The key single measure of the financial strength of a Non-Profit Hospital Organization is its Net Assets, the excess of its Total Assets over its Total Liabilities.
The highly respected Mayo Clinic had a very solid Net Asset position of $4.312 bil at Dec 31, 2007. Then the financial implosion occurred in the latter part of 2008 resulting in The Mayo Clinic's Net Asset position dropping by $1.986 bil, or by a massive 46%, in 2008, down to $2.326 bil at Dec 31, 2008.
Enter the Obama Administration, which took wise steps to strengthen the severely damaged US financial foundation. The US Fed, particularly Ben Bernanke and Janet Yellen, also played key roles in resuscitating the very shaky US financial foundation.
The result was that The Mayo Clinic was able to recoup in 2009 $1.945 bil of the $1.986 bil Net Asset position it had lost in 2008. The main driver of this massive turnaround was the stock market collapse in 2008 coupled with its massive rise in 2009. Non-profit hospitals hold a huge portfolio of investments in stocks and bonds.
But it was not just The Mayo Clinic. Nearly all Non-profit hospitals experienced huge declines in their Net Asset positions in 2008 coupled with a substantial recovery in Net Asset positions in 2009.
Below here are the Net Asset positions at four points in time.....at Dec 2007, Dec 2008, Dec 2009 and at the most current date of June 2013 of the 12 Non-profit hospital organizations with December fiscal year ends and with the highest level of current Net Asset positions.....all above $4.0 bil:
| State | 12-31-07 | 12-31-08 | 12-31-09 | 6-30-13 | ||
| Hospital Organization | HQs | Net Assets | Net Assets | Net Assets | Net Assets | |
| mil $s | mil $s | mil $s | mil $s | |||
| Kaiser Permanente | CA | 13,633 | 11,431 | 11,838 | 15,747 | |
| Sutter Health | CA | 4,755 | 4,298 | 5,385 | 7,485 | |
| Providence Health | WA | 4,673 | 3,911 | 4,709 | 6,757 | |
| Adventist Health System | FL | 3,236 | 3,378 | 3,884 | 5,990 | |
| Cleveland Clinic Health System | OH | 3,561 | 2,715 | 3,661 | 5,392 | |
| Mayo Clinic | MN | 4,312 | 2,326 | 4,271 | 5,107 | |
| Advocate HealthCare Network | IL | 2,535 | 1,842 | 2,598 | 4,662 | |
| BJC Healthcare | MO | 3,787 | 2,705 | 3,489 | 4,542 | |
| Memorial Sloan-Kettering Cancer Center | NY | 4,045 | 3,224 | 3,602 | 4,427 | |
| The Methodist Hospital System | TX | 2,867 | 2,375 | 2,902 | 4,122 | |
| IHC Health Solutions | UT | 2,846 | 1,582 | 2,614 | 4,101 | |
| New York and Presbyterian Hospital | NY | 2,621 | 2,333 | 2,787 | 4,082 | |
| Total all 12 | 52,871 | 42,120 | 51,740 | 72,414 | ||
| Annual Increase(Decrease) | ||||||
| …..Amount | (10,751) | 9,620 | ||||
| …..Percentage | -20% | 23% | ||||
| Increase from Dec 2008 to Jun 2013 | ||||||
| …..Amount | 30,294 | |||||
| …..Percentage | 72% |
So, these 12 largest Non-profit hospital organizations lost $10.8 bil in their Net Asset positions in 2008 and recouped $9.6 bil back in 2009. And their current total Net Asset positions of $72.4 bil are $30.3 bil, or 72%, above their Dec 2008 total Net Asset amounts of $42.1 bil.
But it's not just the Non-profit hospital organizations with December fiscal years ends. Ascension Health has a June fiscal year end. Its Net Asset position was $9.7 bil at June 30, 2008, before the financial meltdown. It lost $1.5 bil of Net Assets in the fiscal year ended June 2009 and then recouped $1.2 bil of this Net Asset loss in the following fiscal year. And its Net Asset position at June 30, 2013 of $17.1 bil is $8.9 bil higher, or a massive 107% higher, than it was at June 30, 2009.
From mostly a quick review of the Electronic Municipal Market Access (EMMA), below here are the 82 non-profit hospital organizations I found with December fiscal year ends and with current (June 30, 2013) Net Asset positions of more than $400 mil each:
| Obama | ||||||
| First | Bump | |||||
| Half | 4 1/2 | |||||
| 2013 | Years | |||||
| State | 6-30-13 | 12-31-12 | 12-31-08 | % | % | |
| Hospital Organization | HQs | Net Assets | Net Assets | Net Assets | Change | Change |
| mil $s | mil $s | mil $s | ||||
| Kaiser Permanente | CA | 15,747 | 14,284 | 11,431 | 10% | 38% |
| Sutter Health | CA | 7,485 | 7,362 | 4,298 | 2% | 74% |
| Providence Health | WA | 6,757 | 6,674 | 3,911 | 1% | 73% |
| Adventist Health System | FL | 5,990 | 5,756 | 3,407 | 4% | 76% |
| Cleveland Clinic Health System | OH | 5,392 | 5,002 | 2,715 | 8% | 99% |
| Mayo Clinic | MN | 5,107 | 4,686 | 2,326 | 9% | 120% |
| Advocate HealthCare Network | IL | 4,662 | 4,265 | 1,842 | 9% | 153% |
| BJC Healthcare | MO | 4,542 | 4,347 | 2,705 | 4% | 68% |
| Memorial Sloan-Kettering Cancer Center | NY | 4,427 | 4,233 | 3,224 | 5% | 37% |
| The Methodist Hospital System | TX | 4,122 | 3,822 | 2,375 | 8% | 74% |
| New York and Presbyterian Hospital | NY | 4,082 | 3,689 | 2,333 | 11% | 75% |
| Banner Health | AZ | 3,950 | 3,512 | 1,669 | 12% | 137% |
| Carolinas Health Care System | NC | 3,797 | 3,603 | 2,340 | 5% | 62% |
| Inova Health System | VA | 3,766 | 3,593 | 1,885 | 5% | 100% |
| Indiana University Health | IN | 3,763 | 3,530 | 1,434 | 7% | 162% |
| Catholic Health East | PA | 3,631 | 3,340 | 1,978 | 9% | 84% |
| Texas Health Resources | TX | 3,437 | 3,213 | 1,921 | 7% | 79% |
| BayCare Health System | FL | 2,980 | 2,842 | 1,523 | 5% | 96% |
| Sentara HealthCare | VA | 2,966 | 2,717 | 1,489 | 9% | 99% |
| Children's HealthCare Atlanta | GA | 2,867 | 2,617 | 1,482 | 10% | 93% |
| Catholic Health Partners | OH | 2,636 | 2,530 | 1,614 | 4% | 63% |
| North Shore Long Island Jewish Health | NY | 2,545 | 2,430 | 614 | 5% | 314% |
| Novant Health | NC | 2,297 | 2,163 | 1,557 | 6% | 48% |
| Iowa Health System | IA | 2,071 | 1,953 | 1,067 | 6% | 94% |
| Franciscan Alliance | IN | 2,068 | 1,962 | 1,463 | 5% | 41% |
| HealthPartners | MN | 1,949 | 1,320 | 503 | 48% | 287% |
| Allina Health System | MN | 1,804 | 1,637 | 804 | 10% | 124% |
| SSM HealthCare | MO | 1,642 | 1,567 | 933 | 5% | 76% |
| Nationwide Children's Hosital | OH | 1,572 | 1,433 | 761 | 10% | 107% |
| Adventist Health West | CA | 1,559 | 1,528 | 969 | 2% | 61% |
| Presbyterian Health Care Services | NM | 1,529 | 1,453 | 706 | 5% | 117% |
| Children's Medical Center of Dallas | TX | 1,507 | 1,406 | 821 | 7% | 84% |
| ProMedica Health Care | OH | 1,485 | 1,416 | 1,042 | 5% | 43% |
| MultiCare Health System | WA | 1,475 | 1,358 | 650 | 9% | 127% |
| University Hospitals Health System | OH | 1,454 | 1,359 | 1,078 | 7% | 35% |
| Henry Ford Health System | MI | 1,418 | 1,437 | 1,053 | -1% | 35% |
| Fairview Health Services | MN | 1,384 | 1,282 | 732 | 8% | 89% |
| John Muir Health | CA | 1,328 | 1,273 | 756 | 4% | 76% |
| St Luke's Episcopal Health System | TX | 1,241 | 1,097 | 692 | 13% | 79% |
| Children's Hospital Colorado Health System | CO | 1,188 | 1,115 | 678 | 7% | 75% |
| Mount Sinai Hospital | NY | 1,133 | 1,093 | 477 | 4% | 138% |
| Cottage Health System | CA | 1,070 | 1,020 | 675 | 5% | 59% |
| Virtua Health | NJ | 1,035 | 1,039 | 566 | 0% | 83% |
| St Luke's Health System | MO | 1,033 | 982 | 703 | 5% | 47% |
| Aurora Health Care | WI | 1,029 | 969 | 546 | 6% | 88% |
| West Virginia United Health System | WV | 1,002 | 919 | 608 | 9% | 65% |
| Catholic Health Services Long Island | NY | 971 | 965 | 561 | 1% | 73% |
| Beaumont Health System | MI | 968 | 941 | 787 | 3% | 23% |
| Children's Hospital and Health System | WI | 954 | 920 | 460 | 4% | 107% |
| Parkview Health System | IN | 934 | 878 | 543 | 6% | 72% |
| Beacon Health System | IN | 931 | 898 | 341 | 4% | 173% |
| Community Health Network | IN | 869 | 864 | 482 | 1% | 80% |
| Children's Hospital Alabama | AL | 795 | 771 | 418 | 3% | 90% |
| Norton Health Care | KY | 784 | 782 | 399 | 0% | 96% |
| Montefiore Medical Center | NY | 765 | 692 | 320 | 11% | 139% |
| Robert Wood Johnson University Hospital | NJ | 765 | 736 | 457 | 4% | 67% |
| Meridian Hospitals | NJ | 757 | 702 | 339 | 8% | 123% |
| MedAmerica Health Systems | OH | 756 | 724 | 585 | 4% | 29% |
| Kettering Health Network | OH | 699 | 664 | 340 | 5% | 106% |
| Huntington Memorial Hospital Pasadena | CA | 670 | 648 | 446 | 3% | 50% |
| Virginia Hospital Center Arlington | VA | 651 | 636 | 351 | 2% | 85% |
| Loma Linda University Medical Center | CA | 646 | 601 | 415 | 7% | 56% |
| Valley Health System | VA | 640 | 602 | 434 | 6% | 47% |
| Sparrow Health System | MI | 623 | 594 | 318 | 5% | 96% |
| Children's Hospitals and Clinics Minnesota | MN | 620 | 581 | 370 | 7% | 68% |
| Summa Health System | OH | 618 | 595 | 407 | 4% | 52% |
| Hackensack University Medical Center | NJ | 593 | 474 | 297 | 25% | 100% |
| Park Nicollet Health Services | MN | 538 | 523 | 299 | 3% | 80% |
| Bronson Healthcare Group | MI | 509 | 428 | 226 | 19% | 125% |
| Total all 69 | 156,980 | 147,047 | 87,951 | 7% | 78% | |
| Late Additions (13) | ||||||
| IHC Health Services | UT | 4,101 | 1,582 | 159% | ||
| SCL Health Systems | KS | 2,156 | 2,263 | -5% | ||
| Methodist Le Bonheur Healthcare | TN | 969 | 451 | 115% | ||
| AHS Hospital | NJ | 966 | 510 | 89% | ||
| Evangelican Lutheran Good Samaritan | SD | 809 | 618 | 31% | ||
| Barnabus Health | NJ | 515 | (290) | 278% | ||
| Community Hospital Foundation | CA | 513 | 341 | 50% | ||
| Oschner Health System | LA | 491 | 321 | 53% | ||
| Torrance Memorial Medical Center | CA | 458 | 302 | 52% | ||
| AtlantiCare Regional Medical Center | NJ | 435 | 262 | 66% | ||
| Nebraska Methodist Health System | NE | 435 | 300 | 45% | ||
| Centra Health | VA | 434 | 233 | 86% | ||
| Denver Health & Hospital Authority | CO | 419 | 406 | 3% | ||
| Grand Total all 82 including 13 Late Additions | 169,681 | 95,250 | 78% |
These 82 had a Total Net Assets increase of a huge 78% during the first four and a half years of the Obama Administration.
And yeah, only 1 of these 82 had a Net Asset decrease during the Obama Administration and there are only 4 of them with percentage increases below 30%, only 9 of them with increases below 40% and only 15 of them with increases below 50%.
The total Net Asset increase in just the first half of 2013 was 7%.
These Non-profit hospitals have operated on all cylinders financially during the Obama Administration, consistently growing their Net Asset positions.
It is pretty clear to me that these 82 large Non-profit hospital organizations have the exceptional financial strength to make the ACA work very effectively.
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Below here are 5 additional Non-Profit Hospital Organizations with December FYEs but which didn't report a June 30, 2013 Net Assets Amount:
And yeah, only 1 of these 82 had a Net Asset decrease during the Obama Administration and there are only 4 of them with percentage increases below 30%, only 9 of them with increases below 40% and only 15 of them with increases below 50%.
The total Net Asset increase in just the first half of 2013 was 7%.
These Non-profit hospitals have operated on all cylinders financially during the Obama Administration, consistently growing their Net Asset positions.
It is pretty clear to me that these 82 large Non-profit hospital organizations have the exceptional financial strength to make the ACA work very effectively.
=========================================================
Below here are 5 additional Non-Profit Hospital Organizations with December FYEs but which didn't report a June 30, 2013 Net Assets Amount:
| Most | |||||
| Most | Recent | ||||
| Recent | Balance | ||||
| Balance | Sheet | 12-31-08 | |||
| State | Sheet | Net | Net | % | |
| Hospital Organization | HQs | Date | Assets | Assets | Increase |
| mil $s | mil $s | ||||
| Icahn School Medicine Mount Sinai | NY | Dec 12 | 1,040 | 765 | 36% |
| Nemours Foundation | FL | Dec 12 | 956 | 744 | 28% |
| University Health (Richmond County) | GA | Dec 12 | 481 | 317 | 52% |
| Miami Children's Hospital | FL | Mar 13 | 464 | 236 | 97% |
| Covenant Health Systems | MA | Mar 13 | 406 | 242 | 68% |
| Total all 5 | 3,347 |
