| Most | |||||
| Recent | |||||
| Annual | Bottom | ||||
| Fiscal | Line | Total | Profit | ||
| City | Year | Net | Operating | Margin | |
| HQs | End | Income | Revenues | % | |
| mils $s | mils $s | ||||
| Florida Hospital Organizations | |||||
| Adventist Health System | Altamonte Springs | Dec 2012 | 508 | 7,347 | 6.9% |
| BayCare Health System | Clearwater | Dec 2012 | 423 | 2,426 | 17.4% |
| Baptist Health South Florida | Coral Gables | Sep 2012 | 328 | 2,038 | 16.1% |
| Baptist Health System | Jacksonville | Sep 2012 | 201 | 1,183 | 17.0% |
| Shands Teaching Hospitals & Clinics | Gainesville | Jun 2012 | 126 | 1,160 | 10.9% |
| South Broward Hospital District | Hollywood | Apr 2013 | 111 | 1,481 | 7.5% |
| Orlando Health | Orlando | Sep 2012 | 82 | 1,827 | 4.5% |
| Lee Memorial Health System | Fort Myers | Sep 2012 | 73 | 1,213 | 6.0% |
| Lakeland Regional Medical Center | Lakeland | Sep 2012 | 67 | 583 | 11.5% |
| Sarasota County Hospital District | Sarasota | Sep 2012 | 60 | 493 | 12.2% |
| Miami Children's Hospital | Miami | Dec 2012 | 56 | 505 | 11.1% |
| Tampa General Hospital | Tampa | Sep 2012 | 48 | 988 | 4.9% |
| All Children's Hospital | St Petersburg | Jun 2013 | 45 | 397 | 11.3% |
| Nemours Foundation | Jacksonville | Dec 2012 | 33 | 861 | 3.8% |
| Health First | Rockledge | Sep 2012 | 27 | 998 | 2.7% |
| H. Lee Moffitt Cancer Center | Tampa | Jun 2013 | 18 | 779 | 2.3% |
| North Broward Hospital District | Fort Lauderdale | Jun 2012 | 16 | 962 | 1.7% |
| Halifax Hospital Medical Center | Daytona Beach | Sep 2012 | 11 | 426 | 2.6% |
| NCH Healthcare System | Naples | Sep 2012 | 10 | 473 | 2.1% |
| Total all 19 | 2,243 | 26,140 | 8.6% |
As you can see in the above chart, the Total Bottom Line Profits for these 19 Florida Non-Profit Hospital Organizations was $2.243 bil in the most recent audited fiscal year reported, which was a very robust 8.6% of Total Operating Revenues. As a comparison, the Combined Bottom Line Profit Margin of the prestigious 30 Dow Industrial companies is just a bit higher 9.6% of their Total Revenues in the most recent year.
When you compare the 8.6% Total Bottom Line Profit Margin of these 19 Florida Non-Profit Hospital Organizations with the 9.6% Total Bottom Line Profit Margin of the 30 Dow Industrials, which are some of the very best For-Profit US companies, the clear conclusion is that the earnings of these Florida Hospital Organizations in the most recent year were on fire.
These very strong bottom line profits of these 19 Florida Non-Profit Hospital Organizations were attributable to superb fiscal measures and much more effective health care delivery adopted by hospital executives and hospital employees, which were initiated in conjunction with Obamacare. In addition, the strong US stock market and lower interest rates added to investment returns and thus also to bottom line profits of these Hospital Organizations.
And it wasn't just the current fiscal year where these Florida Non-Profit Hospital Bottom Line Earnings were so strong.
A Non-Profit Hospital Organization's Net Assets, or its Excess of Total Assets over Total Liabilities, results overwhelmingly from the accumulated Tax-free Bottom Line Profits over time.
Since the beginning of the Obama Administration, these 19 Florida Non-Profit Hospital Organizations have seen their Total Net Assets grow from $15.108 bil to $23.562 bil at the most recently reported date, or an increase of a huge $8.454 bil, or up 56%.
But there's even much more to this incredibly positive earnings story.
When the Insurance Exchanges kick in starting in 2014, these Florida Non-Profit Hospital Organizations should see their profits increase even more......and by quite a bit more.
Under the Affordable Care Act (ACA), Hospital Organizations' both future Hospital Operating Income and future Bottom Line Income will be bolstered robustly due to many of the Uninsured getting insurance and also due to the many of the Underinsured getting much better insurance.
Bottom Line Income is a combination of Hospital Operating Income and Non-Operating Income, with the latter being predominantly Investment Returns.
There are specifically two items which will drive higher Hospital Organization profits due to the ACA.
First, there is the Operating Statement Provision for Bad Debts' earnings charge which will be significantly reduced due to the substantially better insurance situation of hospital patients. This Provision for Bad Debts' earnings charge is usually a separate report line on a Hospital Organization's audited Operating Statement.
And second, there is the Operating Statement Uncompensated Charity Care Costs' earnings charge for the amounts hospitals spend on charity care which will also be significantly reduced. This Estimated Costs for Uncompensated Charity Care is usually disclosed in a Hospital Organization's footnotes which accompany its audited financial statements.
So what about the amounts of these two items? Well, they are very large when compared to the related Hospital Operating Income.
From a review of the Electronic Municipal Market Access (EMMA), below here are the most recent audited year's Provision for Bad Debts and Uncompensated Charity Care Costs for the 17 Florida Non-Profit Hospital Organizations which had Net Assets above $400 mil currently. I excluded below the two Florida Children's Hospitals located in Miami and St. Petersburg. And I added below the one large Florida For-Profit Hospital Organization Naples-based Health Management Associates, an allocation of 24.5% of For-Profit HCA's consolidated amounts for the 24.5% of HCA's total licensed beds located in Florida and an allocation of the 26.4% of For-Profit Tenet HealthCare's consolidated amounts for the 26.4% of Tenet HealthCare's total licensed beds located in Florida:
| One Year | One | |||||
| One Year | Estimated | Year | One | |||
| Most | Provision | Cost of | Total | Year | ||
| Recent | For | Uncompensated | Earnings | Hospital | ||
| Annual | Bad | Charity | Charge | Operating | ||
| FYE | Debts | Care | of Both | Income | ||
| mils $s | mils $s | mils $s | mils $s | |||
| Florida Hospital Organizations | ||||||
| Florida 24.5% Share of HCA | Dec 2012 | 924 | 583 | 1,507 | 709 | |
| Health Management Associates | Dec 2012 | 874 | 497 | 1,371 | 301 | |
| Adventist Health System | Dec 2012 | 331 | 302 | 633 | 512 | |
| North Broward Hospital District | Jun 2012 | 396 | 72 | 468 | (114) | |
| South Broward Hosp District | Apr 2013 | 348 | 108 | 456 | 88 | |
| Baptist Health South Florida | Sep 2012 | 282 | 95 | 377 | 83 | |
| Lee Memorial Health System | Sep 2012 | 159 | 164 | 323 | 45 | |
| Florida 26.4% Share of Tenet HealthCare | Dec 2012 | 207 | 115 | 322 | 88 | |
| Lakeland Regional Medical Center | Sep 2012 | 135 | 133 | 268 | 41 | |
| BayCare Health System | Dec 2012 | 138 | 86 | 224 | 199 | |
| Orlando Health | Sep 2012 | 60 | 119 | 179 | 27 | |
| Baptist Health Jacksonville | Sep 2012 | 113 | 35 | 148 | 86 | |
| Shands Teaching Hospitals&Clinics | Jun 2013 | 88 | 60 | 148 | 118 | |
| Sarasota County Hosp District | Sep 2012 | 70 | 54 | 124 | (2) | |
| Halifax Hospital Medical Center | Sep 2012 | 98 | - | 98 | (3) | |
| Florida Health Science Ctr (Tampa Hosp) | Sep 2012 | 49 | 38 | 87 | 11 | |
| NCH Healthcare System | Sep 2012 | 44 | 35 | 79 | 1 | |
| Health First | Sep 2012 | 26 | 37 | 63 | 24 | |
| H. Lee Moffitt Cancer Center | Jun 2013 | 14 | 37 | 51 | 8 | |
| Nemours Foundation | Dec 2012 | 24 | 13 | 37 | 33 | |
| Total all 20 | 4,380 | 2,583 | 6,963 | 2,255 | ||
| Provision for Bad Debts | 4,380 | |||||
| Estimated Costs of Uncompensated Charity Care | 2,583 | |||||
| Operating Income Excluding Bad Debts and Uncompensated Charity Care Costs | 9,218 | |||||
So, these 20 Florida Hospital Organizations had Audited Total Hospital Operating Income of $2.255 bil in the most recent fiscal year audited. Driving down this $2.255 bil Total Hospital Operating Income were Total Provisions for Bad Debts of $4.380 bil and Total Costs of Uncompensated Charity Care of another $2.583 bil. Thus, exclusive of these two huge earnings charges, Total Hospital Operating Income would have been $9.218 bil, which is $6.963 bil higher than the reported $2.255 bil.
Granted these two earnings charges will not be totally eliminated with the ACA, but a very significant amount of these two huge earnings charges will be eliminated. The percentage of these two charges eliminated will not be nearly as high in Florida since it has chosen not to expand Medicaid as it will be in the States electing to expand Medicaid. But it will still be a very significant percentage reduction in Florida.
And the above two huge earnings charges are just for one year.
With these very strong, ongoing Florida Hospital earnings under Obamacare, the ultimate result should be a significant reduction in hospital patient charges, a significant bending back of the US Long-term Total Health Care Cost Curve and a significant reduction in the US Debt.
That's quite a financial Trifecta!
And it also only makes sense that some of these huge past and future bottom line profits of these US Hospital Organizations, both Non-Profit and For-Profit ones, should be used to wisely fund a substantial portion of the elimination of the US Government Sequester Cost Cuts over the next several years which are now being negotiated by 29 US Congressional members of the Bicameral Committee Conference on Budget Negotiations. Both clear-thinking Republicans and clear-thinking Democrats should be on board with this wise funding vehicle.
There is another huge economic benefit if Florida Expands Medicaid. Since the Operating Losses of Florida Government Hospitals should drop precipitously if Medicaid is expanded in Florida, it only makes since that the Local Taxes Funding these Operating Losses will likewise drop precipitously if Florida expands Medicaid. Let me address just 4 of these Florida Public Government Hospital Organizations collecting Local Taxes from a review of audited financial statements shown in EMMA.
First, the Public Health Trust of Miami-Dade County, which is predominantly the Jackson Memorial Hospitals, posted Total Operating Losses of a massive $2.247 bil in the most recent five years. Total Sales Tax revenues collected of $928 mil funded 41% of these Total Operating Losses.
Second, the North Broward Hospital District generated Total Operating Losses of $578 mil in the most recent five years. The Property Taxes Funding these Operating Losses totaled $807 mil in the most recent five years.
Third, the Sarasota County Public Hospital District collected $238 mil of Property Tax Revenues in the most recent five years. The related Operating Losses totaled $16 mil over the past five years.
And fourth, Daytona Beach-based Halifax Medical Center collected $126 mil of Property Tax Revenues in the most recent four years. The related Operating Income totaled $9 mil over the past four years.
Florida residents would be very pleased if the above massive Local Taxes they paid were substantially reduced due to Medicaid Expansion in Florida.
