In my earlier post on this same topic, from a review of financial statements through the end of June 2011, 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.
In early July 2011, I went into more depth in this research review and I found 23 additional Non-Catholic, Non-Profit Hospital Organizations with Hospital Operating Revenues in excess of $800 mil each in FYE 2010.
Below are the individual hospital organization Operating Earnings for each of the past three fiscal years for these 23 additional Non-Catholic, Non-Profit Hospital Organizations, 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 73% for all of these 23 late addition Non-Profit Hospital Organizations combined....and even a bit higher than the 59% Obama growth bump for the 113 Big Non-Profit Hospital Organizations in the original research.
...........................................................................2 YR
..........................................................................Obama
.........................................FYE.....FYE.....FYE....Admin
.........................................2010...2009...2008...Oper
.........................................Oper....Oper....Oper...Inc %
.........................................Inc......Inc.......Inc.....Bump
......................................(in millions of dollars)
Health Partners..................138.......96........65......112%
John Muir Health(1)...........132.......99........41......222%
Geisinger Health System.....127.......80.......83.......53%
Wellstar Health System........97.......81........52.......87%
Multicare Health System......95......121......110......-14%
VA Commonwlth Univ Hlth..89.......96........90.......-1%
Fairview Health Services......81......110........21......286%
Children's Med Ctr Boston....67.......83........65........3%
Children's Hospital Cincy.....64.......60........66.......-3%
Univ Hlth Syst East Carolina.62.......55........60.........3%
Nationwide Children's Hosp.54.......45.........24......125%
Park Nicollet Health.............47.......44.......(14).....436%
Saint Luke's Health System...43.......25..........4......975%
Avera...................................41.......20........25.......64%
Children's National Med Ctr..38........3...........3.....1167%
Mission Health System..........36.......40........30.......20%
Summa Health System...........32........8.......(13).....346%
Meridian Health System........31.......28........16.......94%
Wakemed Health...................20.......19........24......-17%
Dartmouth-Hitchcock...........19.......45........25......-24%
Scottsdale Healthcare............16........4.......(16).....200%
Lifebridge Health....................4.......22........20......-80%
Loyola Univ Health System.....0......(43).......(9).....100%
Total 23 Late Additions.....1,333...1,141.....772.......73%
% Increase Over Prior Year..17%....48%
(1) John Muir Health FYE 2008 Operating Earnings excludes Impairment Losses on Investments.
When I combine the above 23 Late Additions with the original 113 Non-Profit Hospital Organizations, the Total Operating Revenues of these 136 Non-Profit Hospitals was $329.7 bil, and Total Hospital Operating Income was $14.4 bil in FYE 2010.
My best estimate is that this sample of 136 Non-Catholic Hospital Organizations comprises 29% 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 136 combined Non-Profit Hospital Organizations during the Obama Administration:
Annual FYE 2009.........................+34%
Annual FYE 2010.........................+19%
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 136 combined Non-Profit Hospitals from 2008 to March 2011:
Annual FYE 2008………...............3.14%
Annual FYE 2009………...............3.89%
Annual FYE 2010………...............4.37%
Fiscal Year to date March 2011...4.57%
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.
Embedded as charges in the FYE 2010 Total Operating Income of $14,422 mil were Total Bad Debt Expenses of a huge $13,989 mil. Thus the Total Bad Debt Expense as a percentage of Operating Income in FYE 2010 was 97% for these combined 136 Non-Profit Hospitals, much lower than the 209% comparable ratio for the 25 Catholic Hospitals.
I didn't capture Total Charity Care Costs for these 136 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 136 Non-Profit Hospitals would be $12,763 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 136 Non-Catholic, Non-Profit Hospital Organizations Reported Total Operating Income of $14,422 mil in FYE 2010 would nearly double to $27,920 mil, computed as follows:
FYE 2010 Total Operating Income,
.....as reported…………………………................................$14,422 mil
+ 2010 Reported Bad Debt Exp of $13,989 mil X 60%...$8,393 mil
+ 2010 Charity Care Costs of $12,763 mil X 40%..........$5,105 mil
= FYE 2010 Pro-forma Total Operating Income,
.....as adjusted for the above two items……..................$27,920 mil
It should be emphasized that the above $27.920 bil of 2010 Pro-forma Total Operating Income is just for the sample of 136 Non-Profit Hospital Organizations, which comprise roughly only 29% 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 136 combined 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.....John Muir Health.............................. CA......9.03%
9.....Inova Health System.........................VA......8.60%
10....Univ California San Francisco...........CA......8.45%
11....Loma Linda Univ Medical Center......CA......8.03%
12....Baylor Health Care System................TX......7.97%
13....Children's Hospital Philadelphia........PA......7.91%
14....The Methodist Hospital System.........TX......7.89%
15....Virtua Health....................................NJ......7.84%
16....University Chicago Medical Center.....IL......7.80%
17....Presbyterian Health Care Services....NM......7.60%
18....Sutter Health.....................................CA......7.51%
19....Advocate HealthCare Network............IL......7.43%
20....OhioHealth........................................OH......7.40%
21....Univ Penn Health System...................PA......7.11%
22....Multicare Health System...................WA......6.86%
23....Mayo Clinic.......................................MN......6.80%
24....Adventist Health System....................FL......6.47%
25....Northwestern Memorial Health Care...IL......6.42%
26....Wellstar Health System......................GA......6.31%
27....Allina Health System.........................MN......6.14%
28....Adventist Health West........................CA......6.13%
29....Univ of Kansas Hospital......................KS......6.10%
30....Texas Health Resources.....................TX......6.02%
31....ProMedica Health Care......................OH......6.00%
32....Vanderbilt U Hosps & Clinics..............TN......5.81%
33....Scripps Health...................................CA......5.79%
34....Banner Health....................................AZ......5.78%
35....Cedars-Sinai Medical Center...............CA......5.78%
36....Baycare Health System.......................FL......5.69%
37....Shands Teaching Hosps & Clinics.........FL......5.68%
38....NYU Langone Medical Center.............NY......5.65%
39....Sentara Health Care............................VA......5.61%
40....North Shore Univ Health Systems........IL......5.58%
41....BJC Healthcare...................................MO......5.53%
42....Univ North Carolina Healthcare Syst...NC......5.48%
43....Geisinger Health System......................PA......5.36%
44....Mount Sinai Hospital...........................NY......5.35%
45....Rush University Medical Center............IL......5.28%
46....Christiana Care Health Services............DE......5.23%
47....Hoag Memorial Hosp Presbyterian.......CA......5.13%
48....Stanford Hospital & Clinics...................CA......5.08%
49....Palmetto Health...................................SC......5.07%
50....Virginia Commonwealth Univ Health...VA......5.06%
51....Yale-New Haven Hospital.....................CT......5.05%
52....Children's Medical Center Boston.........MA......4.93%
53....Scott & White Healthcare......................TX......4.89%
54....Cone Health..........................................NC......4.82%
55....Univ Health System East Carolina..........NC......4.73%
56....Medical College of Wisconsin................WI......4.70%
57....St Luke's Episcopal Health System.........TX......4.68%
58....Indiana University Health.....................IN......4.67%
59....Jefferson Health System........................PA......4.64%
60....Sharp Health Care.................................CA......4.55%
61....Nationwide Children's Hospital.............OH......4.48%
62....Avera....................................................SD......4.41%
63....University Hospitals Health System......OH......4.40%
64....Children's National Medical Center........DC......4.34%
65....Hackensack Univ Medical Center...........NJ......4.31%
66....Norton Health Care................................KY......4.30%
67....Cleveland Clinic Health System..............OH......4.26%
68....Health First............................................FL......4.14%
69....Saint Luke's Health System Kansas City..MO......4.08%
70....Baptist Memorial Health Care................TN......4.04%
71....Park Nicollet Health..............................MN......3.99%
72....Children's Hospital Cincy.......................OH......3.99%
73....Children's Medical Center of Dallas.........TX......3.95%
74....Premier Health Partners.........................OH......3.93%
75....Johns Hopkins Health System................MD......3.92%
76....Health Partners.....................................MN......3.86%
77....Sparrow Health System..........................MI......3.76%
78....Mission Health System...........................NC......3.72%
79....Piedmont Health Care.............................GA......3.72%
80....Memorial Sloan-Kettering Cancer Ctr......NY......3.69%
81....Memorial Hermann Healthcare System...TX......3.62%
82....Carolinas Health Care System.................NC......3.59%
83....Orlando Health........................................FL......3.59%
84....Montefiore Medical Center......................NY......3.45%
85....Community Health Network....................IN......3.40%
86....Integris Health........................................OK......3.36%
87....Parkview Health System..........................IN......3.34%
88....Baystate Medical Center..........................MA......3.34%
89....NY and Presbyterian Hospital..................NY......3.33%
90....Wake Forest Univ Health Sciences............NC......3.25%
91....Legacy Health System..............................OR......3.24%
92....Texas Children's Hospital.........................TX......3.23%
93....NorthShore Long Island Jewish Health....NY......3.22%
94....Essentia Health........................................MN......3.20%
95....Reading Hospital......................................PA......3.14%
96....Saint Barnabas..........................................NJ......3.06%
97....Kettering Health Network.........................OH......3.04%
98....Univ Michigan Hosp & Health Ctrs............MI......3.04%
99....West Virginia United Health System.........WV......3.02%
100...Lee Memorial Health System....................FL......3.00%
101...North Carolina Baptist Hospital................NC......2.88%
102...Fairview Health Services.........................MN......2.87%
103...Lehigh Valley Health Network..................PA......2.86%
104...CareGroup Health Care System.................MA......2.86%
105...University Maryland Medical System.......MD......2.82%
106...University Iowa Hospitals & Clinics...........IA......2.76%
107...Kaiser Permanente....................................CA......2.72%
108...UPMC........................................................PA......2.71%
109...Ochsner Health System..............................LA......2.63%
110...Iowa Health System...................................IA......2.59%
111...Meridian Health System.............................NJ......2.54%
112...Aurora Health Care...................................WI......2.49%
113...Partners Healthcare System......................MA......2.40%
114...Summa Health System..............................OH......2.38%
115...McLaren Health Care................................MI......2.32%
116...Sanford.....................................................SD......2.31%
117...South Broward Hospital District................FL......2.28%
118...Wakemed Health.......................................NC......2.10%
119...Greenville Hospital System.......................SC......2.06%
120...Novant Health..........................................NC......1.92%
121...LifeSpan....................................................RI......1.91%
122...Scottsdale Healthcare...............................AZ......1.87%
123...Mount Sinai School of Medicine................NY......1.64%
124...MedStar Health........................................MD......1.63%
125...Kaleida Health.........................................NY......1.58%
126...Henry Ford Health System......................MI......1.52%
127...WellSpan Health......................................PA......1.49%
128...Spectrum Health System.........................MI......1.30%
129...Dartmouth-Hitchcock.............................NH......1.25%
130...Oregon Health & Science Univ.................OR......0.48%
131...Lifebridge Health....................................MD......0.41%
132...Children's Health Care Minnesota............MN......0.35%
133...Loyola Univ Health System......................IL......0.00%
134...West Penn Allegheny Health Sys..............PA.....-1.17%
135...Alegent Health.........................................NE.....-1.35%
136...Baylor College of Medicine.......................TX.....-3.36%
Total all 136 Hospitals................................................4.37%
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.
But the question that I think has to be answered....In all fairness, just like Health Insurance Corps should, shouldn't all Hospital Organizations also be reducing their stiff prices in order to both patriotically and compassionately help reduce total US health care costs, to help suffering US individual hospital patients, to ease the health care burdens on US businesses, and to soften both the crushing US Federal Deficit and the many State Government severely-stressed Budgets?
