Tuesday, December 31, 2013

All Large Iowa Hospitals Are Driving Down Health Insurance Premium Prices on Insurance Exchange

From a review of audited financial statements in the Electronic Municipal Market Access (EMMA), I found 4 Iowa Non-Profit Hospital Organizations with Net Assets above $400 mil in the most recent year.   

These 4 large Iowa Non-Profit Hospital Organizations generated a Total Operating Income of $131 mil in the most recent year reported, which was an exceptionally modest 2.5% of Total Operating Revenues of $5.175 bil.

There were very modest Operating Income Margins all across the board, with the highest one being only 4.3%.

With all 4 of these large Iowa Non-Profit Hospital Organizations generating Operating Income Margins of 4.3% or below, a key beneficiary of this will be Iowa citizens buying health insurance on the Health Insurance Exchange.  These Iowa Hospitals, for the most part, will not be baking in excessive Hospital profits demands in their negotiations with health insurance companies on pricing for hospital procedures which ultimately determines what insurance premiums are set by health insurance companies on the Health Insurance exchange.

Another factor which will drive down insurance premium prices even more in the health insurance exchange is that Iowa is fully expanding Medicaid.  This will increase Iowa Hospital profits substantially and thus permit Iowa Hospitals to be even more reasonable in their negotiations with health insurance companies on pricing for hospital procedures which ultimately drives what health insurance premiums are set at by health insurers on the Insurance Exchange.

So just how much will Iowa Hospital Profits increase due to the ACA and the Expansion of Medicaid?

Well, these 4 large Iowa Non-Profit Hospital Organization's audited financial statements show it will be huge.

For these 4 large Iowa Non-Profit Hospital Organizations, Total Operating Income was $131 mil in the most recent fiscal year.  Driving down this Total Operating Income were Total Provisions for Bad Debts was $232 mil.  Thus Total Operating Income Before Bad Debt Charges was $363 mil, which was 2.8 times the reported Total operating Income of $131 mil.  In addition, Total Uncompensated Charity Care Costs Incurred was also very large.

Granted not all of these two Earnings Charges will be eliminated with ACA and Medicaid Expansion, but a substantial portion of them will.

Below here are the Audited Operating Income or Loss, Total Operating Revenues and Operating Income (Loss) Margin Percentage in the most recent year for each of these 4 large Iowa Non-Profit Hospital Organizations:



Operating

Operating Total Income

City Income Operating (Loss)

HQs (Loss) Revenues Margin


mils $s mils $s %
Iowa Non-Profit Hospital Organizations








UnityPoint Health Des Moines        61.4      2,733 2.2%
Univ Iowa Hospitals & Clinics Iowa City        46.7      1,098 4.3%
Genesis Health Davenport        17.3         553 3.1%
Mercy Medical Center Iowa Various*          5.7         792 0.7%





Total all 4
     131.1      5,175 2.5%

*Mercy Medical Center has the following major facilities in Iowa: Mason City, Sioux Falls, Dubuque and Clinton.



All Arkansas Hospitals Are Driving Down Health Insurance Premium Prices on Insurance Exchange

From a review of audited financial statements in the Electronic Municipal Market Access (EMMA), I found 10 Arkansas Non-Profit Hospital Organizations with Total Operating Revenues of more than $10 mil in the most recent year.  After excluding the Arkansas Children's Hospital, that leaves 9. 

These 9 Arkansas Non-Profit Hospital Organizations generated a Total Operating Loss of $(15) mil in the most recent year reported, which was a negative (0.9)% of Total Operating Revenues of $1.736 bil.  Baptist Health was the driver of this Total Loss.

There were very modest Operating Income Margins across the board, with the highest one being only 4.6%.

With all of these Arkansas Hospitals generating either Operating Losses or such incredibly low Operating Income Margins, a key beneficiary of this will be Arkansas citizens buying health insurance on the Health Insurance Exchange.  These Arkansas Hospitals, for the most part, will not be baking in excessive Hospital profits demands in their negotiations with health insurance companies on pricing for hospital procedures which ultimately determines what insurance premiums are set by health insurance companies on the Health Insurance exchange.

Another factor which will drive down insurance premium prices even more in the health insurance exchange is that Arkansas is in essence fully expanding Medicaid.  This will increase Arkansas Hospital profits substantially and thus permit Arkansas Hospitals to be even more reasonable in their negotiations with health insurance companies on pricing for hospital procedures which ultimately drives what health insurance premiums are set at by health insurers on the Insurance Exchange.

So just how much will Arkansas Hospital Profits increase due to the ACA and the Expansion of Medicaid?

Well, these 9 Arkansas Hospital Organization's audited financial statements show it will be just huge.

For these 9 Arkansas Hospital Organizations, Total Operating Loss was $(15) mil in the most recent fiscal year.  Causing this Operating Loss were Total Provisions for Bad Debts of $170 mil and Uncompensated Charity Care Costs Incurred of another $52 mil.  Thus Total Operating Income exclusive of these two Earnings Charges was $207 mil, which was an earnings improvement of $222 mil from the reported Total Operating Loss of $(15) mil.

Granted not all of these two Earnings Charges will be eliminated with ACA and Medicaid Expansion, but a substantial portion of them will.

Below here are the Audited Operating Income or Loss, Total Operating Revenues and Operating Income (Loss) Margin Percentage in the most recent year for each of these 9 Arkansas Non-Profit Hospital Organizations:




Operating

Operating Total Income

City Income Operating (Loss)

HQs (Loss) Revenues Margin


mils $s mils $s %
Arkansas Non-Profit Hospital Organizations







Jefferson Hospital Association Pine Bluff         (4.4)         179 -2.5%
Baptist Health Little Rock       (16.1)         837 -1.9%
Conway Regional Medical Ctr Conway         (2.6)         136 -1.9%
Baxter Regional Health Mountain Home         (0.4)         162 -0.2%
Arkansas Methodist Hospital Paragould          0.3           64 0.5%
White River Health Batesville          1.9         170 1.1%
Saline County Medical Benton          2.4           84 2.8%
North Arkansas Medical Harrison          2.5           76 3.3%
Mena Hospital Mena          1.3           28 4.6%





Total all 9
      (15.1)      1,736 -0.9%




Most Oklahoma Hospitals Are Driving Down Health Insurance Premium Prices on Federal Insurance Exchange

This post relates to information contained in a just excellent web article on Oklahoma smaller hospitals by Oklahoma Watch Small Hospitals Hemorrhaging Big Losses.  The authors of this web article obtained their data from the Centers for Medicare and Medicaid Services via a Freedom of Information Act request, and from the American Hospital Directory, which compiles hospital cost report data.

I excluded from their study hospitals which I didn't consider general purpose ones.  I was left with 97 Oklahoma Hospitals.

These 97 Oklahoma Hospital Organizations generated Total Operating Income of $188 mil in 2012, which was a very modest 2.5% of Total Net Patient Revenues of $7.422 bil.

There were some of these 97 Oklahoma Hospitals which greedily generated excessive Operating Income in 2012.  There were 11 of them which generated Operating Income as a Percentage of Net Patient Revenues in excess of 10.0% each.  One of them, Tulsa-based St. Francis, generated Total Operating Income of $124 mil, which was 15.1% of its Net Patient Revenues.  Yeah, this $124 mil of Operating Profit comprised 66% of the Total Operating Income of $188 mil for all 97 Oklahoma Hospitals combined in 2012.

But an amazingly high 64 of these 97 Oklahoma Hospitals, or 66% of them, had Operating Losses in 2012.  And 55 of the 64 Oklahoma Hospitals with Operating Losses had fewer than 100 beds.  Oklahoma has a very embarrassing situation here with its so many struggling Hospitals, coupled with its massive Hospital Operating Profit Inequality.  But frankly, the solution is very simple.....full expansion of Medicaid in Oklahoma. 

With so many of these Oklahoma Hospitals generating Operating Losses or modest Operating Income, a key beneficiary of this will be Oklahoma citizens buying health insurance on the Federal insurance exchange.  These Oklahoma Hospitals, for the most part, will not be baking in excessive Hospital profits demands in their negotiations with health insurance companies on pricing for hospital procedures which ultimately determines what insurance premiums are set by health insurance companies on the Federal insurance exchange. 

So far, Oklahoma has decided to not expand Medicaid.  If Oklahoma changed its mind and decided to fully Expand Medicaid, then the consequences of this action would be to significantly drive down insurance premium prices even more for Oklahoma citizens in the Federal health insurance exchange.  This Oklahoma Medicaid Expansion would increase Oklahoma Hospital profits substantially and thus permit Oklahoma Hospitals to be even more reasonable in their negotiations with health insurance companies on pricing for hospital procedures which ultimately drives what health insurance premiums are set at by health insurers for Oklahoma citizens on the Federal Health Insurance Exchange.

So just how much would Oklahoma Hospital Profits increase due to the ACA and the Expansion of Medicaid?

Well, the Total Uncompensated Care in 2012 for the 83 of these 97 Oklahoma Hospitals which disclosed them was $466 mil, which is 2.5 times the Total Operating Income of $188 mil.

Granted not all of this $466 mil of Total Uncompensated Care will be eliminated with ACA and Medicaid Expansion, but a substantial portion of it will.

Below here are the Operating Income or Loss, Total Net Patient Revenues and Operating Income (Loss) Margin Percentage in the most recent year for each of these 97 Oklahoma Hospital Organizations:


Operating Net


Income Patient
Oklahoma Hospital City (Loss) Revenues Margin


$000s $000s %





Beaver County Memorial Hospital Beaver           (3,362)              1,722 -195.2%
Stroud Regional Medical Center Stroud           (7,147)              6,972 -102.5%
Physicians Hospital at Anadarko Anadarko           (7,072)              7,626 -92.7%
Integris Edmond Edmond           (9,557)             12,558 -76.1%
Great Plains Regional Medical Center Elk City         (18,756)             25,677 -73.0%
Latimer County Hospital Wilburton           (3,017)              5,630 -53.6%
Sayre Memorial Hospital Sayer           (3,516)              7,464 -47.1%
Pauls Valley General Hospital Pauls Valley           (5,032)             12,629 -39.8%
Atoka Memorial Hospital Atoka           (3,034)              7,668 -39.6%
Cimarron Memorial Hospital Boise City           (1,099)              3,001 -36.6%
Kingfisher Regional Hospital Kingfisher           (4,557)             12,590 -36.2%
OSU Medical Center Tulsa         (32,022)           123,164 -26.0%
Okmulgee Memorial Hospital Okmulgee           (3,219)             13,855 -23.2%
Harmon Memorial Hospital Hollis              (977)              4,822 -20.3%
Roger Mills Memorial Hospital Cheyenne              (639)              3,391 -18.8%
Mercy Hospital Tishomingo Tishomingo              (777)              4,214 -18.4%
Share Medical Center Alva           (1,544)              9,458 -16.3%
Cordell Memorial Hospital Cordell              (543)              3,336 -16.3%
Integris Seminole Medical Center Seminole           (1,331)              8,297 -16.0%
Carnegie Tri-County Municipal Hospital Carnegie              (586)              3,701 -15.8%
Memorial Hospital Of Texas County Guymon           (3,338)             21,426 -15.6%
Coal County General Hospital Coalgate              (555)              3,864 -14.4%
Integris Marshall County Med. Cntr Madill           (1,007)              7,070 -14.2%
Jefferson County Hospital Waurika              (357)              2,639 -13.5%
St. John Sapulpa Sapulpa           (2,661)             20,796 -12.8%
Cleveland Area Hospital Cleveland           (1,244)              9,824 -12.7%
Fairview Regional Medical Center Fairview              (653)              5,177 -12.6%
Arbuckle Memorial Hospital Sulphur           (1,476)             11,819 -12.5%
St. John Broken Arrow Broken Arrow           (6,017)             49,450 -12.2%
Mercy Hospital El Reno El Reno           (1,353)             11,552 -11.7%
Perry Memorial Hospital Perry              (817)              7,240 -11.3%
Choctaw Memorial Hospital Hugo           (1,119)             10,126 -11.1%
Integris Blackwell Regional Hospital Blackwell           (1,341)             12,367 -10.8%
Harper County Community Hospital Buffalo              (347)              3,385 -10.3%
McCurtain Memorial Hospital Idabel           (1,887)             18,399 -10.3%
Mercy Hospital Watonga Watonga              (405)              4,192 -9.7%
St. John Medical Center Tulsa         (40,892)           436,306 -9.4%
Mercy Hospital Healdton Healdton              (387)              4,430 -8.7%
Memorial Hospital & Physician Group Frederick              (664)              7,681 -8.6%
Hillcrest Hospital Cushing Cushing           (2,417)             29,665 -8.1%
Craig General Hospital Vinita           (2,060)             25,458 -8.1%
Integris Clinton Regional Hospital Clinton           (1,416)             17,950 -7.9%
Haskell County Hospital Stigler              (450)              6,234 -7.2%
Mercy Hospital Logan County Guthrie              (869)             13,462 -6.5%
Fairfax Memorial Hospital Fairfax              (286)              4,658 -6.1%
Elkview General Hospital Hobart              (715)             13,379 -5.3%
Integris Baptist Regional Health Center Miami           (2,870)             54,634 -5.3%
Bristow Medical Center Bristow              (713)             14,562 -4.9%
Integris Mayes County Med. Cntr. Pryor              (782)             17,265 -4.5%
Woodward Regional Hospital Woodward           (1,513)             34,159 -4.4%
St. Anthony Hospital Oklahoma City         (17,501)           412,037 -4.2%
Drumright Regional Hospital Drumright              (357)              9,901 -3.6%
Eastern Oklahoma Medical Center Poteau              (756)             21,070 -3.6%
Integris Grove General Hospital Grove           (1,765)             50,671 -3.5%
Comanche County Memorial Hospital Lawton           (6,922)           198,821 -3.5%
Sequoyah Memorial Hospital Sallisaw              (414)             14,125 -2.9%
Mercy Hospital Ada Ada           (1,963)             67,130 -2.9%
Seiling Community Hospital Seiling              (125)              4,341 -2.9%
Integris Southwest Medical Center Oklahoma City           (6,104)           218,797 -2.8%
Holdenville General Hospital Holdenville              (247)              8,964 -2.8%
Weatherford Regional Hospital Weatherford              (462)             18,339 -2.5%
Duncan Regional Hospital Duncan           (1,520)             76,682 -2.0%
Quartz Mountain Medical Center Mangum                (90)              7,019 -1.3%
Norman Regional Hospital Norman              (244)           316,736 -0.1%
Mercy Health/Love County Marietta                  (8)             12,637 -0.1%
Adair County Memorial Hospital Stilwell                 89             18,037 0.5%
Pawhuska Hospital Pawhuska                 26              4,291 0.6%
Jackson County Memorial Hospital Altus               429             69,069 0.6%
EASTAR Health System Muskogee               874           103,248 0.8%
Purcell Municipal Hospital Purcell               129             14,116 0.9%
Lindsay Municipal Hospital Lindsay               122              9,527 1.3%
OU Medical Center Oklahoma City           14,086           741,801 1.9%
Tahlequah City Hospital Tahlequah             1,758             77,472 2.3%
Jane Phillips Nowata Health Center Nowata                 82              3,377 2.4%
Deaconess Hospital Oklahoma City             4,298           172,159 2.5%
McAlester Regional Health Center McAlester             2,643             77,938 3.4%
Southcrest Hospital Tulsa             7,391           127,431 5.8%
St. Mary's Regional Medical Center Enid             5,600             96,435 5.8%
Integris Baptist Medical Center Oklahoma City           42,720           619,968 6.9%
Hillcrest Medical Center Tulsa           30,909           438,209 7.1%
Southwestern Medical Center Lawton             5,008             68,460 7.3%
Ponca City Medical Center Ponca City             5,007             64,563 7.8%
Integris Canadian Valley Reg. Hsptl. Yukon             4,849             61,642 7.9%
Mercy Hospital Ardmore Ardmore           10,581           129,079 8.2%
Integris Bass Baptist Health Center Enid           11,056           117,528 9.4%
Mercy Hospital Oklahoma City           32,447           344,880 9.4%
Hillcrest Hospital Claremore Claremore             5,254             52,203 10.1%
Jane Phillips Memorial Medical Center Bartlesville           13,454           114,848 11.7%
Midwest Regional Medical Center Midwest City           24,060           169,452 14.2%
Okeene Municipal Hospital Okeene               840              5,750 14.6%
St. Francis Tulsa        124,194           821,234 15.1%
Prague Municipal Hospital Prague             1,001              6,582 15.2%
St. John Owasso Owasso             5,664             35,589 15.9%
St. Francis Hospital South Tulsa           11,979             67,829 17.7%
Wagoner Community Hospital Wagoner             4,278             19,679 21.7%
Community Hospital Oklahoma City           21,926             89,260 24.6%
Medical Center Of Southeastern Okla. Durant           21,771             86,125 25.3%





Total all 97 Hospitals
        187,651        7,421,994 2.5%




  










Monday, December 30, 2013

Nearly All Nebraska Hospitals Are Driving Down Health Insurance Premium Prices on Federal Insurance Exchange

From a review of audited financial statements in the Electronic Municipal Market Access (EMMA), I found 15 Nebraska Non-Profit Hospital Organizations reporting here.  Included in these 15 Nebraska Hospitals was Children's Hospital and Medical Center in Omaha.  After excluding it, that leaves 14 Hospitals.

These 14 Nebraska Non-Profit Hospital Organizations generated Total Operating Income of $114 mil in the most recent year reported, which was a very modest 3.0% of Total Operating Revenues of $3.757 bil.

These modest Operating Income Margins were across the board, with the highest margin being 7.1%.

With all of these Nebraska Non-Profit Hospitals generating Operating Income Margins of 7.1% and below, a key beneficiary of this will be Nebraska citizens buying health insurance on the Federal insurance exchange.  These Nebraska Hospitals, for the most part, will not be baking in excessive Hospital profits demands in their negotiations with health insurance companies on pricing for hospital procedures which ultimately determines what insurance premiums are set by health insurance companies on the Federal insurance exchange. 

So far, Nebraska has decided to not expand Medicaid.  If Nebraska changed its mind and decided to fully Expand Medicaid, then the consequences of this action would be to significantly drive down insurance premium prices even more for Nebraska citizens in the Federal health insurance exchange.  This Nebraska Medicaid Expansion would increase Nebraska Hospital profits very significantly and thus permit Nebraska Hospitals to be even more reasonable in their negotiations with health insurance companies on pricing for hospital procedures which ultimately drives what health insurance premiums are set at by health insurers for Nebraska citizens on the Federal Health Insurance Exchange.

So just how much would Nebraska Hospital Profits increase due to the ACA and the Expansion of Medicaid?

Well, these 14 Nebraska Non-Profit Hospital Organization's audited financial statements show it will be huge.

For these 14 Nebraska Hospital Organizations, Total Operating Income was $114 mil in the most recent fiscal year.  Driving down these Operating Profits were Provisions for Bad Debts of $185 mil.  Thus Total Operating Income Before Provisions for Bad Debts was $299 mil, which was 2.6 times the reported Total Operating Income of $114 mil.  But there's even more to this story.  Total Uncompensated Charity Care Charges Foregone were also very large in the most recent year. 

Granted not all of these two huge Earnings Charges will be eliminated with ACA and Medicaid Expansion, but a substantial portion of them will.

Below here are the Audited Operating Income or Loss, Total Operating Revenues and Operating Income (Loss) Margin Percentage in the most recent year for each of these 14 Nebraska Non-Profit Hospital Organizations: 



Operating

 Operating  Total Income

City  Income  Operating (Loss)

HQs  (Loss)  Revenues  Margin 


mils $s mils $s  % 
Nebraska Non-Profit Hospital Organizations








Osmond General Hospital Osmond -0.2             6 -3.3%
Beatrice Community Hospital and Health Ctr Beatrice -0.4           47 -0.9%
Pender Community Hospital District Pender 0.1           15 0.7%
Antelope Memorial Hospital Neligh 0.1           13 0.8%
Faith Regional Health Services Norfolk 1.2         149 0.8%
Regional West Health Services Scottsbluff 2.1         244 0.9%
Nebraska Methodist Health Omaha 10.3         655 1.6%
Nebraska Medical Center Omaha 14.8         803 1.8%
Fillmore County Hospital Geneva 0.4           12 3.3%
Alegent Health Omaha 34.9      1,012 3.4%
York General Health Care Services York 1.3           37 3.5%
Mary Lanning Memorial Hospital Hastings 4.5         113 4.0%
North Platte Hospital North Platte 9.6         145 6.6%
Bryan Health Lincoln 35.7         506 7.1%





Total all 14
114.4      3,757 3.0%



 

Most Kansas Hospitals Are Driving Down Health Insurance Premium Prices on Federal Insurance Exchange

From a review of audited financial statements in the Electronic Municipal Market Access (EMMA), I found 23 Kansas Non-Profit Hospital Organizations, including Governmental Hospitals, with Total Operating Revenues above $10 mil in the most recent year reported.

These 23 Kansas Non-Profit Hospital Organizations generated Total Operating Income of $164 mil in the most recent year reported, which was a modest 4.0% of Total Operating Revenues of $3.323 bil.

These modest Operating Income Margins were across the board, with the highest margin being 8.2%.

With all of these Kansas Non-Profit Hospitals generating Operating Income Margins of 8.2% and below, a key beneficiary of this will be Kansas citizens buying health insurance on the Federal insurance exchange.  These Kansas Hospitals, for the most part, will not be baking in excessive Hospital profits demands in their negotiations with health insurance companies on pricing for hospital procedures which ultimately determines what insurance premiums are set by health insurance companies on the Federal insurance exchange. 

So far, Kansas has decided to not expand Medicaid.  If Kansas changed its mind and decided to fully Expand Medicaid, then the consequences of this action would be to significantly drive down insurance premium prices even more for Kansas citizens in the Federal health insurance exchange.  This Kansas Medicaid Expansion would increase Kansas Hospital profits very significantly and thus permit Kansas Hospitals to be even more reasonable in their negotiations with health insurance companies on pricing for hospital procedures which ultimately drives what health insurance premiums are set at by health insurers for Kansas citizens on the Federal Health Insurance Exchange.

So just how much would Kansas Hospital Profits increase due to the ACA and the Expansion of Medicaid?

Well, these 23 Kansas Non-Profit Hospital Organization's audited financial statements show it will be huge.

For these 23 Kansas Hospital Organizations, Total Operating Income was $164 mil in the most recent fiscal year.  Driving down these Operating Profits were Provisions for Bad Debts of $217 mil.  Thus Total Operating Income Before Provisions for Bad Debts was $381 mil, which was 2.3 times the reported Total Operating Income of $164 mil.  But there's even more to this story.  Total Uncompensated Charity Care Charges Foregone were also very large in the most recent year. 

Granted not all of these two huge Earnings Charges will be eliminated with ACA and Medicaid Expansion, but a substantial portion of them will.

Below here are the Audited Operating Income or Loss, Total Operating Revenues and Operating Income (Loss) Margin Percentage in the most recent year for each of these 23 Kansas Non-Profit Hospital Organizations: 




 Operating 

 Operating  Total  Income 

City  Income  Operating  (Loss) 

HQs  (Loss)  Revenues Margin


mils $s mils $s %
Kansas Non-Profit Hospitals








Meade Hospital District Meade         (1.8)           12 -15.0%
Rooks County Health Center Plainville         (0.4)           11 -3.6%
Wilson County Hospital Neodesha         (0.4)           11 -3.6%
Hiawatha Hospital Assoc Hiawatha         (0.6)           22 -2.7%
Labette County Med Center Parsons         (0.1)           56 -0.2%
Fredonia Regional Hospital Fredonia           -             12 0.0%
South Central Kansas Med Ctr Arkansas City          0.2           17 1.2%
Dickinson County Hospital Abilene          0.3           24 1.3%
Atchison Hospital Assoc Atchison          0.4           32 1.3%
Anderson County Hospital Garnett          0.3           17 1.8%
Southwest Medical Center Liberal          1.0           41 2.4%
Holton Community Hospital Holton          0.3           11 2.7%
Crawford County Hospital Girard          0.5           18 2.8%
Via Christi Health Wichita        32.0      1,136 2.8%
Hays Medical Center Hays          6.0         200 3.0%
Univ Kansas Hosp Authority Kansas City        46.3      1,163 4.0%
Olathe Medical Center Olathe        11.0         272 4.0%
Nemaha Valley Community Hosp Seneca          0.6           11 5.5%
Stormant-Vail Health Care Topeka        32.9         533 6.2%
Lawrence Memorial Hospital Lawrence        11.6         175 6.6%
Mercy Regional Health Ctr Manhattan          6.8         101 6.7%
Neosho Meml Reg Med Ctr Chanute          3.1           42 7.4%
Salina Regional Health Care Salina        13.5         164 8.2%





Total all 23
     163.5      4,081 4.0%