Characteristics Of Biomedical Industry Payments To Teaching Hospitals

Health Aff (Millwood). 2020 Sep;39(9):1583-1591. doi: 10.1377/hlthaff.2020.00385.


The Physician Payments Sunshine Act requires biomedical companies to report payments made to physicians and teaching hospitals to the Centers for Medicare and Medicaid Services (CMS). Despite significant attention paid to industry payments to physicians, little is known about payments to teaching hospitals, which create the potential for both benefits and institutional conflicts of interest. We examined 2018 CMS Open Payments program data to identify all nonresearch payments made by industry to teaching hospitals and determined that 91 percent of teaching hospitals received industry payments totaling $832 million in 2018. We observed substantial royalty payments, which may reflect the downstream benefits of research partnerships, as well as substantial payments for gifts and education, which raise concerns for institutional conflicts of interest. Hospital predictors of receiving payments included large bed size, major medical school affiliation, and inclusion on the U.S. News & World Report Best Hospitals Honor Roll. Financial payments from industry to teaching hospitals are common and previously underrecognized. Hospitals should strengthen policies to prevent the institutional conflicts of interest that may arise from these payments while promoting beneficial industry collaborations. We also suggest that CMS reporting requirements be broadened to all hospitals to meet the Sunshine Act's goals of encouraging transparency and preventing inappropriate industry influence.

Keywords: Biomedical industry; Conflicts of interest; Education; Medical device companies; Medical devices; Medical education; Medicare; Open payments program; Payment; Pharmaceutical companies; Physician Payments Sunshine Act; Physician payment; Physician reporting; Psychiatric hospitals; Teaching hospitals; health policy.

MeSH terms

  • Aged
  • Centers for Medicare and Medicaid Services, U.S.
  • Conflict of Interest*
  • Drug Industry
  • Hospitals, Teaching
  • Humans
  • Industry
  • Medicare*
  • United States