Thursday, October 10, 2013

Indiana Non-Profit Hospitals Net Assets Up 88% Under Obama and the Affordable Care Act

From a review of the Electronic Municipal Market Access (EMMA), I found 8 Non-Profit Hospital Organizations headquartered in the State of Indiana with Net Assets at the most recent date reported of more than $400 mil each.  In addition, from a review of the Indiana State Dept of Health's Website, I found 2 additional Indiana Non-Profit Hospital Organizations with Net Assets at the most recent date reported of more than $400 mil each.  Below here are the Net Assets of these 10 at both the most recent reported date and also at the beginning of the Obama Administration:






2008 2008 Obama




Most
or or ACA



Most Recent
2009 2009 and



Recent Balance
FYE Balance US Fed



Balance Sheet
Balance Sheet Bump
City State Sheet Net
Sheet Net %
Hospital Organization HQs HQs Date Assets
Date Assets Change




mil $s

mil $s









Indiana University Health Indianapolis IN  Jun 13      3,763
Dec 08     1,434 162%
St Vincent Health Indianapolis IN Jun 13     3,040 Jun 09     1,561 95%
Franciscan Alliance Mishawaka IN  Jun 13      2,068
Dec 08     1,463 41%
Parkview Health System Fort Wayne IN  Jun 13         934
Dec 08        543 72%
Beacon Health System South Bend IN  Jun 13         931
Dec 08        341 173%
Community Health Network Indianapolis IN  Jun 13         869
Dec 08        482 80%
Marion County Hospital Corp Indianapolis IN Dec 12        586
Dec 08        446 31%
Deaconess Health System Evansville IN Jun 13        493
Sep 09        365 35%
St Mary's Health Evansville IN Jun 12        448 Jun 09        292 53%
Community Healthcare System Munster IN Jun 13        428
Jun 09        289 48%









Total all 10


   13,560

     7,216 88%

As you can see from the above chart, the Total Net Assets (Excess of Total Assets over Total Liabilities) of these 10 Indiana Non-Profit Hospital Organizations increased by an exceptional 88% to $13.560 bil during the Obama Administration.  Indiana citizens should be pleased with the superb fiscal performance of their largest Indiana Non-Profit Hospital Organizations. 

Indianapolis-based IU Health generated a massive $1.435 bil of Bottom Line Profits in the most recent 3.5 years, which was a very healthy 8.6% of Total Revenues.  For the most recent 1.5 years, this Bottom Line Profit Margin was an even higher 11.9% of Total Revenues, which was higher than half of that of the pristine 30 Dow Industrial companies.  As a comparison, the Combined Bottom Line Profit Margin was a much lower 9.6% in the most recent year for the prestigious 30 Dow Industrial companies.

Indianapolis-based St. Vincent Health and Evansville-based St. Mary's Health System are both part of the huge Ascension Health Alliance.  They don't file their separate financial statements with EMMA but they both do file their separate annual audited financial statements at the Indiana State Dept of Health Website.  St Vincent has just recently filed its June 2013 financial statements but St Mary's Health hasn't yet.

In its Fiscal Year Ended (FYE) June 2009, St. Vincent Health recorded an Investment Loss of $206 mil due to the financial meltdown in late 2008.  This $206 mil Investment Loss resulted in a Bottom Line Loss of $45 mil in FYE June 2009.

However, in the four fiscal years since then, St. Vincent Health generated Total Investment Income of $570 mil, which was a huge 45% of its Total Bottom Line Profit of $1.256 bil over the same four year period.  And over this four year period ended June 30, 2013, St. Vincent Health generated a Profit Margin of an exceptional 13.2% of its Total Revenues.  This 13.2% Profit Margin exceeds that of more than half of the 30 Dow Industrials over the same time span.

Similarly, St. Mary's Health recorded an Investment Loss of $60 mil due to the financial meltdown in late 2008.  This $60 mil Investment Loss resulted in a Bottom Line Loss of $45 mil in FYE June 2009.

However, in the three fiscal years since then, St. Mary's Health generated Total Investment Income of $97 mil, which was a huge 50% of its Total Bottom Line Profit over the same three year period.  And over this three year period ended June 30, 2012, St. Mary's Health generated a Profit Margin of an exceptional 13.7% of its Total Revenues, substantially exceeding the Combined Bottom Line Profit Margin of 9.6% for the prestigious 30 Dow Industrial companies.  

In similar fashion, Mishawaka-based Franciscan Alliance recorded an Investment Loss of $440 mil in annual 2008 due to the financial meltdown in late 2008.  This $440 mil Investment Loss resulted in a Bottom Line Loss of $314 mil in annual 2008.

However, in the 4.5 years since then, Franciscan Alliance generated Total Investment Income of $638 mil, which was a huge 69% of its Total Bottom Line Profit over the same three year period.  And over this 4.5 year period, Franciscan Alliance generated a Bottom Line Profit Margin of a high 8.7% of Total Revenues.

Fort Wayne-based Parkview Health System generated Total Bottom Line Profits of $435 mil in the most recently reported 4.5 years ended June 30, 2013, which was a very high 10.6% of its Total Revenues over the same time period.

South Bend-based Beacon Health System generated Total Bottom Line Profits of $215 mil in the most recent 1.5 years ended June 30, 2013, which was an extremely high 16.7% of Total Revenues over the same time span.

Indianapolis-based Community Health Network generated Total Bottom Line Profits of $525 mil in the most recently reported 4.5 years ended June 30, 2013, which was a high 8.3% of its Total Revenues over the same time period.

Evansville-based  Deaconess Health System's Total Bottom Line Profits of $143 mil in the most recently reported 3.75 years ended June 30, 2013 were 6.0% of its Total Revenues over the same time period.

Munster is not only the home of 3 Floyds Craft Beer Brewery but also the headquarters of  Community Healthcare System.  Its Total Bottom Line Profits of $203 mil in the most recently reported 4.5 years ended June 30, 2013 were 5.0% of its Total Revenues over the same time period.

Very positively impacting this major increase in the Net Assets (Financial Strength) of all of these hospitals were actions taken by both the Obama Administration and the US Fed to strengthen the US Financial Foundation which was severely damaged from the financial meltdown in late 2008.

In addition, the Affordable Care Act (ACA) has also played a key role in this increase in Net Assets (Financial Strength) of these Non-Profit Hospital Organizations.

A remarkable thing is that these robust increases in Net Assets of these Non-Profit Hospital Organizations occurred when these Non-Profit Hospitals were also able to substantially bend down the Total US Health Care Cost Curve in each of the most recent three years.

With future Non-Profit Hospital Organizations' Hospital Operating Income being bolstered by both many of the Uninsured getting insurance and by the many of the Underinsured getting much better insurance, both under the ACA,  future Net Asset growth of these Non-Profit Hospital Organizations should be very robust.  And for States electing to expand Medicaid, this future Net Asset growth will be exceptionally robust.

OK, so that's the story with Indiana's largest Non-Profit Hospital Organizations with Net Assets above $400 mil.  And it's a great story financially.

What about the smaller hospitals?

That's the beauty about Indiana.....all of its hospitals are required to file annual audited financial statements at its State Dept of Health website.  Indiana is way ahead of the curve in financial transparency in this regard.

There were 36 Indiana Hospital Organizations with Net Assets below $400 mil which filed their operating statements containing both their 2012 and 2011 financial information at the Indiana State Dept of Health website.  The overwhelming majority of them are Non-Profit Hospital Organizations. 

These 36 Indiana Hospital Organizations generated Total Bottom Line Profits (Excess of Revenues over Expenses) of $321.5 mil in 2012, an incredible 232% increase over the $96.9 mil earned in 2011.  Total Revenues in 2012 of $4.439 bil were up a very sharp 21% over 2011.  And the Total Bottom Line Profit as a percentage of Total Operating Revenues was 7.2% in 2012, spiking up sharply from the comparable Profit Margin of 2.6% in 2011.

Of the 36 Hospital Organizations, thirteen of them had Bottom Line Losses in 2011.  This was reduced down to only four of them in 2012.....a remarkable reversal.

So clearly, it's not just the largest Indiana Hospitals but also the smaller ones that have performed exceptionally well in 2012 under the Affordable Care Act.

Below here are the Bottom Line Profits and Profit Margin Percentages for both fiscal year ended (FYE) 2012 and 2011 for each of these Indiana Hospital Organizations:






2012 2011


2012 2011
Bottom Bottom


FYE FYE
Line Line


Bottom Bottom Profit Profit

Indiana Line Line (Loss) (Loss)
City Profit Profit % of % of
Hospital Organization HQs (Loss) (Loss) Revenues Revenues


$ 000's $ 000's









Indiana Orthopaedic Hospital Indianapolis     43,836        41,411
33.8% 34.9%
Hendricks Regional Health Danville     28,772        13,415
10.3% 7.2%
Union Hospital Terre Haute     28,419           (463)
6.6% -0.1%
The Methodist Hospitals Merrillville     28,216        19,256
8.5% 6.6%
Witham Health Services Lebanon     25,857          6,888
9.8% 5.7%
Marion General Hospital Marion     17,892        19,862
11.3% 13.8%
Jackson County Schneck Hosp Seymour     16,833        11,624
13.1% 10.6%
Heart Hospital at Deaconess Newburgh     13,303          8,301
25.8% 18.5%
Reid Hospital Richmond     12,787      (19,807)
3.6% -6.7%
Good Samaritan Hospital Vincennes     12,651          8,439
6.6% 4.8%
Deaconess Women's Hospital Newburgh     11,738          2,970
17.6% 5.9%
Floyd Memorial Hospital New Albany     10,639          1,190
4.0% 0.5%
Columbus Regional Hospital Columbus     10,482          6,046
4.5% 3.1%
Major Health Partners Shelbyville       9,404          3,943
7.5% 4.1%
Hancock Regional Hospital Greenfield       9,037           (119)
7.3% -0.1%
Memorial Hospital Logansport Logansport       8,241          1,457
11.5% 2.5%
Dearborn County Hospital Lawrenceburg       7,471        (4,487)
5.6% -5.5%
Johnson Memorial Hospital Franklin       5,178          1,122
4.3% 1.5%
Henry County Hospital New Castle       4,436           (423)
4.3% -0.5%
Memorial Hospital Jasper Jasper       3,848        16,540
2.3% 11.0%
Cameron Community Hospital Angola       3,402           (136)
7.1% -0.3%
DeKalb Memorial Hospital Auburn       3,312        (1,124)
5.4% -2.3%
Sullivan County Community Hosp Sullivan       1,918             691
7.3% 2.6%
Woodlawn Hospital Rochester       1,891             133
4.2% 0.3%
Rehabilitation Hospital Indiana Indianapolis       1,627             877
4.3% 2.2%
Rush Memorial Hospital Rushville       1,489           (156)
5.2% -0.7%
Perry County Memorial Hospital Tell City       1,308             527
3.7% 1.6%
Fayette Regional Health Connersville          915        (1,656)
1.5% -2.9%
Pulaski Memorial Hospital Winamac          759             615
3.6% 3.2%
Jay County Hospital Portland          665          1,260
1.9% 3.8%
So Indiana Rehabilitation Hosp New Albany          642             (29)
3.5% -0.2%
Physicians Medical Center New Albany          336             686
3.0% 6.6%
Community Hospital Bremen Bremen          (12)             336
-0.1% 2.4%
Howard Regional Health (1) Kokomo          (88)        (8,410)
-0.1% -5.6%
Scott Memorial Hospital Scottsburg     (2,316)        (3,407)
-11.3% -18.0%
Clark Memorial Hospital Jeffersonville     (3,348)      (30,441)
-1.9% -23.8%







Total all 36
  321,540        96,931
7.2% 2.6%







Total % Increase 2012 over 2011
232%










(1) Howard Regional Health 2012 is for 6 Months and 2011 is for 12 months




From a review of their audited financial statements filed at the Indiana State Dept of Health website,  I found 33 Hospital Organizations headquartered in the State of Indiana with Net Assets below $400 mil each and which also reported their Net Assets amount in both 2012 and also at the beginning of the Obama Administration.  These 33 had Total Net Assets of $3.039 bil in 2012, an increase of 25% over this 3.74 average year period of time.  Below here are the Net Assets of these 33 at both the 2012 date and also at the beginning of the Obama Administration:






Dec





Dec 2008





2008 or Obama




or FYE ACA


2012
FYE 2009 and


2012 Balance
2009 Balance US Fed

Indiana Balance Sheet
Balance Sheet Bump
City Sheet Net
Sheet Net %
Hospital Organization HQs Date Assets
Date Assets Change



$ 000's

$ 000's








Reid Hospital Richmond Dec      357,558
Dec 08      355,014 1%
Columbus Regional Hospital Columbus Dec      250,790
Dec 08      139,682 80%
Hendricks Regional Health Danville Dec      236,486
Dec 08      168,698 40%
The Methodist Hospitals Merrillville Dec      202,217
Dec 08      145,442 39%
Marion General Hospital Marion Jun      188,024
Jun 09      133,633 41%
Jackson County Schneck Hosp Seymour Dec      185,315
Dec 08      138,976 33%
Good Samaritan Hospital Vincennes Dec      182,998
Dec 08      142,094 29%
Union Hospital Terre Haute Aug      144,621
Aug 09      127,592 13%
Floyd Memorial Hospital New Albany Dec      138,363
Dec 08        96,779 43%
Memorial Hospital Jasper Jasper Jun      138,131
Jun 09      108,863 27%
Hancock Regional Hospital Greenfield Dec      107,335
Dec 08        75,893 41%
Major Health Partners Shelbyville Dec        97,341
Dec 08        70,106 39%
Dearborn County Hospital Lawrenceburg Dec        91,057
Dec 08        82,797 10%
Johnson Memorial Hospital Franklin Dec        90,597
Dec 08        80,891 12%
Witham Health Services Lebanon Dec        86,448
Dec 08        47,735 81%
Henry County Hospital New Castle Dec        70,734
Dec 08        62,127 14%
Howard Regional Health Kokomo Jun        56,896
Dec 08        66,126 -14%
Memorial Hospital Logansport Logansport Dec        51,979
Dec 08        42,677 22%
DeKalb Memorial Hospital Auburn Sep        50,433
Sep 09        45,585 11%
Clark Memorial Hospital Jeffersonville Dec        46,910
Dec 08        76,746 -39%
Jay County Hospital Portland Sep        41,120
Sep 09        37,810 9%
Perry County Memorial Hospital Tell City Dec        33,383
Dec 08        28,182 18%
Indiana Orthopaedic Hospital Indianapolis Dec        30,384
Dec 08        18,387 65%
Sullivan County Community Hosp Sullivan Dec        30,116
Dec 08        25,105 20%
Cameron Community Hospital Angola Sep        29,729
Sep 09        23,909 24%
Scott Memorial Hospital Scottsburg Dec        24,129
Dec 08        30,725 -21%
Woodlawn Hospital Rochester Dec        14,554
Dec 08        12,834 13%
Heart Hospital at Deaconess Newburgh Sep        13,932
Sep 09        10,970 27%
Rush Memorial Hospital Rushville Dec        12,599
Dec 08        11,121 13%
Pulaski Memorial Hospital Winamac Sep        11,349
Sep 09        10,386 9%
Deaconess Women's Hospital Newburgh Dec        10,090
Dec 08          6,766 49%
Physicians Medical Center New Albany Dec          8,375
Dec 08           (251) NM
Rehabilitation Hospital Indiana Indianapolis Dec          4,603
Dec 08          1,838 150%








Total all 33

  3,038,596

  2,425,238 25%