Iowa Non-Profit Hospitals Net Assets Up 67% Under Obama and the Affordable Care Act

From a review of the Electronic Municipal Market Access (EMMA), I found 3 Non-Profit Hospital Organizations headquartered in the State of Iowa with Net Assets (i.e. Financial Strength or Total Assets minus Total Liabilities) at the most recent date of more than $400 mil each.  Below here are the Net Assets of these 3 at both the most recent reported date and also at the Fiscal Year End (FYE) closest to the beginning of the Obama Administration:

						FYE	Balance	Net
				Most		Balance	Sheet	Assets
			Most	Recent		Sheet	Net	%
			Recent	Balance		Date	Assets	Change
			Balance	Sheet		Beginning	Beginning	During
	City	State	Sheet	Net		Obama	Obama	Obama
Hospital Organization	HQs	HQs	Date	Assets		Admin	Admin	Admin
				mil $s			mil $s
UnityPoint Health	Des Moines	IA	Dec 13	2,322		Dec 08	1,067	118%
University Iowa Hospitals & Clinics	Iowa City	IA	Jun 13	1,172		Jun 09	969	21%
Genesis Health System	Davenport	IA	Dec 13	549		Jun 09	387	42%
Total all 3				4,043			2,423	67%

As you can see from the above chart, the Total Net Assets (Financial Strength) of these 3 Iowa Non-Profit Hospital Organizations increased by a very impressive 67% to $4.043 bil for their average 4.50 years during the Obama Administration.

Very positively impacting this very robust increase in the Net Assets (Financial Strength) of these 3 Iowa Hospital Organizations 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 very impressive increase in Net Assets (Financial Strength) of these 3 Iowa Non-Profit Hospital Organizations.

A remarkable thing is that these very robust increases in Net Assets (Financial Strength) of these Non-Profit Hospital Organizations occurred when these Non-Profit Hospitals were also playing very instrumental roles in the substantial annual percentage growth reduction of Total US Health Care Costs which occurred in each of the most recent three years under the ACA.

With such impressive Net Asset percentage increases of these 3 Iowa Hospitals, a key beneficiary of this will be Iowa citizens electing to buy health insurance on the Health Insurance Exchange.  This strong Net Asset growth gives these Iowa Hospitals the financial flexibility to moderate their pricing for hospital procedures in their negotiations with health insurance companies which ultimately determines what insurance premium prices are set at by health insurance companies on the Health Insurance Exchange.
 
Iowa's Many Struggling Smaller Hospitals

Iowa's Hospital Facts at the Iowa Hospital Association's website contains key operating data related to Iowa's individual Hospitals.  There were 118 Iowa Hospitals presented there.

The positive side here is that the 22 Iowa Urban Hospitals generated an operating Income Margin of a very respectable 4.1% of Total Operating Revenues in 2012.  The Iowa rural Hospitals also did just fine.

But the big negative side here is that the 82 Iowa smaller Critical Access Hospitals generated an operating Income Margin of a very modest 1.1% of Total Operating Revenues in 2012.

Altogether, there were 41 or 35% of these 118 Iowa Hospitals which had Operating Losses in 2012, with 37 of them in the smaller Critical Access Hospital category.  Yeah, an amazingly high 37 or 45% of the 82 Iowa Critical Access Hospitals had Operating Losses.

In addition, there were another 21 or 18% of these 118 Iowa Hospitals which had very modest Operating Income of 0.0% to 2.5% of their Total Operating Revenues in 2012.  Again, Iowa's smaller Critical Access Hospitals comprised the bulk of these with 16.

In the chart below are these 118 Iowa Hospitals.

				2012
		2012	2012	Operating
		Operating	Total	Income
		Income	Operating	(Loss)
Iowa City	Iowa Community Hospitals	(Loss)	Revenues	Margin
		$000s	$000s	%
Urban Hospitals
Des Moines	Broadlawns Medical Center	(47,430)	72,174	-65.7%
Sioux City	Mercy Medical Center-Sioux City	448	194,503	0.2%
Dubuque	Mercy Medical Center-Dubuque	4,307	142,233	3.0%
Cedar Rapids	UnityPoint Health-St Luke's Hospital	10,119	324,526	3.1%
Sioux City	UnityPoint Health-St Luke's Hospital	4,472	128,363	3.5%
Council Bluffs	Methodist Jennie Edmundson Hospital	3,255	89,364	3.6%
Iowa City	University Iowa Hospitals and Clinics	42,645	1,098,292	3.9%
Waterloo	Covenant Medical Center	10,642	254,753	4.2%
Dubuque	UnityPoint Health-Finley Hospital	4,110	96,370	4.3%
Waterloo	UnityPoint Health-Allen Hospital	9,427	209,552	4.5%
Des Moines	Mercy Medical Center-Des Moines	27,809	589,348	4.7%
Cedar Rapids	Mercy Medical Center-Cedar Rapids	13,158	264,282	5.0%
West Des Moines	UnityPoint Health-Methodist West Hospital	4,034	75,131	5.4%
Davenport	Genesis Medical Center-Davenport	17,895	332,137	5.4%
Des Moines	UnityPoint Health-Iowa Methodist Med Ctr	27,284	460,944	5.9%
Des Moines	UnityPoint Health-Iowa Lutheran Hosp	7,378	118,446	6.2%
Iowa City	Mercy Iowa City	9,807	152,176	6.4%
Council Bluffs	Alegent Creighton Health Mercy Hosp	10,296	125,357	8.2%
Ames	Mary Greeley Medical Center	16,042	171,416	9.4%
Bettendorf	UnityPoint Health-Quad Cities	7,594	69,481	10.9%
Cedar Falls	Sartori Memorial Hospital	5,893	35,102	16.8%
West Des Moines	Mercy Medical Center-West Lakes	17,895	66,823	26.8%
Total 22 Urban Hospitals		207,080	5,070,773	4.1%
Critical Access Hospitals
Leon		(1,669)	7,628	-21.9%
Jefferson		(3,200)	19,414	-16.5%
Mount Ayr		(2,282)	14,128	-16.2%
Dyersville		(584)	4,317	-13.5%
Chariton		(2,012)	15,689	-12.8%
Corydon		(2,317)	19,071	-12.1%
Greenfield		(1,096)	9,262	-11.8%
Guthrie Center		(1,286)	12,674	-10.1%
Keosauqua		(1,137)	11,389	-10.0%
Clarinda		(1,655)	21,817	-7.6%
Nevada		(1,287)	17,966	-7.2%
Winterset		(1,128)	16,558	-6.8%
Denison		(1,329)	23,809	-5.6%
Perry		(654)	13,165	-5.0%
Marengo		(738)	15,223	-4.8%
Red Oak		(1,028)	26,890	-3.8%
Sigourney		(296)	8,490	-3.5%
West Union		(671)	21,179	-3.2%
Oskaloosa		(1,137)	36,524	-3.1%
Belmond		(338)	13,285	-2.5%
Cresco		(336)	14,154	-2.4%
Bloomfield		(434)	20,564	-2.1%
Maquoketa		(244)	12,673	-1.9%
Sumner		(179)	9,598	-1.9%
Hunboldt		(212)	12,789	-1.7%
Sac City		(190)	11,953	-1.6%
Atlantic		(445)	33,282	-1.3%
Pocahontas		(128)	9,681	-1.3%
Osceola		(207)	17,418	-1.2%
Hampton		(186)	15,969	-1.2%
Boone		(340)	42,969	-0.8%
Oelwein		(94)	12,478	-0.8%
Webster City		(171)	23,662	-0.7%
Harlan		(209)	31,004	-0.7%
Manchester		(198)	35,689	-0.6%
Le Mars		(118)	31,302	-0.4%
Albia		(54)	15,819	-0.3%
Hamburg		8	9,913	0.1%
Sibley		9	10,349	0.1%
Clarion		68	45,993	0.1%
Mount Pleasant		68	30,330	0.2%
Grundy Center		58	18,236	0.3%
Shenandoah		166	26,108	0.6%
Cherokee		217	19,598	1.1%
Audubon		119	10,182	1.2%
Creston		457	39,065	1.2%
Britt		187	14,508	1.3%
Missouri Valley		291	22,182	1.3%
Algona		446	29,902	1.5%
Emmetsburg		371	22,334	1.7%
Iowa Falls		372	19,962	1.9%
Elkader		116	6,052	1.9%
Lake City		647	30,631	2.1%
Ida Grove		435	16,984	2.6%
Vinton		637	21,696	2.9%
Osage		536	18,048	3.0%
Decorah		1,408	45,024	3.1%
Orange City		1,422	39,286	3.6%
Charles City		844	23,052	3.7%
Estherville		855	23,190	3.7%
Onawa		951	24,397	3.9%
Sheldon		1,159	26,760	4.3%
Waverly		2,260	51,021	4.4%
Waukon		682	15,145	4.5%
Storm Lake		1,894	41,859	4.5%
Sioux Center		1,369	29,231	4.7%
Fairfield		1,249	25,691	4.9%
Primghar		371	7,534	4.9%
Rock Rapids		470	8,284	5.7%
Centerville		1,392	24,090	5.8%
Washington		1,482	24,666	6.0%
New Hampton		1,191	15,801	7.5%
Independence		1,446	18,930	7.6%
De Witt		1,378	17,408	7.9%
Rock Valley		1,352	16,812	8.0%
Knoxville		2,437	27,081	9.0%
Guttenberg		1,022	11,003	9.3%
Corning		1,679	17,150	9.8%
Manning		1,663	13,908	12.0%
Pella		9,137	58,800	15.5%
Hawarden		1,330	7,979	16.7%
Anamosa		3,485	20,508	17.0%
Total 82 Critical Acess Hospitals		19,547	1,726,165	1.1%
Rural Hospitals
Keokuk		(891)	24,854	-3.6%
Grinnell		776	43,003	1.8%
Newton		779	38,202	2.0%
Spirit Lake		804	29,529	2.7%
Fort Madison		2,445	51,862	4.7%
Carroll		3,494	63,491	5.5%
Spencer		6,298	67,720	9.3%
Muscatine		11,162	47,404	23.5%
Total 8 Rural Hospitals		24,867	366,065	6.8%
Rural Referral Hospitals
Mason City		(6,704)	309,829	-2.2%
Marshalltown		(954)	59,735	-1.6%
Ottumwa		787	81,138	1.0%
Fort Dodge		1,296	96,131	1.3%
Clinton		8,906	93,969	9.5%
West Burlington		25,602	171,948	14.9%
Total 6 Rural Referral Hospitals		28,933	812,750	3.6%
Grand Total 118 Hospitals		280,427	7,975,753	3.5%

When 35% of Iowa's Hospitals have Operating Losses and 53% have Operating Income of 2.5% or less, then the State of Iowa has a huge financial quality problem with its Hospitals, particularly so with its 82 smaller Critical Access Hospitals, which are in desperate need of financial help.  A clear majority of Iowa citizens must be very disappointed that nothing has happened yet.

By far the best and only way to substantially strengthen the financial status of so many Iowa smaller struggling Hospitals is for the State of Iowa to fully expand Medicaid and to do so as soon as possible.  If Iowa did this, with the resultant massive inflow of Patient Revenues from Medicaid expansion, the so many Iowa smaller struggling Hospitals would be able to substantially reduce their huge Losses and perhaps even turn nearly all of them into profits.  And the Iowa smaller Hospitals with very modest Operating Income would have their profits bolstered very robustly.

If Iowa were to fully expanded Medicaid, one of the key beneficiaries of the resultant very healthy profit improvement and thus also Total Net Assets improvement of all Iowa Hospitals would be Iowa citizens electing to buy health insurance on the Health Insurance Exchange.  This exceptional Net Asset growth from Medicaid expansion would give all Iowa Hospitals the financial flexibility to moderate their pricing for hospital and other health care procedures in their negotiations with health insurance companies which ultimately determines what insurance premium prices are set at by health insurance companies on the Health Insurance Exchange.