Wednesday, March 19, 2014

New Hampshire Non-Profit Hospitals Net Assets Up 62% Under Obama and the Affordable Care Act

From a review of the Electronic Municipal Market Access (EMMA), I found 4 Non-Profit Hospital Organizations headquartered in the State of New Hampshire with Net Assets (i.e. Financial Strength or Total Assets minus Total Liabilities) at the most recent date of more than $150 mil each.  Below here are the Net Assets of these 4 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









Dartmouth-Hitchcock Lebanon NH  Dec 13         453
Sep 09          262 73%
Concord Hospital Concord NH  Dec 13         304
Sep 09          197 54%
Wentworth-Douglas Health System Dover NH  Dec 13         242
Dec 09          171 42%
Elliot Health System Manchester NH  Dec 13         166
Jun 09            90 84%









Total all 4


    1,165

         720 62%

As you can see from the above chart, the Total Net Assets (Financial Strength) of these 4 New Hampshire Non-Profit Hospital Organizations increased by a very robust 62% to $1.165 bil during their short average 4.13 years during the Obama Administration.

To illustrate the very recent explosive Total Net Asset growth, in just the past 6 months, this Total Net Asset increase grew massively from 32% to 62%.

Very positively impacting this impressive increase in the Net Assets (Financial Strength) of these 4 New Hampshire 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 very robust increase in Net Assets (Financial Strength) of these 4 New Hampshire 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 very solid Net Asset percentage increases of these 4 New Hampshire Hospitals, a key beneficiary of this will be New Hampshire citizens electing to buy health insurance on the Health Insurance Exchange.  This exceptional Net Asset growth gives these New Hampshire 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.   

New Hampshire Struggling Hospitals

From EMMA, I found 11 New Hampshire Hospital Organizations.  The Total Operating Income of these 11 was only 2.5% of their Total Operating Revenues in the most recent year.  And 6 of the 11 have Operating Income Margins of 2.0% or less, as you can see in the below chart:


Most Most Most


Recent Recent Recent Operating


Annual Year Year Income

Fiscal Operating Total (Loss)

City Year Income Operating Margin

HQs End (Loss) Revenues %



mils $s mils $s
New Hampshire Non-Profit Hospital Organizations










Exeter Health Resources Exeter Sep 2013          (17.2)      254.3 -6.8%
Huggins Hospital Wolfeboro Sep 2013            (0.7)        52.6 -1.3%
Elliot Health Manchester Jun 2013             3.2      441.8 0.7%
Cheshire Medical Center Keene Jun 2013             1.9      143.2 1.3%
Memorial Hospital at North Conway North Conway Jun 2013             1.1        62.9 1.7%
LRGHealthCare Laconia Sep 2013             4.5      220.6 2.0%
Dartmouth Hitchcock Oblig Group Lebanon Jun 2013           38.7    1,322.1 2.9%
Concord Hospital Concord Sep 2013           14.8      426.8 3.5%
Wentworth Douglass Health Dover Dec 2013             9.8      278.0 3.5%
Southern New Hampshire Health Pelham Sep 2013           13.2      285.8 4.6%
Catholic Medical Center Manchester Jun 2013           26.5      292.4 9.1%





Total all 11

          95.8    3,780.5 2.5%


So clearly, the majority of the New Hampshire Hospitals are struggling financially.

By far the best and only way to put a major dent in the operating losses and very modest profits of the struggling New Hampshire Hospitals is for the State of New Hampshire to fully expand Medicaid, which it wisely has.  There will be a resultant massive inflow of Patient Revenues from Medicaid expansion, and thus these struggling New Hampshire Hospitals will be able to substantially increase their Hospital profitability.

In addition, one of the key beneficiaries of the resultant very healthy profit improvement and thus also Total Net Assets improvement of all New Hampshire Hospitals due to Medicaid expansion in New Hampshire will be New Hampshire citizens electing to buy health insurance on the Health Insurance Exchange.  This exceptional Net Asset growth from Medicaid expansion will give all New Hampshire 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.