Tuesday, March 18, 2014

Oklahoma Non-Profit Hospitals Net Assets Up 51% 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 Oklahoma 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 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









Saint Francis Health System Tulsa OK Mar 14     1,766
Jun 09          946 87%
Integris Health Oklahoma City OK Mar 14     1,138
Jun 09          774 47%
Univ Oklahoma Health Sciences Ctr Oklahoma City OK Jun 13        931
Jun 09          717 30%
St John Health System Tulsa OK Dec 13        763
Jun 09          614 24%









Total all 4


    4,598

      3,051 51%

As you can see from the above chart, the Total Net Assets (Financial Strength) of these 4 Oklahoma Non-Profit Hospital Organizations increased by a robust 51% to $4.598 bil during their average 4.50 years of the Obama Administration.

Very positively impacting this very solid increase in the Net Assets (Financial Strength) of these 4 Oklahoma 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 increase in Net Assets (Financial Strength) of these 4 Oklahoma Non-Profit Hospital Organizations.

A remarkable thing is that these 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 Oklahoma Hospitals, a key beneficiary of this will be Oklahoma citizens electing to buy health insurance on the Health Insurance Exchange.  This excellent Net Asset growth gives these Oklahoma 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.  

So Many Struggling Smaller Oklahoma Hospitals

There is an 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.

Of these 97 Oklahoma Hospitals, 65 of them generated Operating Losses in 2012.....as you can see in the below chart:



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%





Total all 65
       (226,875)        2,594,212 -8.7%

When you have 67% of your State's Hospitals generating Operating Losses, the responsible thing to do is to deal with them and not ignore them.  So far, the State of Oklahoma has decided to ignore them.  It sounds a little bit like Katrina.

The best and only way to substantially strengthen these struggling smaller Oklahoma Hospitals is for the State of Oklahoma to fully expand Medicaid.

A key side benefit here to Oklahoma citizens is that the resultant profit enhancements and thus Net Asset enhancements of all Oklahoma Hospitals due to Medicaid expansion will give them 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.