From a review of financial statements in mostly two Internet sites: Dac.bond and EMMA (Electronic Municipal Market Access of the Municipal Securities Rulemaking Board), I found 113 Non-Catholic, Non-Profit Hospital Organizations with Hospital Operating Revenues in excess of $800 mil each in the fiscal year ended (FYE) 2010.
These 113 Non-Profit Hospital Organizations had Total Operating Revenues of $296.4 bil and Total Hospital Operating Income of $13.1 bil in FYE 2010.
My best estimate is that this sample of 113 Non-Catholic Hospital Organizations comprises 26% of the Total Operating Revenues of all Non-Profit Hospital Organizations in the US, including all Catholic, all Non-Catholic, and all Governmental ones.
Here are the Annual Total Operating Earnings % Increases over the Prior Year of these 113 Non-Profit Hospital Organizations during the Obama Administration:
Annual FYE 2009.........................+33%
Annual FYE 2010.........................+20%
Fiscal Year to date March 2011.....+25%
When you compound those three above percentage increases, you get precisely a doubling of Non-Profit Hospital Operating Profit during roughly the entire period of the Obama Administration so far.
And here are the Total Operating Margin Percentages (i.e. Total Operating Income / Total Operating Revenues) for these 113 Non-Profit Hospitals from 2008 to March 2011:
Annual FYE 2008………...............3.18%
Annual FYE 2009………...............3.92%
Annual FYE 2010………...............4.42%
Fiscal Year to date March 2011...4.64%
Now that is what I call superb, very consistent earnings and profit margin percentage increases, which was even much more robust than that of the Catholic Hospitals. This is particularly impressive given the horrible unemployment and underemployment prevailing during these periods, with the resultant increases in the number of uninsured and underinsured.
Below are the individual hospital organization Operating Earnings for each of the past three fiscal years, along with the percentage change in Operating Earnings in the past two fiscal years from FYE 2008 to FYE 2010....what I call the Two-year Obama Administration Non-Profit Hospital Operating Income Percentage Bump, which totaled an incredibly strong 59% for all 113 Non-Profit Hospital Organizations combined.
...........................................................................2 YR
..........................................................................Obama
.........................................FYE.....FYE.....FYE....Admin
.........................................2010...2009...2008...Oper
.........................................Oper....Oper....Oper...Inc %
.........................................Inc......Inc.......Inc.....Bump
......................................(in millions of dollars)
Kaiser Permanente..........1,202...1,585...1,459...-18%
Sutter Health......................685......471.....463....48%
Mayo Clinic........................540......360.....106...409%
Adventist Health System....436......364.....234....86%
Advocate HlthCare Ntwrk...335......254.....231....45%
Baylor Health Care Syst......305......246.....204....50%
Banner Health.....................281......318.....126...123%
Cleveland Clinic..................251......359.....239......5%
Baptist Health So FL(1).......238......140.....137.....74%
Univ Penn Health Syst........225......168.....235....-4%
UCLA Medical Center.........224......134.......58...286%
UPMC.................................218......192.....137....59%
Duke Univ Health Syst........209......155.....112....87%
Indiana Univ Health...........202......174.......56...261%
BJC Healthcare..................200......157.....125....60%
Inova Health System..........200......174.....148....35%
Texas Health Resrcs...........198.......142.......97...104%
Partners Healthcare Sys......195......164.....119....64%
Sentara Health Care............190......126.....115....65%
Allina Health System..........189.......177......86...120%
The Methodist Hosp Syst....167.......217.....119....40%
Adventist Health West........163........84.......31...426%
OhioHealth.........................162......128.......93....74%
Presbyter Hlth Care NM......153......140.......81....89%
Univ Calif San Fran.............151.......101.......45...236%
NYU Langone Med Ctr........148........23.......15...887%
Chldrn's Hlthcre Atlanta.....142........63.......95....49%
Johns Hopkins Health Sys...138......144.....131......5%
Cedars-Sinai Med Ctr..........138......133.....154...-10%
Scripps Health....................133......101.....109....22%
Baycare Health System.......130......127.....100....30%
Carolinas Hlth Care Sys......129........99........65....98%
Jefferson Health System.....128......135......163...-21%
Memorl Hermann Hlthcre...121........42.......98....23%
NY Presbyterian Hosp........115........82.....103....12%
Children's Hosp Philly(2).....114........31.......35...226%
NorthShore LI Jewish.........111........70.......31...258%
Univ Colorado Hosp...........108......100.......40...170%
Aurora Health Care............104......157.......96......8%
Northwestern Memorl HC..102.......60........30...240%
Univ of No Carolina HC.......102.......63.......39...162%
Sharp Health Care...............101........51.......68....49%
Vanderbilt U Hosps&Clncs..101........80.......51....98%
Stanford Hosp&Clinics........100........95.....105....-5%
Montefiore Med Ctr(3)..........99........36.......45...120%
Shands Teachng Hosps..........97........97.......74....31%
Scott & White HC...................96........52.......44...118%
Loma Linda Univ Med(4).......95........45.......(4).2475%
Cook Children's Health...........93........97.......65....43%
Univ Chicago Med Ctr............92........69.......89......3%
Memorl Sloan-Kett Cancer....89........12......110...-19%
North Shore Univ Hlth..........89........65........51....75%
Rush Univ Med Ctr................89........77.......75....19%
Univ Hosps Hlth OH..............88........21.......61....44%
Mount Sinai Hospital............87........57.......64....36%
Methodist Health Syst..........84........60.......56....50%
ProMedica Health Care.........76........69.......67....13%
Virtua Health.......................76........82.......92...-17%
Saint Barnabas.....................73........19....(208)..135%
Yale-New Haven Hosp..........69........67.......49....41%
Christiana Care Hlth.............68........49.......41....66%
Baptist Memorial HC............67........82.......41....63%
Premier Hlth Partnrs............66......(17)......29...128%
CareGroup HC System..........66........38.......57....16%
Palmetto Health...................66........37.......12...450%
Novant Health.....................65........79......(51)..227%
Norton Health Care..............64.........8........21...205%
MedStar Health....................63........60.......58......9%
Henry Ford Hlth Sys.............62........32........8...675%
Univ Maryland Med..............62........30........4..1450%
Orlando Health.....................61........59.......41....49%
Univ Mich Hosps..................60........15.......36....67%
Iowa Health System..............58........60.......49....18%
St Luke's Episcopal................57........41.......30....90%
Hackensack Univ Med(5).......54........21.......12...350%
Texas Chldrn's Hosp..............52........63.......43....21%
Univ of Kansas Hosp..............52........58.......39....33%
Baystate Med Center.............49........67.......44....11%
Sanford.................................48........24.......29....66%
Essentia Health.....................48........20.......17...182%
Ochsner Health Syst..............48........32.....(14)..443%
Integris Health.....................47........51.......58...-19%
McLaren Health Care............46........54.......48....-4%
Piedmont Health Care...........46........44.......33....39%
Community Hlth Ntwrk.........45........38.......29....55%
Cone Health..........................43........47.......37....16%
Legacy Health System...........42........45.......36....17%
Hoag Memorial Hosp.............42........38.......37....14%
Spectrum Health Syst............41......107.......83...-51%
Medical College WI................40........11........5...700%
Sparrow Health Syst..............40........42........2..1900%
Lehigh Valley Health.............40........11.......18...122%
South Broward Hosp.............39........30.......(5)..880%
Health First............................38.......34.......28....36%
Lee Memorial Health.............37........37........3..1133%
Chldrn's Med Dallas...............36........28.......24....50%
Kettering Health...................32........43.......12...167%
LifeSpan................................31........32.......32....-3%
West VA United Hlth.............31........13........3...933%
Greenville Hosp....................31.........8........22....41%
No Carolna Bapt Hosp...........28.........2........10...180%
Parkview Health Syst............28........71........61...-54%
Wake Forest Univ Hlth..........27........13.........6...350%
Reading Hospital..................26.........6........16....63%
Univ Iowa Hospitals.............26........(9).......19....37%
Mt Sinai School Med.............22........53.........1..2100%
Kaleida Health......................19........14........17....12%
WellSpan Health...................16........17.......22...-27%
Oregon Hlth&Sci Univ............9......132......(40)..123%
Children's HC MN...................2........28........35...-94%
Alegent Health....................(14).......37........58..-124%
West Penn Allegheny HS(6).(19).....(38).....(89)...79%
Baylor College Medicine......(40).....(73).....(68)...41%
Total 113 Non-Profit
......Hospitals..................13,089..10,935..8,213...59%
% Increase Over Prior Year.20%.....33%
(1) Baptist Health South Florida 2009 Operating Income excludes a large Asset Impairment Charge.
(2) Children's Hospital Philadelphia 2008 Operating Income excludes a large Gain from Sale of a Vaccine.
(3) Montefiore Operating Income exclude Gains on sales of Marketable Securities.
(4) Loma Linda Operating Income(Loss)exclude Gains and Losses from Changes in Fair Value of Interest Rate Swaps.
(5) Hackensack University 2008 Operating Income excludes large Investment Loss and Loss on Debt Retirement.
(6) West Penn Allegheny 2010 Operating Loss excludes large Asset Impairment Charge.
And below here are the 31 Big Non-Profit Hospital Organizations that recently really stepped it up and registered just exceptional Hospital Operating Earnings growth so far in the most recent 2011 FYE through March 31, 2011:
.................................# of
.................................Mos
...................................in
................................2011...2011....2010
................................FYE....Oper.....Oper...Increase
................................Here...Inc........Inc....Amt.....%
.........................................(in millions of dollars)
Kaiser Permanente.....3.......630......481.....149....31%
UPMC.........................9.......313......171.....142....83%
Scripps Health............6.......134........50......84...168%
Johns Hopkins Health.9.......163........88.......75....85%
Sharp Health Care.......6.......118........47.......71...151%
Sutter Health..............3.......210......140.......70....50%
Partners HC System....6.........94........46.......48...104%
Lehigh Valley..............9.........56........14.......42...300%
Alegent Health............9.........26.......(14)......40...286%
Stanford Hospitals.......6.........80........41.......39....95%
Baptist Health So FL.....6.......105........68.......37....54%
Texas Children's Hosp..6.........54........19.......35...184%
Memorial Hermann......9.........87........56.......31....55%
Northwestern Memorl..6.........67........38.......29....76%
Children's Med Dallas....3.........49........20.......29...145%
Inova Health System....3.........56........30.......26....87%
Cook Children's Health..6.........70.......47.......23....49%
Univ Maryland Med......9.........59........38.......21....55%
Hackensack Univ Med...3.........22..........1.......21..2100%
Rush Univ Med Ctr........9.........74........54.......20....37%
Wake Forest Baptist.......9.........41........21.......20....95%
So Broward Hospital......9.........51........32.......19....59%
Carolinas HC System......3.........40........21.......19....90%
Loma Linda Univ.Med...3.........14.........(5)......19...380%
Sentara Health...............3.........64........46.......18....39%
NY Presbyterian Hosp...3.........21..........6.......15...250%
Reading Hospital...........9.........29........15.......14....93%
WellSpan Health............9.........22........10.......12...120%
Community Hlth Netwk.3.........15........3.........12...400%
Norton Health...............3.........17.........7.......10...143%
West VA United Hlth.....3.........11..........1.......10..1000%
Embedded as charges in the FYE 2010 Total Operating Income of $13,089 mil were Total Bad Debt Expenses of a huge $12,565 mil. Thus the Total Bad Debt Expense as a percentage of Operating Income in FYE 2010 was 96% for these 113 Non-Profit Hospitals, much lower than the 209% comparable ratio for the 22 Catholic Hospitals.
I didn't capture Total Charity Care Costs for these 113 Non-Profit Hospitals. However, if you conservatively assume the same relative Non-Catholic, Non-Profit Hospital to Catholic Hospital Bad Debt Expense to Operating Income Ratio also applies to Total Charity Care Costs, then the estimated Total Charity Costs for these 113 Non-Profit Hospitals would be $11,060 mil for FYE 2010.
With the Affordable Health Care Plan, many of the presently uninsured will get insurance, starting in 2014. Likewise, many of the presently underinsured will get better insured, again starting in 2014.
It is difficult to estimate precisely how much Bad Debt Expense will be eliminated, as well as precisely how much unrecorded Charity Care Income will be picked up, as part of the Affordable Health Care Plan, once it fully kicks in.
But just as a perspective, let me assume that 60% of the Bad Debt Expense will be eliminated, and that 40% of the Charity Care Cost will be added to Revenues. Under these assumptions, and ignoring the Hospital Buy-in Costs that are part of the Affordable Health Care Plan, these 113 Non-Catholic, Non-Profit Hospital Organizations Reported Total Operating Income of $13,089 mil in FYE 2010 would nearly double to $25,052 mil, computed as follows:
FYE 2010 Total Operating Income,
.....as reported…………………………................................$13,089 mil
+ 2010 Reported Bad Debt Exp of $12,565 mil X 60%...$7,539 mil
+ 2010 Charity Care Costs of $11,060 mil X 40%..........$4,424 mil
= FYE 2010 Pro-forma Total Operating Income,
.....as adjusted for the above two items……..................$25,052 mil
It should be emphasized that the above $25.052 bil of 2010 Pro-forma Total Operating Income is just for the sample of 113 Non-Profit Hospital Organizations, which comprise roughly only 26% of the Total Operating Revenues of all US Non-Profit Hospital Organizations, including all Catholic, all Non-Catholic, and all Governmental ones.
Here are the Hospital Operating Income as a Percentage of Total Operating Revenue Margins for FYE 2010 for all of the 113 Non-Catholic, Non-Profit Hospital Organizations:
1.....Children's Healthcare of Atlanta.........GA.....14.39%
2.....UCLA Medical Center.........................CA.....13.78%
3.....University of Colorado Hospital.........CO.....13.17%
4.....Baptist Health South Florida...............FL.....10.94%
5.....Cook Children's Health.......................TX.....10.60%
6.....Duke University Health System..........NC......9.72%
7.....Methodist Health System...................TX......9.44%
8.....Inova Health System.........................VA......8.60%
9.....Univ California San Francisco............CA......8.45%
10....Loma Linda Univ Medical Center......CA......8.03%
11....Baylor Health Care System................TX......7.97%
12....Children's Hospital Philadelphia........PA......7.91%
13....The Methodist Hospital System.........TX......7.89%
14....Virtua Health....................................NJ......7.84%
15....University Chicago Medical Center.....IL......7.80%
16....Presbyterian Health Care Services....NM......7.60%
17....Sutter Health.....................................CA......7.51%
18....Advocate HealthCare Network............IL......7.43%
19....OhioHealth........................................OH......7.40%
20....Univ Penn Health System..................PA......7.11%
21....Mayo Clinic.......................................MN......6.80%
22....Adventist Health System....................FL......6.47%
23....Northwestern Memorial Health Care...IL......6.42%
24....Allina Health System.........................MN......6.14%
25....Adventist Health West........................CA......6.13%
26....Univ of Kansas Hospital......................KS......6.10%
27....Texas Health Resources.....................TX......6.02%
28....ProMedica Health Care......................OH......6.00%
29....Vanderbilt U Hosps & Clinics..............TN......5.81%
30....Scripps Health...................................CA......5.79%
31....Banner Health....................................AZ......5.78%
32....Cedars-Sinai Medical Center...............CA......5.78%
33....Baycare Health System.......................FL......5.69%
34....Shands Teaching Hosps & Clinics.........FL......5.68%
35....NYU Langone Medical Center.............NY......5.65%
36....Sentara Health Care............................VA......5.61%
37....North Shore Univ Health Systems........IL......5.58%
38....BJC Healthcare...................................MO......5.53%
39....Univ North Carolina Healthcare Syst...NC......5.48%
40....Mount Sinai Hospital...........................NY......5.35%
41....Rush University Medical Center............IL......5.28%
42....Christiana Care Health Services............DE......5.23%
43....Hoag Memorial Hosp Presbyterian.......CA......5.13%
44....Stanford Hospital & Clinics...................CA......5.08%
45....Palmetto Health...................................SC......5.07%
46....Yale-New Haven Hospital.....................CT......5.05%
47....Scott & White Healthcare......................TX......4.89%
48....Cone Health..........................................NC......4.82%
49....Medical College of Wisconsin................WI......4.70%
50....St Luke's Episcopal Health System.........TX......4.68%
51....Indiana University Health.....................IN......4.67%
52....Jefferson Health System........................PA......4.64%
53....Sharp Health Care.................................CA......4.55%
54....University Hospitals Health System.......OH......4.40%
55....Hackensack Univ Medical Center...........NJ......4.31%
56....Norton Health Care................................KY......4.30%
57....Cleveland Clinic Health System..............OH......4.26%
58....Health First............................................FL......4.14%
59....Baptist Memorial Health Care................TN......4.04%
60....Children's Medical Center of Dallas.........TX......3.95%
61....Premier Health Partners.........................OH......3.93%
62....Johns Hopkins Health System................MD......3.92%
63....Sparrow Health System...........................MI......3.76%
64....Piedmont Health Care.............................GA......3.72%
65....Memorial Sloan-Kettering Cancer Ctr......NY......3.69%
66....Memorial Hermann Healthcare System...TX......3.62%
67....Carolinas Health Care System.................NC......3.59%
68....Orlando Health........................................FL......3.59%
69....Montefiore Medical Center.....................NY......3.45%
70....Community Health Network...................IN......3.40%
71....Integris Health........................................OK......3.36%
72....Parkview Health System..........................IN......3.34%
73....Baystate Medical Center..........................MA......3.34%
74....NY and Presbyterian Hospital..................NY......3.33%
75....Wake Forest Univ Health Sciences............NC......3.25%
76....Legacy Health System..............................OR......3.24%
77....Texas Children's Hospital.........................TX......3.23%
78....NorthShore Long Island Jewish Health....NY......3.22%
79....Essentia Health........................................MN......3.20%
80....Reading Hospital......................................PA......3.14%
81....Saint Barnabas..........................................NJ......3.06%
82....Kettering Health Network.........................OH......3.04%
83....Univ Michigan Hosp & Health Ctrs............MI......3.04%
84....West Virginia United Health System.........WV......3.02%
85....Lee Memorial Health System....................FL......3.00%
86....North Carolina Baptist Hospital................NC......2.88%
87....Lehigh Valley Health Network..................PA......2.86%
88....CareGroup Health Care System.................MA......2.86%
89....University Maryland Medical System.......MD......2.82%
90....University Iowa Hospitals & Clinics..........IA......2.76%
91....Kaiser Permanente....................................CA......2.72%
92....UPMC.......................................................PA......2.71%
93....Ochsner Health System.............................LA......2.63%
94....Iowa Health System..................................IA......2.59%
95....Aurora Health Care..................................WI......2.49%
96....Partners Healthcare System.....................MA......2.40%
97....McLaren Health Care...............................MI......2.32%
98....Sanford....................................................SD......2.31%
99....South Broward Hospital District...............FL......2.28%
100...Greenville Hospital System.....................SC......2.06%
101...Novant Health........................................NC......1.92%
102...LifeSpan..................................................RI......1.91%
103...Mount Sinai School of Medicine...............NY......1.64%
104...MedStar Health.......................................MD......1.63%
105...Kaleida Health........................................NY......1.58%
106...Henry Ford Health System.....................MI......1.52%
107...WellSpan Health.....................................PA......1.49%
108...Spectrum Health System........................MI......1.30%
109...Oregon Health & Science Univ................OR......0.48%
110...Children's Health Care Minnesota...........MN......0.35%
111...West Penn Allegheny Health Sys.............PA.....-1.17%
112...Alegent Health........................................NE.....-1.35%
113...Baylor College of Medicine......................TX.....-3.36%
Total all 113 Hospitals..............................................4.42%
The Big Non-Profit Hospital Organizations have to be extremely happy with how their finances have already been substantially strengthened by wise actions of the Obama Administration, of the Fed, and of the US Congress. And competent HHS Secretary Kathleen Sebelius has to be very high on their thank you list.
And they also have to be licking their chops for the significant step up in Hospital Operating Earnings they will be receiving when the Affordable Health Care Plan totally kicks in.
