CARE HOSPITALSSeniorcare LLC Louisville $15,800,000 15 850 INTERMEDIATE NURSING HOMESHoldaway Medical Services LLC Louisville $15,229,000 95 100 RENTS & RETAILS MEDICAL EQUIPMENTCardiovascular Associates PSC Louisville $15,000,000 195 220 MEDICAL DOCTOR'S OFFICEKutz Kleinert and Associates Louisville $13,100,000 130 200 PHYSICIANS & SURGEONCharlestown Hospital, Inc. Charlestown $12,500,000 270 289 GENERAL HOSPITALKentucky United Medical Corp Louisville $11,600,000 200 380 SPECIALTY OUTPATIENT FAC RESIDENTIAL CARE SERVICE SPECIALT

Health-Related Companies Headquarterd in the Louisville Areawith sales greater than $10 million


Companies Headquartered in the Louisville Metro Areawith sales greater than $10 million

Line of Business Company Name City Sales Employment Here Employment Total

Humana Inc. Louisville $13,104,325,000 1,100 13,700Humana Health Plan, Inc Louisville $2,199,657,000 4 3,000Anthem Health Plans of KY Louisville $698,700,000 200 1,800Norton Healthcare, Inc Louisville $312,700,000 950 9,300Humana Mlitary Healthcare Svcs Louisville $269,800,000 190 700Delta Dental of Kentucky Inc Louisville $91,430,000 0 89Compdent Corporation Louisville $30,700,000 64 79Holdaway Medical Services LLC Louisville $15,229,000 95 100Kindred Healthcare Inc Louisville $3,531,223,000 50 50,840Baptist Healthcare System Louisville $1,283,966,000 224 8,996Kosair Children's Hospital Louisville $779,264,000 1,200 1,500Norton Audubon Hospital Louisville $580,000,000 1,100 1,242University Medical Center Inc Louisville $290,676,000 1,955 2,000Floyd Mem Hosp & Hlth Svcs New Albany $240,488,000 1,100 1,200Clark Memorial Hospital Jeffersonville $109,656,000 1,498 1,500Norton Hospitals, Inc Louisville $69,800,000 50 1,500Norton Hospital Louisville $57,600,000 1,150 1,242Vencare Kentucky, Inc Louisville $44,300,000 82 900Baptist Hlthcare Affliates Inc Louisville $34,898,000 10 415Transitional Hospitals Corp Louisville $16,300,000 150 368Charlestown Hospital, Inc. Charlestown $12,500,000 270 289RES-Care Inc Louisville $1,009,016,000 300 30,000Atria Senior Living Group Louisville $183,600,000 120 7,500Trilogy Health Services LLC Louisville $62,727,000 25 2,000Vencare Rehab Services Inc Louisville $45,800,000 115 2,000United Rehab LLC Louisville $41,000,000 25 2,200Presbyterian Homes Svcs of KY Louisville $19,793,000 12 382Christian Ch Campus of Wstn KY Louisville $18,800,000 30 850Masonic Homes of KY Inc Louisville $16,846,000 230 375Seniorcare LLC Louisville $15,800,000 15 850Almost Family Inc Louisville $86,827,000 40 3,182Spectracare Inc Louisville $64,987,000 300 1,400Lifespring, Inc Jeffersonville $18,280,000 150 291Kentucky United Medical Corp Louisville $11,600,000 200 380Healthessentials Solutions Inc Louisville $53,102,000 250 684Seven Counties Services Inc Louisville $78,504,000 0 1,300Christian Care Community Inc Louisville $48,386,000 40 1,300

Dr Bizer's Visionworld Clarksville $25,000,000 30 500Cardiovascular Associates PSC Louisville $15,000,000 195 220Kutz Kleinert and Associates Louisville $13,100,000 130 200

Source: Dun & Bradstreet Business Director 47y, query February 2006

Soc

ial

Serv

ices

Med

ical

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MSA Annual RevenuesPrivate Research and DevelopmentBattelle Memorial Institute Columbus, OH Over $1 BillionPharmaceuticalsEli Lilly & Co Indianapolis, IN $13,857,900,000Cumberland Swan Holdings Inc Nashville, TN $100 to $500 MillionOmnicare Inc Cincinnati, OH-KY-IN $4,119,891,000Medical InstrumentsMettler-Toledo Inc Columbus, OH Over $1 BillionReynolds & Reynolds Co Dayton-Springfield, OH $982,241,000Aearo Co Indianapolis, IN $100 to $500 MillionMeridian Bioscience Inc Cincinnati, OH-KY-IN $79,606,000Medical SuppliesCardinal Health Inc Columbus, OH $74,910,700,000Guidant Corp Indianapolis, IN $3,765,600,000PSS World Medical Inc Jacksonville, FL $1,473,769,000Barnhardt Manufacturing Co Charlotte-Gastonia, NC-SC $100 to $500 MillionGuilford Mills Inc Greensboro-Winston Salem, NC $100 to $500 MillionVitafoam Inc Greensboro-Winston Salem, NC $100 to $500 MillionAmerican Home Patient Inc Nashville, TN $335,823,000Outpatient Medical ServicesHealth South Corp Birmingham, AL $3,753,781,000Renal Care Group Inc Nashville, TN $1,345,047,000AM Surg Corp Nashville, TN $301,408,000Symbion Inc Nashville, TN $216,325,000LCA-Vision Inc Cincinnati, OH-KY-IN $127,122,000Sight Resource Corp Cincinnati, OH-KY-IN $50 to $100 Million

Corporate Headquarters, Health-Related Companies

continued……


Inpatient Health ServicesHCA Inc Nashville, TN $23,502,000,000Community Health Systems Inc Nashville, TN $3,332,641,000Catholic Healthcare Partners Cincinnati, OH-KY-IN Over $1 BillionVanguard Health Systems Inc Nashville, TN Over $1 BillionLife Point Hospitals Inc Nashville, TN $996,900,000Iasis Healthcare Corp Nashville, TN $500 Million to $1 BillionBaptist Health System Inc Birmingham, AL $500 Million to $1 BillionNorton Health Care Louisville, KY-IN $500 Million to $1 BillionAlegent Health Omaha, NE-IA $500 Million to $1 BillionMed Cath Corp Charlotte-Gastonia, NC-SC $692,791,000America Service Group Inc Nashville, TN $665,113,000Psychiatric Solutions Inc Nashville, TN $480,190,000Kettering Medical Ctr Network Dayton-Springfield, OH $100 to $500 MillionNursing Homes, Assisted Living, Home HealthKindred Healthcare Inc Louisville, KY-IN $3,531,223,000Res Care Inc Louisville, KY-IN $1,009,016,000National Health Care CORP Nashville, TN $521,829,000American Retirement Corp Nashville, TN $447,609,000Advocat Inc Nashville, TN $202,819,000Almost Family Inc Louisville, KY-IN $86,827,000Health Management Assoc Inc Lexington, KY $10 to $20 MillionHealth Insurance/ Health ManagementHumana Inc Louisville, KY-IN $13,104,325,000Conseco Inc Indianapolis, IN $4,330,000,000Jefferson-Pilot Corp Greensboro-Winston Salem, NC $4,102,000,000Torchmark Corp Birmingham, AL $3,071,500,000Nationwide Mutual Ins Co Columbus, OH Over $1 BillionCerner Corp Kansas City, MO-KS $926,356,000American Healthways Inc Nashville, TN $245,410,000Source: Reference USA , February 2006, with companies screened to ensure proper industrial classification.

Corporate Headquarters, Health-Related Companies (cont)


Scientific Research & DevelopmentWe have some limited data on establishments engaged in scientific research and

development (NAICS 5417). Detailed metro-level data on industries is only available every five years when the economic census is taken. The last economic census covered the year 2002, and was published in late 2005. No data was disclosed on sales or payrolls for any of the sixteen comparison metros, but job estimates were reported in ranges.

According to the economic census, the Louisville metro area has 27 establishments in this industrial category. Only Omaha, Lexington, and Greensboro have fewer among the comparison metros. On a per capita basis, Louisville ranks last.


51

Scientific R&D Establishments per 100,000 population

2.36

2.46

2.68

2.88

3.47

3.50

3.74

3.81

3.87

4.17

4.17

5.48

5.76

8.74

14.55

5.47

2.28

0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0

Louisville

Memphis

Jacksonville

Omaha

Nashville

Charlotte

Greensboro

Birmingham

Kansas City

Indianapolis

Cincinnati

Richmond

Columbus

Lexington

Dayton

Raleigh

US

Source: US Bureau of the Census, 2002 Economic Census, NAICS 5417.


According to the last economic census, Louisville has only 27 establishments engaged in scientific research and development, ranking last on a per capita basis among the comparison metros.

No sales, payroll, or job data were disclosed by the Census Bureau, though a range of 500-999 employees was given for Louisville.

University Research ActivityThe University of Louisville continues to move up in important rankings of research activity.

In the next few slides, we summarize data on research funding, scholarship, and licensing.

Over the last eight years tracked, UL passed one hundred institutions in the amount of research funding from the National Institutes of Health, the prime supporter of basic research in the life sciences. UL now receives over $50 million annually in NIH funding, compared to only $7 million eight years ago. In 2004, UL ranked 103rd among all institutions, up from 204th in 1996.

UL medical school faculty and scientists are the main attractor of NIH funding. The school gained 40 million in NIH funding in FY04. We have identified fifteen medical schools located in the comparison metros. UL now ranks 8th highest in NIH funding among those schools, up three places since our 2001 study. Across all medical schools in the United States, UL has moved up from 95th to 72nd place in just five years. Vanderbilt University and the University of Alabama at Birmingham continue to top the rankings among the comparison metros, with five times the NIH funding as UL. Several of the metros have more than one medical school, including Kansas City, Nashville, and Omaha.

Considering only the life sciences, UL attracted $31 million in federal research funding in FY04, the latest year for which data are available.

UL health scholars published 2,588 journal articles between 2001 and the beginning of 2006. This is 8th highest among the universities in the sixteen metro areas. The recent growth in scholarship was 7th highest.

Finally, UL executed four commercialization licenses in FY04, and received around $100,000 in license income. On this measure, Louisville still ranks near the bottom of the rankings with our comparison metros.


University Research ActivityNational Institutes of Health research funding

University of Louisville, 1996 thru 200415 medical schools, and NIH funding, 2004NIH research funding, medical schools in comparison metros, 2004Growth in NIH research funding, medical schools in comparison metros, 2000 to 2004Federally-funded university research in life sciences fields, 2001-2003

Faculty research, Louisville vs. comparison metrosArticles published, 2001 thru presentGrowth in articles published, 1996/00 to 2001/presentNumber of articles published, 1996/00 and 2001/presentArticles published, selected universities, 2000 thru present

Licenses and royalties, Louisville and comparison metrosLicenses and options executed, 2004Adjusted gross license income received, 2004


Awards from N ational Institutes of Healthto the University of Louisville

$0

$10,000,000

$20,000,000

$30,000,000

$40,000,000

$50,000,000

1996 1997 1998 1999 2000 2001 2002 2003 2004

Fiscal Year

rank among all institutions = 103rd


rank among all institutions = 204th

Source: National Institutes for Health

Medical School portion

Schools City

Total, including research, training, fellowships, other Research

University of Alabama School of Medicine Birmingham $207,078,637 $164,468,537University of Cincinnati College of Medicine Cincinnati $92,000,206 $85,350,481Ohio State University College of Medicine Columbus $77,046,216 $72,663,412Wright State Univeristy School of Medicine Dayton $8,884,435 $8,835,506Indiana University School of Medicine Indianapolis $102,406,769 $94,084,915Univesity of Kansas School of Medicine Kansas City $34,291,511 $32,690,756University of Missouri-Kansas City School of Medicine Kansas City $3,434,690 $3,434,690University of Kentucky College of Medicine Lexington $62,202,492 $60,093,460University of Louisville School of Medicine Louisville $40,117,515 $39,503,200University of Tennessee College of Medicine Memphis $46,912,901 $44,575,404Vanderbilt University School of Medicine Nashville $226,826,142 $206,509,582Meharry Medical College School of Medicine Nashville $26,181,050 $21,356,870Creighton University School of Medicine Omaha $7,291,315 $6,611,791University of Nebraska College of Medicine Omaha $34,006,282 $32,496,519Virginia Commonwealth University School of Medicine Richmond $59,133,196 $56,387,293Source: National Institutes of Health

National Institutes of Health Funding, FY 2004

Medical Schools in Comparison Metropolitan Areas


Federal Research Grants and Contracts Awarded to Medical Schools, by Metro Area, 2004

$8,884,435

$37,726,201

$41,297,597

$46,912,901

$59,133,196

$62,202,492

$77,046,216

$92,000,206

$102,406,769

$207,078,637

$253,007,192

$40,117,515

$- $50,000,000 $100,000,000 $150,000,000 $200,000,000 $250,000,000 $300,000,000

DAYTON

KANSAS CITY

LOUISVILLE

OMAHA

MEMPHIS

RICHMOND

LEXINGTON

COLUMBUS

CINCINNATI

INDIANAPOLIS

BIRMINGHAM

NASHVILLE

Source: National Institutes of Health. Total federal research awards, including grants, fellowships and contracts, to U.S. med schools in 2004 was approx. $11.2 billion.

There are 15 medical schools

located in 12 of the 16 comparison

metros. Louisville ranked 10th in

funding in 2004.


57

Federal Research Grants and Contracts Awarded to Medical Schools, Growth FY99 to FY04, by Metro Area

7%

12%

20%

42%

51%

65%

70%

103%

105%

109%

175%

302%

COLUMBUS

CINCINNATI

DAYTON

KANSAS CITY

RICHMOND

BIRMINGHAM

INDIANAPOLIS

LEXINGTON

OMAHA

MEMPHIS

NASHVILLE

LOUISVILLE

Source: National Institutes of Health. At the national level, federal research grants and contracts awarded to med schools increased by 50% between fiscal years 1999 and 2004.


Louisville (UL) ranks first in

growth rate for federal research

grants this decade. Awards rose from $10 million to $40

million in five years.

University City 2000 2001 2002Total Life Sciences

Agricultural Sciences

Biological Sciences

Medical Sciences

Life sciences, nec

University of Alabama-Birmingham Birmingham $162,927 $182,745 $203,111 $226,708 $0 $71,622 $152,411 $2,675University of Cincinnati all campuses Cincinnati $94,624 $112,087 $133,431 $167,484 $0 $48,856 $115,730 $2,898Ohio State University, all campuses Columbus $79,507 $94,278 $109,006 $116,877 $6,306 $40,152 $55,686 $14,733Wright State University, all campuses Dayton $8,064 $10,229 $10,321 $12,098 $0 $779 $11,258 $61University of Missouri-Kansas City Kansas City $5,939 $6,667 $8,819 $12,021 $0 $4,289 $7,732 $0University of Kentucky, all campuses Lexington $50,133 $60,341 $66,199 $79,976 $6,988 $34,550 $36,580 $1,858University of Louisville Louisville $13,668 $19,988 $30,070 $30,931 $0 $3,767 $24,871 $2,293Meharry Medical College Nashville $8,865 $14,305 $20,453 $24,195 $0 $23,331 $864 $0Vanderbilt University Nashville $103,565 $117,681 $138,209 $179,144 $0 $93,586 $80,036 $5,522North Carolina State University Raleigh $31,200 $34,243 $37,438 $39,689 $10,426 $28,316 $0 $947Virginina Commonwealth University Richmond $45,047 $48,836 $56,343 $69,759 $0 $26,882 $38,509 $4,368

2003, by sub-field

Federally financed R&D expenditures in the life sciences at universities and colleges, ranked by all FY 2003 life sciences for the first 150 institutions: FY 2000–03 and by subfield for FY 2003 (in thousands of dollars)

SOURCE: National Science Foundation/ Division of Science Resources Statistics, Survey of Research and Development Expenditures at Universities and Colleges, FY 2003; <http:/ / www.nsf.gov/ statistics/ nsf05320/ > Table 53 fy 2003.

Federally-funded life sciences research at the University of Louisville is concentrated in the medical fields. Some comparison universities, particularly state flagships, have a

major research emphasis in agricultural and/or biological sciences.(Indianapolis activity is counted under IU and Purdue. University of Memphis activity counted under UT system. State medical school activity in Kansas City and Omaha are counted under University of Missouri and University of Nebraska, respectively).



Number of Journal Articles Published 2001 to February 2006, by Metro Area

82

182

221

320

726

1,824

1,831

2,170

2,683

3,077

3,977

5,109

5,166

5,975

6,127

2,588

0 1,000 2,000 3,000 4,000 5,000 6,000 7,000

Jacksonville

Greensboro

Charlotte

Indianapolis

Dayton

Kansas City

Memphis

Raleigh

Louisville

Omaha

Richmond

Lexington

Birmingham

Cincinnati

Nashville

Columbus

Source: Medline database [via Pubmed], widely recognized as the premier source for bibliographic coverage of biomedical literature. Years 2001 to 2006 (Feb).


Growth in Articles Published by University and Medical School Faculty, 1996/ 00 to 2001/ 2006, by Metro Area

22%

23%

27%

27%

38%

42%

49%

58%

59%

61%

37%

21%

2%

7%

8%

9%

0% 10% 20% 30% 40% 50% 60% 70%

Dayton

Memphis

Omaha

Kansas City

Lexington

Richmond

Columbus

Nashville

Birmingham

Louisville

Indianapolis

Raleigh

Jacksonville

Greensboro

Cincinnati

Charlotte



1,884

2,588

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

Jack

sonv

ille

Gre

ensb

oro

Char

lotte

Indi

anap

olis

Day

ton

Kan

sas C

ity

Mem

phis

Ralei

gh

Loui

svill

e

Om

aha

Rich

mon

d

Lexi

ngto

n

Birm

ingh

am

Cinc

inna

ti

Nas

hvill

e

Colu

mbu

s

1996-2000 2001-2006

Source: Medline database [via Pubmed], widely recognized as the premier source for bibliographic

coverage of biomedical literature. Years 2001 to 2006 (Feb).

Journal Articles Published by University Faculty 1996-2000 and 2001-2006, by Metro Area

373

1,307

2,064

3,673

4,361

4,696

7,164

7,548

3,846

7,085

0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000

Indiana University - PurdueUniversity at Indianapolis

University of Kansas Medical Center

University of Nebraska MedicalCenter

Virginia Commonwealth University

University of Louisville

University of Cincinnati

University of Kentucky

Vanderbilt University

Ohio State University

University of Alabama atBirmingham

Number of Medical Articles Published by University of Louisville and Selected Universities, 2000-2006



University Licenses and Options Executed, FY 2004

4

4

5

5

9

11

14

14

16

17

28

28

30

72

4

0 10 20 30 40 50 60 70 80

Charlotte

Dayton

Louisville

Greensboro

Kansas City

Indianapolis

Lexington

Birmingham

Memphis

Omaha

Richmond

Cincinnati

Nashville

Columbus

Raleigh

Source: AUTM Licensing Survey: Selected Facts and Figures for Fiscal Year 2004. Association of University Technology Managers. Data were aggregated for metros with more than one university engaged in licensing. Data for Indianapolis, Memphis, and Omaha interpolated from figures on state university system. Jacksonville has a Mayo Clinic facility, and we did not feel comforable assigning a portion of the total for the organization to that market.


University Adjusted Gross License Income Received, FY 2004

$32,212

$77,300

$110,680

$237,124

$486,995

$629,033

$670,007

$749,582

$762,530

$1,979,931

$3,353,967

$4,293,311

$4,459,038

$4,813,156

$98,841

$- $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 $6,000,000

Greensboro

Charlotte

Louisville

Kansas City

Dayton

Memphis

Columbus

Richmond

Omaha

Lexington

Birmingham

Cincinnati

Indianapolis

Nashville

Raleigh

Source: AUTM Licensing Survey: Selected Facts and Figures for Fiscal Year 2004. Association of University Technology Managers. Data were aggregated for metros with more than one university engaged in licensing. Data for Indianapolis, Memphis, and Omaha interpolated from figures on state university system. Jacksonville has a Mayo Clinic facility, and we did not feel comforable assigning a portion of the total for the organization to that market.


Small Business Innovation Research and Technology Transfer Grants

U.S. Small Business Administration programs for technology-oriented start-ups: “The Office of Technology promotes small business high technology programs to improve the competitive capability of small research and development businesses with particular emphasis on emerging and under served small firms. It encourages state-of-the-market technology training, technology information exchange, and outreach on federal technology programs.” in 2004, Louisville area companies won 12 grants worth $5 million (fifth highest among comparison metros in both number and value). Dayton is clear leader.over the 2000-04 period, Louisville area companies won 39 grants worth $11 million



SBIR-STTR awards by Government Agency Louisville Metro Area

FY 2004

Defense8%Health & Human

Services 67%

NASA8% Agriculture

7%

Source: US Small Business Administration, Small Business Innovation Research Program and Small Business Technology Transfer Program,

2004 d

1 award @ $69,992,000 2 awards totaling $154,700

1 award @ $1.5 million

8 awards totaling $3.3 million

Total Amount Awarded FY 2004:$5.04 million

Number of SBIR-STTR Awards Granted by Fiscal Year 2004

1

2

2

4

5

7

8

8

8

9

10

29

34

39

108

12

0 20 40 60 80 100 120

Memphis

Lexington

Jacksonville

Omaha

Kansas City

Nashville

Birmingham

Greensboro

Richmond

Indianapolis

Charlotte

Louisville

Cincinnati

Columbus

Raleigh

Dayton

Source: US Small Business Administration, Small Business Innovation Research Program and Small Business Technology

Transfer Program, 2004 data.


SBIR-STTR Awards by Metro Area Fiscal Year 2004

$100,000

$900,837

$1,280,049

$1,805,831

$1,844,602

$2,584,021

$2,700,163

$3,144,392

$3,444,605

$3,840,474

$4,510,914

$7,997,570

$10,603,385

$12,667,456

$30,911,835

$5,047,291

$0 $5,000,000 $10,000,000 $15,000,000 $20,000,000 $25,000,000 $30,000,000 $35,000,000

Memphis

Jacksonville

Lexington

Kansas City

Birmingham

Charlotte

Greensboro

Richmond

Indianapolis

Omaha

Nashville

Louisville

Cincinnati

Raleigh

Columbus

Dayton

Source: US Small Business Administration, Small Business Innovation Research Program and Small Business

Technology Transfer Program, 2004 data.



Year Firm Federal Agency Amount2004 Vitok Engineers, Inc. Defense $1,500,0002004 Space Hardware Optimization Technology, Inc. Health & Human $1,188,6912004 Peptides International, Inc. Health & Human $822,2612003 Space Hardware Optimization Technology, Inc. Defense $777,2362002 Space Hardware Optimization Technology NASA $669,8812000 Visual Computing Systems Corporation NASA $600,0002002 Space Hardware Optimization Technology, NASA $600,0002002 Intellas Group, LLC NASA $598,3462000 Space Hardware Optimization Technology Inc NASA $580,0002004 Potentia Pharmaceuticals Health & Human $504,0002003 Assenti, LLC Health & Human $501,4642004 Potentia Pharmaceuticals Health & Human $252,7982004 Regenerex, LLC Health & Human $220,5002002 Space Hardware Optimization Technology, Inc. Health & Human $176,9462000 Graphzepp Health & Human $149,3922004 Neuronetrix, Inc. Health & Human $126,6832004 Ocular Transplantation, LLC Health & Human $107,6592003 Vitatech, LLC Health & Human $107,0002000 Visual Computing Systems Corporation Energy $100,0002000 Ocular Transplantation, LLC Health & Human $100,0002001 Peptides International, Inc. Health & Human $100,0002002 Kinetic Art & Technology Corp. Energy $100,0002002 Apoimmune. Inc. Health & Human $100,0002002 Space Hardware Optimization Technology NASA $100,0002004 Apoimmune. Inc. Health & Human $100,0002001 Visual Computing Systems Corp. Defense $99,9932003 Space Hardware Optimization Technology, Inc. National Scien $99,9762002 Borries Design & Consulting Defense $99,0002002 Neurotek, Llc D/ B/ A Peak Achievement Training Defense $99,0002003 Space Hardware Optimization Technology, Inc. Health & Human $92,5492004 NetQuest Services, LLC Agriculture $80,0002004 Caudill Seed Co., Inc. Agriculture $74,7072001 Space Hardware Optimization Technology NASA $69,9952001 Space Hardware Optimization Technology NASA $69,9942004 Space Hardware Optimization Technology, Inc. NASA $69,9922003 Vitok Engineers, Inc. Defense $69,9212002 Space Hardware Optimization Technology NASA $69,8222002 Space Hardware Optimization Technology, Inc. Defense $69,0002003 Vitok Engineers, Inc. Defense $68,648Total $11,315,454

Source: U.S. Small Business Administration

SBIR/ STTR Grants to Louisville MSA Companies, 2000 to 2004

Growth in the Number of SBIR-STTR Awards Granted by Fiscal Year, 2000 to 2004

0

1

1

1

2

2

2

4

5

10

7

7

-1

-2

-400% -200% 0% 200% 400% 600% 800% 1000% 1200%

Birmingham

Nashville

Omaha

Greensboro

Lexington

Memphis

Indianapolis

Jacksonville

Richmond

Kansas City

Cincinnati

Charlotte

Louisville

Columbus

Source: US Small Business Administration, Small Business Innovation Research Program and Small Business

Technology Transfer Program, 2000-2004 data.


Growth in Value of SBIR-STTR Awards by Metro Area, FY 2000 to 2004

$1,040,049

$1,540,831

$1,762,802

$2,645,722

$2,651,767

$3,561,080

$3,847,761

$4,555,071

$8,577,088

$9,481,244

$16,217,381

$3,517,899

-$235,758

$1,985,055

-$2,000,000 $0 $2,000,000 $4,000,000 $6,000,000 $8,000,000 $10,000,000 $12,000,000 $14,000,000 $16,000,000 $18,000,000

Birmingham

Lexington

Kansas City

Greensboro

Charlotte

Richmond

Indianapolis

Louisville

Omaha

Nashville

Cincinnati

Raleigh

Columbus

Dayton

Source: US Small Business Administration, Small Business Innovation Research Program and Small

Business Technology Transfer Program, 2000-2004 data.


Utility Patents Granted, by Metro Area, 2004

1

4

7

9

10

11

16

17

25

39

41

44

79

88

104

15

0 20 40 60 80 100 120

Lexington

Greensboro

Nashville

Dayton

Richmond

Charlotte

Louisville

Omaha

Jacksonville

Kansas City

Birmingham

Columbus

Memphis

Raleigh

Indianapolis

Cincinnati


Percent Growth in Utility Patents Granted,by Metro Area, 2000 to 2004

-61.5%

-52.6%

-52.2%

-48.8%

-47.2%

-46.8%

-22.8%

-22.2%

-20.0%

-19.6%

0.0%

0.0%

6.3%

7.1%

8.2%

25.8%

-70.0% -60.0% -50.0% -40.0% -30.0% -20.0% -10.0% 0.0% 10.0% 20.0% 30.0% 40.0%

Richmond

Dayton

Charlotte

Indianapolis

Cincinnati

Kansas City

Memphis

Nashville

Omaha

Columbus

Lexington

Greensboro

Jacksonville

Louisville

Raleigh

Birmingham


Notes1. Metropolitan area definitions have changed since our last report. For example, the Louisville MSA now includes thirteen

counties rather than seven. The changes impacted rankings of health-related activity, particularly for the North Carolina metros. The Charlottte, Greensboro, and Raleigh metros were split into multiple metros, thus lowering their populations, dropping some universities, and narrowing their economic bases. The Raleigh metro formerly included counties containing the Duke University and the University of North Carolina, as well as North Carolina State University. Only NCSU is located in the newly defined Raleigh metro. See accompanying table for a detailed list of changes to metropolitan area definitions since our last study.

2. Historical comparisons are also made more tricky due to the conversion from the Standard Industrial Classification (SIC) system to the North American Industrial Classification System (NAICS). The conversion took place for most data series in the late 1990s. Some statistical agencies have made retroactive estimates, others have not.. See the following web site for a correspondence between SIC and NAICS industrial classifications: www.census.gov/epcd/www/naicstab.htm


Green (additions), Red (subtractions) from previous MSA definition

CountyCode

Metropolitan Statistical Area or equivalent 2003

Population 2002

13820 Birmingham-Hoover, AL 1,068,17701007 .Bibb County, AL, added to Brimingham MSA in 2003 21,83801009 .Blount County, AL 52,96801021 .Chilton County, AL added to Brimingham MSA in 2003 40,51601073 .Jefferson County, AL 661,15301115 .St. Clair County, AL 67,21501117 .Shelby County, AL 153,83201127 .Walker County, AL added to Brimingham MSA in 2003 70,655

16740 Charlotte-Gastonia-Concord, N C-SC 1,410,29237007 .Anson County, NC added to Charlotte MSA in 2003 25,35137025 .Cabarrus County, NC 140,18237071 .Gaston County, NC 193,44337119 .Mecklenburg County, NC 737,95037179 .Union County, NC 139,61145091 .York County, SC 173,75537159 Rowan, NC becomes part of Salisbury NC Micropolitan Area 133,35937109 Lincoln, NC becomes part of Lincolnton NC Micropolitan Area 66,598

17140 Cincinnati-Middletown, OH-KY-IN 2,040,74618029 .Dearborn County, IN 47,33318047 .Franklin County, IN added to Cincinnati MSA in 2003 22,58518115 .Ohio County, IN 5,80421015 .Boone County, KY 93,29021023 .Bracken County, KY added to Cincinnati MSA in 2003 8,48221037 .Campbell County, KY 88,60421077 .Gallatin County, KY 7,83621081 .Grant County, KY 23,62021117 .Kenton County, KY 152,16421191 .Pendleton County, KY 14,81539015 .Brown County, OH 43,46439017 .Butler County, OH added to Cincinnati MSA in 2003 340,54339025 .Clermont County, OH 183,35239061 .Hamilton County, OH 833,72139165 .Warren County, OH 175,133

MSA Definitions, as of 2005 18140 Columbus, OH 1,659,89339041 Delaware County, OH 125,39939045 Fairfield County, OH 129,16139049 Franklin County, OH 1,086,81439089 Licking County, OH 148,73139097 Madison County, OH 40,36539117 Morrow County, OH added to Columbus MSA in 2003 32,97639129 Pickaway County, OH 53,43739159 Union County, OH added to Columbus MSA in 2003 43,010

19380 Dayton, OH 846,71039057 .Greene County, OH 149,96439109 .Miami County, OH 99,59639113 .Montgomery County, OH 554,47039135 .Preble County, OH added to Dayton MSA in 2003 42,68039023 Clark, OH becomes part of Springfield OH MSA in 2003 143,416

Greensboro-High Point, N C 657,93237081 .Guilford County, NC 430,93737151 .Randolph County, NC 134,21737157 .Rockingham County, NC added to Greensboro MSA in 2003 92,77837057 Davidson, NC becomes part of Lexington-Thomasville, NC Micro SA in 2003 151,23837059 Davie County, NC becomes part of Winston-Salem NC MSA in 2003 36,73437169 Stokes County, NC becomes part of Winston-Salem NC MSA in 2003 44,98437067 Forsyth County, NC becomes part of Winston-Salem NC MSA in 2003 314,93337197 Yadkin County, NC becomes part of Winston-Salem NC MSA in 2003 37,32937001 Alamance County, NC becomes part of Burlington NC MSA in 2003 135,893

26900 Indianapolis, IN 1,574,68018011 .Boone County, IN 48,27718013 .Brown County, IN added to Indianapolis MSA in 2003 15,21118057 .Hamilton County, IN 205,61018059 .Hancock County, IN 58,34318063 .Hendricks County, IN 114,30118081 .Johnson County, IN 121,60418097 .Marion County, IN 863,42918109 .Morgan County, IN 67,79118133 .Putnam County, IN added to Indianapolis MSA in 2003 36,44018145 .Shelby County, IN 43,67418095 Madison County, IN becomes part of Anderson, IN MSA in 2003 132,068


27260 Jacksonville, FL 1,177,60212003 .Baker County, FL added to Jacksonville MSA in 2003 22,79312019 .Clay County, FL 152,09312031 .Duval County, FL 806,12012089 .Nassau County, FL 60,55812109 .St. Johns County, FL 136,038

28140 Kansas City, MO-KS 1,889,31529013 .Bates County, MO added to Kansas City MSA in 2003 16,97629025 .Caldwell County, MO added to Kansas City MSA in 2003 9,09629037 .Cass County, MO 87,31029047 .Clay County, MO 191,38129049 .Clinton County, MO 19,63220059 .Franklin County, KS added to Kansas City MSA in 2003 25,32229095 .Jackson County, MO 660,77320091 .Johnson County, KS 476,53629107 .Lafayette County, MO 33,12520103 .Leavenworth County, KS 70,78920107 .Linn County, KS added to Kansas City MSA in 2003 9,67420121 .Miami County, KS 28,90429165 .Platte County, MO 77,65529177 .Ray County, MO 23,81120209 .Wyandotte County, KS 158,331

30460 Lexington-Fayette, KY 416,38321017 .Bourbon County, KY 19,57621049 .Clark County, KY 33,72621067 .Fayette County, KY 263,61821113 .Jessamine County, KY 40,74021209 .Scott County, KY 35,32021239 .Woodford County, KY 23,40321151 Madison County, KY becomes part of Richmond KY Micropolitan Area in 200 73,334

31140 Louisville, KY-IN 1,182,83221029 .Bullitt County, KY 63,80018019 .Clark County, IN 98,19818043 .Floyd County, IN 71,63318061 .Harrison County, IN 35,24421103 .Henry County, KY added to Louisville MSA in 2003 15,36721111 .Jefferson County, KY 698,08021163 .Meade County, KY added to Louisville MSA in 2003 27,43921179 .Nelson County, KY added to Louisville MSA in 2003 38,82321185 .Oldham County, KY 49,31021211 .Shelby County, KY added to Louisville MSA in 2003 35,12521215 .Spencer County, KY added to Louisville MSA in 2003 13,52321223 .Trimble County, KY added to Louisville MSA in 2003 8,67218175 .Washington County, IN added to Louisville MSA in 2003 27,61818143 Scott, IN becomes part of Scottsburg, IN Micropolitan Area in 2003 23,334

32820 Memphis, TN -MS-AR 1,230,55405035 .Crittenden County, AR 51,29128033 .DeSoto County, MS 118,45847047 .Fayette County, TN 31,20228093 .Marshall County, MS added to Memphis MSA in 2003 35,16347157 .Shelby County, TN 905,67828137 .Tate County, MS added to Memphis MSA in 2003 25,75147167 .Tipton County, TN 53,43628143 .Tunica County, MS added to Memphis MSA in 2003 9,575

34980 Nashville-Davidson--Murfreesboro, TN 1,353,09647015 .Cannon County, TN added to Nashville MSA in 2003 13,06047021 .Cheatham County, TN 36,98647037 .Davidson County, TN 570,78547043 .Dickson County, TN 44,23147081 .Hickman County, TN added to Nashville MSA in 2003 23,12547111 .Macon County, TN added to Nashville MSA in 2003 20,86047147 .Robertson County, TN 57,44647149 .Rutherford County, TN 194,93447159 .Smith County, TN added to Nashville MSA in 2003 18,17747165 .Sumner County, TN 136,17047169 .Trousdale County, TN added to Nashville MSA in 2003 7,35447187 .Williamson County, TN 136,88947189 .Wilson County, TN 93,079


36540 Omaha-Council Bluffs, N E-IA 784,46331025 .Cass County, NE 24,83931055 .Douglas County, NE 472,74419085 .Harrison County, IA added to Omaha MSA in 2003 15,58519129 .Mills County, IA added to Omaha MSA in 2003 14,71419155 .Pottawattamie County, IA 88,15731153 .Sarpy County, NE 129,31931155 .Saunders County, NE added to Omaha MSA in 2003 19,89431177 .Washington County, NE 19,211

39580 Raleigh-Cary, NC 797,07137069 .Franklin County, NC 47,26037101 .Johnston County, NC 121,96537183 .Wake County, NC 627,84637037 Chatham, NC becomes part of the Durham NC MSA in 2003 53,89337063 Durham, NC becomes part of the Durham NC MSA in 2003 234,19937135 Orange, NC becomes part of the Durham NC MSA in 2003 120,458

40060 Richmond, VA 1,126,26251007 .Amelia County, VA added to Richmond, VA MSA in 2003 11,71451033 .Caroline County, VA added to Richmond, VA MSA in 2003 22,62251036 .Charles City County, VA 7,23951041 .Chesterfield County, VA 271,14251570 .Colonial Heights city, VA 17,06351049 .Cumberland County, VA added to Richmond, VA MSA in 2003 8,89951053 .Dinwiddie County, VA 24,74751075 .Goochland County, VA 17,52351085 .Hanover County, VA 92,05051087 .Henrico County, VA 268,27051670 .Hopewell city, VA 22,52551097 .King and Queen County, VA added to Richmond, VA MSA in 2003 6,55851101 .King William County, VA added to Richmond, VA MSA in 2003 13,82251109 .Louisa County, VA added to Richmond, VA MSA in 2003 27,00751127 .New Kent County, VA 14,15751730 .Petersburg city, VA 33,11551145 .Powhatan County, VA 23,99751149 .Prince George County, VA 34,13551760 .Richmond city, VA 197,45651183 .Sussex County, VA added to Richmond, VA MSA in 2003 12,221


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