Friday, December 27, 2013

Many Missouri Hospitals Are Moderating Health Insurance Premium Prices on Insurance Exchange

More than anything, Hospital Patient Charges drive US Health Care Costs.  When you view a typical US Hospital bill for patient services, it is easy to understand why US Health Care Costs are so much higher than that in any other major country.

One reason US Hospital bills are so high is that many of the larger Hospitals Systems set their pricing for hospital procedures so that they make a lot of money.

Thus, US Hospitals are playing a key role in ultimately determining whether health insurance premiums are fairly priced on the health insurance exchanges.

Some Missouri Hospital Organizations are being very greedy in generating very high operating profits.  But a clear majority of them are not.

The State of Missouri is being very transparent with its citizens by having available for review annually at its State Dept of Health website very detailed financial information on each of its 117 Short-term Acute Care Hospitals which disclosed their numbers.  I excluded Mercy Hospital Joplin below because it had a huge operating loss, coupled with a massive insurance recovery gain, both due to the horrific tornado it had there in 2012. 

These 117 Missouri Hospitals generated Total Operating Income of $779 mil in the most recent year reported, which was a modest 4.5% of their Total Operating Revenues of $17.180 bil.

On the negative side, 18 of these 117 Missouri Hospitals, all with Operating Income Margins as a Percentage of Total Operating Revenues of above 10.0%, generated Total Operating Income of $337 mil, which was a very steep 12.8% of their Total Operating Revenues.

But on the very positive side from a health insurance premium pricing perspective, there were 69 Missouri Hospitals with Operating Income Margins of below 5.0% each  and 93 of them with Operating Income Margins of below 8.0% each.

Of these 117 Missouri Hospitals, 39 of them posted Operating Losses in the most recent year.

With so many of these Missouri Hospitals generating Operating Income Margins below 5.0% and even some others just above 5.0%, a key beneficiary of this will be Missouri citizens buying health insurance on the Federal insurance exchange.  These Missouri 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. 

Presently, Missouri has chosen not to Expand Medicaid.  If Missouri were to change course and Fully Expand Medicaid, then the consequences of this action would be to further moderate insurance premium prices for Missouri residents in the Federal health insurance exchange.  This Missouri Medicaid Expansion would increase Missouri Hospital profits substantially and thus permit Misspouri 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 Missouri residents on the Federal Health Insurance Exchange.

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

Well, from the information contained at the State of Missouri Health Dept website, the 117 Missouri Hospitals generated Total Operating Income of $779 mil in the most recent year, which included an Earnings Charge of a huge $1.238 bil due to Provisions for Bad Debts.  Thus their Total Operating Income Before these Bad Debt Charges were $2.017 bil......yeah that's 2.6 times the Total Operating Income reported of $779 mil.  But that's not all.  In addition, the Total Uncompensated Charity Care Charges Foregone of these 117 Missouri Hospitals were another huge $1.539 bil 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 Audited Operating Income or Loss, Total Operating Revenues and Operating Income (Loss) Margin Percentage in the most recent year for each of these 117 Missouri Hospitals:




Operating


Operating Total Income

Missouri Income Operating (Loss)
Hospital Name City (Loss) Revenues Margin


000s 000s %





Shriners Hospitals for Children St Louis         (20,579)             7,337 -280.5%
Ripley County Meml Hosp Doniphon           (1,739)             6,254 -27.8%
Callaway Community Hospital Fulton           (2,294)             9,477 -24.2%
Cooper County Meml Hospital Boonville           (1,717)             9,459 -18.2%
I-70 Community Hospital Sweet Springs              (831)             6,111 -13.6%
Community Hospital-Fairfax Fairfax           (1,243)             9,617 -12.9%
Royal Oaks Hospital Windsor           (1,049)             9,933 -10.6%
Pemiscot County Meml Hosp Hayti           (3,449)           37,674 -9.2%
Truman Med Ctr Lakewood Kansas City           (9,398)         110,631 -8.5%
St. Francis Hospital Maryville           (4,261)           54,427 -7.8%
Bates County Meml Hospital Butler           (1,701)           27,314 -6.2%
CenterPointe Hospital St Charles           (1,810)           29,421 -6.2%
St Louis University Hospital St Louis         (20,812)         343,507 -6.1%
Sac-Osage Hosp Osceola              (400)             6,640 -6.0%
Mercy Hospital Washington Washington           (4,961)           87,550 -5.7%
Putnam Ciunty Meml Hosp Unionville              (324)             6,359 -5.1%
Northwest Med Ctr Albany              (633)           12,902 -4.9%
Pike County Meml Hosp Louisiana              (527)           11,495 -4.6%
Washington Meml Hosp Potosi              (963)           21,481 -4.5%
Texas County Meml Hosp Houston              (928)           21,702 -4.3%
Missouri Delta Med Ctr Sikeston           (3,069)           72,475 -4.2%
Pershing Memorial Hospital Brookfield              (614)           14,916 -4.1%
Barton County Meml Hospital Lamar              (792)           19,378 -4.1%
St. Mary's Health Ctr Jefferson City           (4,940)         125,631 -3.9%
Scotland County Hosp Memphis              (488)           16,143 -3.0%
Ozarks Community Hospital Springfield           (1,242)           42,994 -2.9%
Salem Meml District Hospital Salem              (404)           14,990 -2.7%
Hermann Area District Hospital Hermann              (402)           15,111 -2.7%
Christian Hospital St Louis           (6,806)         269,706 -2.5%
Samaritan  Macon              (488)           19,893 -2.5%
Wright Memorial Hospital Trenton              (589)           24,474 -2.4%
Saint Luke's Hospital of KC Kansas City           (9,393)         498,933 -1.9%
Iron County Hospital Pilot Knob              (115)             7,438 -1.5%
Liberty Hospital Liberty           (2,548)         175,185 -1.5%
St Anthony's Med Ctr St Louis           (5,571)         411,588 -1.4%
Sullivan County Meml Hosp Milan                (63)             6,304 -1.0%
Audrain Medical Center Mexico              (418)           53,010 -0.8%
Harrison County Community Hosp Bethany                (33)           13,954 -0.2%
Children's Mercy Hospital Kansas City           (1,000)         709,589 -0.1%
Crittenton Children's Center Kansas City                   5           23,984 0.0%
Progress West HealthCare Ctr O Fallon               241           55,849 0.4%
Freeman Health System Joplin             3,035         369,928 0.8%
Lincoln County Med Ctr Troy               312           32,363 1.0%
Bothwell Reg Med Cre Sedalia               923           85,983 1.1%
Truman Med Ctr Hospital Hill Kansas City             4,262         321,551 1.3%
Mineral Area Reg Med Ctr Farmington               542           40,541 1.3%
SSM St Clare Health Ctr Fenton             2,394         163,260 1.5%
Carroll County Meml Hospital Carrollton               174           11,794 1.5%
Missouri Baptist Hosp Sullivan Sullivan               670           40,671 1.6%
Lake Regional Health Osage Beach             2,719         154,794 1.8%
SSM St Joseph Health Ctr St Charles             3,313         184,998 1.8%
Western Missouri Med Ctr Warrensburg             1,329           67,561 2.0%
Ste. Genevieve County Mem Hosp Sainte Genevieve               628           31,389 2.0%
Citizens Meml Hospital Bolivar             1,936           92,129 2.1%
Madison Med Ctr Fredericktown               326           14,825 2.2%
Research  Medical Center Kansas City             6,812         281,198 2.4%
University Hospital and Clinics Columbia           13,854         570,099 2.4%
St. Mary's Med Center Blue Springs Blue Springs             1,651           65,705 2.5%
St Luke's Hospital Chesterfield           11,037         432,032 2.6%
Ray County Meml Hosp Richmond               450           17,329 2.6%
Mercy Hospital Aurora Aurora               368           13,723 2.7%
Excelsior Springs Hospital Excelsior Springs               601           21,698 2.8%
Mercy McCune-Brooks Hospital Carthage               831           28,598 2.9%
CoxHealth Springfield           25,376         806,591 3.1%
Ellett Meml Hosp Appleton City               253             7,680 3.3%
Barnes-Jewish Hospital St Louis           62,999      1,642,386 3.8%
Fitzgibbon Hosp Marshall             1,435           36,734 3.9%
Landmark Hospital of Joplin Joplin               631           15,135 4.2%
Capital Region Med Ctr Jefferson City             7,836         159,318 4.9%
Parkland Health Ctr-Farmington Farmington             3,397           68,401 5.0%
Landmark Hosp Cape Girardeau Cape Girardeau               730           14,547 5.0%
Southeast Hospital Cape Girardeau           14,269         277,239 5.1%
Landmark Hospital of Columbia Columbia               901           17,420 5.2%
Nevada Reg Med Ctr Nevada             1,664           31,552 5.3%
Hannibal Reg Hospital Hannibal             5,539         103,261 5.4%
SSM St Mary's Heallth Ctr Richmond Heights           15,713         287,088 5.5%
Cedar County Meml Hospital El Dorado Springs               684           11,631 5.9%
Des Peres Hospital St Louis             7,314         122,596 6.0%
North Kansas City Hospital Kansas City           23,596         375,617 6.3%
Perry County Meml Hosp Perryville             1,794           28,369 6.3%
Cass Reg Med Ctr Harrisonville             3,198           50,383 6.3%
St. Joseph Med Ctr of KC Kansas City           10,325         160,839 6.4%
Golden Valley Meml Hospital Clinton             3,775           58,762 6.4%
Lafayette Reg Health Ctr Lexington             1,646           24,288 6.8%
Ozarks Medical Center West Plains             8,030         115,877 6.9%
Cox Monett Monett             1,842           26,345 7.0%
Cameron Reg Med Ctr Cameron             2,522           35,905 7.0%
St Louis Children's Hospital St Louis           34,639         486,285 7.1%
St Alexius Hosp-Broadway St Louis             4,259           58,234 7.3%
Mercy St. Francis Hospital Mountain View             1,047           14,171 7.4%
St. Luke's Northland Hosp-Barry Road Kansas City             7,825         104,647 7.5%
Heartland Regional Medical Ctr St Joseph           36,690         480,090 7.6%
SSM DePaul Health Ctr Bridgeton           24,877         312,964 7.9%
Saint Francis Med Ctr Cape Girardeau           27,362         332,479 8.2%
Boone Hospital Center Columbia           24,911         300,635 8.3%
Barnes-Jewish St Peters Hosp St Peters           10,367         121,671 8.5%
SSM St Joseph Hosp West Lake St Louis           10,730         124,361 8.6%
Mercy Hospital St Louis St Louis           71,248         792,462 9.0%
Missouri Baptist Med Ctr St Louis           42,790         474,315 9.0%
Mercy Hospital Springfield Springfield         115,896      1,140,432 10.2%
SSM Cardinal Glennon Children's Med Ctr St Louis           33,025         309,980 10.7%
St Luke's East Lee's Summit Hosp Lee's Summit           15,490         140,882 11.0%
Barnes-Jewish West County Hosp St Louis           11,765         106,590 11.0%
Phelps County Reg Med Ctr Rolla           15,409         138,853 11.1%
Hedrick Med Ctr Chillicothe             4,120           35,264 11.7%
Saint Luke's Cancer Institute Kansas City             2,249           19,185 11.7%
Centerpoint Med Ctr Independence Independence           26,078         197,858 13.2%
Southeast Health Ctr Stoddard Dexter             1,409           10,434 13.5%
Poplar Bluff Reg Med Ctr Poplar Bluff           20,004         137,482 14.6%
Freeman Neosho Hospital Neosho             2,938           18,336 16.0%
Mercy Hospital Cassville Cassville             2,272           13,129 17.3%
Lee's Summit Med Ctr Lee's Summit           13,510           72,744 18.6%
Belton Reg Med Ctr Belton             7,342           39,488 18.6%
Northeast Regional Med Ctr Kirksville           15,377           66,162 23.2%
Mercy Hospital Lebanon Lebanon           19,963           80,832 24.7%
Moberly Reg Med Ctr Moberly           16,839           62,956 26.7%
Twin Rivers Reg Med Ctr Kennett           13,414           46,072 29.1%



                 -  
Total all 117
        779,133     17,179,962 4.5%