Monday, March 17, 2014

Wisconsin Non-Profit Hospitals Net Assets Up 85% Under Obama and the Affordable Care Act

From a review of the Electronic Municipal Market Access (EMMA), I found 12 Non-Profit Hospital Organizations headquartered in the State of Wisconsin with Net Assets (i.e. Financial Strength or Total Assets minus Total Liabilities) at the most recent date reported of more than $400 mil each.  Below here are the Net Assets of these 12 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









Froedtert Health Milwaukee WI Dec 13     1,459
Jun 09          824 77%
Medical College Wisconsin Milwaukee WI Dec 13     1,339
Jun 09          808 66%
Ministry Health Care Milwaukee WI Dec 13     1,164
Sep 09          730 59%
Children's Hospital and Health System Milwaukee WI  Dec 13      1,118
Dec 08          460 143%
Aurora Health Care Milwaukee WI  Dec 13      1,399
Dec 08          546 156%
Wheaton Franciscan Health Glendale WI  Dec 13         974
Jun 09          704 38%
Univ Wisconsin Hospitals & Clinics Madison WI  Mar 14         947
Jun 09          514 84%
Marshfield Clinic Marshfield WI  Dec 13         848
Sep 09          554 53%
Gundersen Lutheran Health La Crosse WI  Dec 13         791
Dec 08          429 84%
ProHealth Care Waukesha WI  Dec 13         688
Sep 09          423 63%
ThedaCare Appleton WI  Mar 14         671
Dec 08          289 132%
Aspirus Obligated Group Wausau WI  Dec 13         592
Jun 09          211 181%









Total all 12


  11,990

      6,492 85%

As you can see from the above chart, the Total Net Assets (Financial Strength) of these 12 Wisconsin Non-Profit Hospital Organizations increased by an exceptional 85% to $11.990 bil during their average 4.58 years of the Obama Administration.  

The lowest Net Asset growth of the 12 was a very respectable 38%.

Very positively impacting this major increase in the Net Assets (Financial Strength) of these 12 Wisconsin 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 12 Wisconsin 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 substantial Net Asset percentage increases of these 12 Wisconsin Hospitals, a key beneficiary of this will be Wisconsin citizens electing to buy health insurance on the Federal Health Insurance Exchange.  This exceptional Net Asset growth gives these Wisconsin 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. 

Wisconsin Blow-out Individual Hospital Operating Profits

The State of Wisconsin is being very transparent with its citizens by having available for review annually at its State Health Dept website very detailed financial information on each of its 129 acute care Hospitals.

How have these 129 Hospitals done on the Operating Earnings front?

Fantastically, with Total Operating Income as a Percentage of Total Operating Revenues of 8.2% in the most recent year reported, which is the highest of any US State.

The chart below breaks down individual Wisconsin Hospitals by Operating Profit Margins.

At the top, there were an incredibly high 39 Wisconsin Hospitals generating Operating Income Margins of more than 10.0%.  These 39 posted a Total Operating Margin of 15.5%, which was more than 50% higher than the After-tax Operating Income of the 30 prestigious Dow Industrial companies combined.  The CEOs and CFOs of these 30 Dow Industrial companies must be shaking their heads at how the 129 Wisconsin Hospitals combined, predominantly Non-Profit ones, can generate such incredibly high Operating Income Profit Margins.  It gives a clue as to why the country's health care costs are so high as compared with all other major countries.  So many Non-Profit Hospitals generate these incredibly high profits year after year, and retain them, increasing their huge treasure chest of investments in debt and equity securities, which have advanced dramatically during the Obama Administration.

There were another 35 individual Wisconsin Hospitals generating a superb Operating Margin of 5.0% to 10.0%.

There were 33 individual Wisconsin Hospitals posting a more modest Operating Margin of 0.0% to 5.0%.

And there were 22 individual Wisconsin Hospitals registering Operating Losses in the most recent year.....including 4 in Milwaukee.

When you ponder the fact that 39 of these Wisconsin Hospitals are generating double-digit Operating Income Margins and that 74 of them, or 57% of them, are generating Operating Income Margins of 5.0% and above, what this clearly says is these Wisconsin Hospitals are ripping off Wisconsin patients by generating obscene profits, instead of responsibly lowering their Patient Charges.

Below here are these 129 Wisconsin Hospitals:



Total
Operating



Operating Total Income



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



000s 000s %
Pure Golden Badger Hospitals




Midwest Orthopedic Specialty Hospital Franklin
        33,323         71,276 46.8%
Orthopaedic Hospital of Wisconsin Glendale
        22,147         56,796 39.0%
Oakleaf Surgical Hospital Eau Claire
        12,201         39,242 31.1%
Aurora Medical Center in Kenosha Kenosha
        46,939       151,660 31.0%
Ministry Sacred Heart Hospital Tomahawk
          4,284         17,982 23.8%
Aurora Sheboygan Meml Medical Ctr Sheboygan
        31,493       136,087 23.1%
Aurora BayCare Med Center Green Bay Green Bay
        64,210       278,839 23.0%
St. Mary's Hospital of Superior Superior
          9,958         43,795 22.7%
River Falls Area Hospital River Falls
          9,650         45,511 21.2%
Aurora West Allis Medical Center West Allis
        50,583       242,849 20.8%
Gundersen Health System La Crosse
        79,139       390,674 20.3%
New London Family Medical Center New London
          5,984         30,283 19.8%
Waupun Memorial Hospital Waupun
          7,573         40,249 18.8%
Aurora Medical Center in Aurora Oshkosh
        16,064         98,742 16.3%
Aurora Medical Ctr Manitowoc County Two Rivers
          9,514         59,368 16.0%
Riverside Medical Center Waupaca
          5,621         35,123 16.0%
Memorial Medical Center Ashland
          8,584         57,667 14.9%
Aurora Lakeland Medical Center Elkhorn
        11,248         77,712 14.5%
Wheaton Franciscan-Elmbrook Campus Brookfield
        18,772       136,271 13.8%
Aurora Memorial Hospital of Burlington Burlington
        10,023         73,790 13.6%
Wheaton Franciscan-Franklin Franklin
          7,830         57,702 13.6%
St. Elizabeth Hospital Appleton
        22,947       173,404 13.2%
Mayo Clinic Health-Red Cedar Menomonee
        11,401         91,033 12.5%
Theda Clark Medical Center Neenah
        21,970       177,599 12.4%
Baldwin Area Medical Center Baldwin
          3,923         31,870 12.3%
Rusk County Meml Hosp&Nursing Home  Ladysmith
          2,311         19,122 12.1%
Spooner Health System Spooner
          2,058         17,529 11.7%
Waukesha Memorial Hospital Waukesha
        50,262       428,615 11.7%
Ministry Health's Howard Young Med Ctr Woodruff
          7,092         60,478 11.7%
Cumberland Memorial Hospital Cumberland
          2,212         18,932 11.7%
Mayo Clinic Health in Eau Claire Eau Claire
        30,484       262,077 11.6%
Sacred Heart Hospital Eau Claire
        24,256       211,589 11.5%
Langlade Hospital-An Aspirus Partner Antigo
          8,521         74,486 11.4%
Ministry Saint Joseph's Hospital Marshfield
        39,869       352,778 11.3%
Prairie du Chien Memorial Hospital Prairie du Chien
          3,732         33,898 11.0%
Mayo Clinic Health-Franciscan Health  La Crosse
        23,351       212,991 11.0%
Aurora Medical Center in Hartford Hartford
          5,704         53,184 10.7%
Aurora St Luke's Medical Center Milwaukee
      108,772     1,026,071 10.6%
Grant Regional Health Center Lancaster
          2,070         20,426 10.1%






Total all 39 Pure Golden Hospitals

      836,075     5,407,700 15.5%






Robust Profit Badger Hospitals




Tomah Memorial Hospital Tomah
          3,585         36,099 9.9%
Aurora Medical Center in Grafton Grafton
        13,977       143,280 9.8%
Memorial Health Center-Aspirus Partner Medford
          4,860         50,674 9.6%
Flambeau Hospital Park Falls
          1,880         19,918 9.4%
Community Memorial Menomonee Falls
        16,325       173,881 9.4%
Aspirus Wausau Hospital Wausau
        32,683       351,596 9.3%
United Hospital System Kenosha
        24,713       284,058 8.7%
St. Joseph's Hospital Chippewa Falls
          5,984         68,825 8.7%
UW Hospitals & Clinics Madison
      101,469     1,200,929 8.4%
Ministry Saint Michael's Hospital Stevens Point
        14,234       177,417 8.0%
Columbus Community Hospital Columbus
          2,336         29,334 8.0%
Vernon Memorial Healthcare Viroqua
          5,032         63,669 7.9%
Appleton Medical Center Appleton
        17,508       223,622 7.8%
Black River Memorial Hospital Black River Falls
          3,045         39,694 7.7%
Children's Hospital of Wisconsin Milwaukee
        40,556       536,754 7.6%
Froedtert Memorial Lutheran Hospital Milwaukee
        72,075       959,768 7.5%
Mayo Clinic Health-Oakridge in Osseo Osseo
          1,424         19,340 7.4%
Hayward Area Memorial Hospital Hayward
          2,257         32,937 6.9%
Hudson Hospital & Clinics Hudson
          3,515         51,791 6.8%
Osceola Medical Center Osceola
          2,044         30,382 6.7%
St. Mary's Hospital Medical Center Madison
        26,926       405,600 6.6%
Lakeview Medical Center Rice Lake
          4,289         64,719 6.6%
Upland Hills Health Dodgeville
          2,497         39,182 6.4%
Gundersen Tri-County Hospital Whitehall
             746         11,829 6.3%
Aurora Medical Center in Summit Summit
          6,062         97,193 6.2%
Ministry Door County Medical Center Sturgeon Bay
          4,252         69,392 6.1%
Divine Savior Healthcare Portage
          4,148         71,186 5.8%
Riverview Hospital Association Wisconsin Rapids
          4,997         86,397 5.8%
The Richland Hospital Richland Center
          1,974         35,222 5.6%
St. Mary's Hospital Medical Center Green Bay
          6,360       114,967 5.5%
Burnett Medical Center Grantsburg
             920         17,001 5.4%
Wheaton Franciscan-All Saints Racine
        19,542       366,452 5.3%
Mayo Clinic Health-Northland in Barron Barron
          2,904         55,621 5.2%
St. Clare Hospital and Health Services Baraboo
          3,052         59,566 5.1%
Sauk Prairie Memorial Hospital Prairie du Sac
          3,074         61,588 5.0%






Total all 35 Robust Profit Badger Hospitals

      461,245     6,049,883 7.6%






Modest Profit Badger Hospitals




Westfields Hospital New Richmond
          1,604         32,414 4.9%
Calumet Medical Center Chilton
          1,055         21,661 4.9%
Gundersen St. Joseph's Hospital&Clinics Hillsboro
             813         16,906 4.8%
St. Vincent Hospital Green Bay
        11,434       254,116 4.5%
Meriter Hospital Madison
        18,802       432,096 4.4%
Mayo Clinic Health-Chippewa in Bloomer Bloomer
          1,542         35,980 4.3%
Stoughton Hospital Association Stoughton
          1,519         37,868 4.0%
Wild Rose Community Meml Hospital  Wild Rose
             533         13,632 3.9%
Mercy Hospital and Trauma Center Janesville
        15,195       392,395 3.9%
Mercy Walworth Hospital&Medical Center Lake Geneva
          2,293         59,804 3.8%
Columbia St Mary's-Ozaukee Campus Mequon
          6,185       163,450 3.8%
Ministry Saint Clare's Hospital Weston
          3,698       100,489 3.7%
St. Croix Regional Medical Center St. Croix Falls
          2,250         62,366 3.6%
Monroe Clinic Monroe
          5,839       163,373 3.6%
Ministry Our Lady of Victory Hospital Stanley
             741         21,104 3.5%
Beaver Dam Community Hospitals Beaver Dam
          2,792         80,146 3.5%
Agnesian HealthCare/St. Agnes Hospital Fond du Lac
          9,989       293,981 3.4%
Bellin Hospital Green Bay
        11,843       350,272 3.4%
Reedsburg Area Medical Center Reedsburg
          1,511         44,962 3.4%
Moundview Memorial Hospital&Clinics Friendship
             489         14,982 3.3%
St. Joseph's Community Hospital West Bend
          2,749         84,276 3.3%
Beloit Health System Beloit
          5,269       190,977 2.8%
Mercy Medical Center Oshkosh
          3,005       110,332 2.7%
Oconomowoc Memorial Hospital Oconomowoc
          2,448         92,638 2.6%
Mile Bluff Medical Center Mauston
          1,224         53,307 2.3%
Midwest Spine Orthopedic&Heart Hosp Wauwatosa
          1,040         46,790 2.2%
Shawano Medical Center Shawano
             680         35,973 1.9%
Memorial Hospital of Lafayette Co. Darlington
             232         12,713 1.8%
Bay Area Medical Center Marinette
          1,589       113,061 1.4%
UW Health Partners Reg Med Ctr Watertown
          1,196         96,095 1.2%
Ministry Good Samaritan Health Cntr Merrill
             208         24,747 0.8%
Amery Regional Medical Center Amery
             111         50,874 0.2%
Holy Family Memorial Manitowoc
              10       127,350 0.0%





Total all 33 Modest Profit Badger Hospitals

      119,888     3,631,130 3.3%






In-The-Red Badger Hospitals




Wheaton Franciscan-St. Joseph Milwaukee
             (21)       275,100 0.0%
Community Memorial Hospital Oconto Falls
            (102)         34,860 -0.3%
Wheaton Franciscan-St. Francis Milwaukee
            (483)       155,569 -0.3%
Ripon Medical Center Ripon
             (84)         22,543 -0.4%
Berlin Memorial Hospital Berlin
            (317)         66,892 -0.5%
Ministry Eagle River Memorial Hospital Eagle River
             (81)         14,528 -0.6%
Columbia St. Mary's Hospital Milwaukee
         (4,765)       442,902 -1.1%
Ministry Saint Mary's Hospital Rhinelander
         (1,281)       115,894 -1.1%
Fort HealthCare Fort Atkinson
         (1,994)       122,645 -1.6%
Boscobel Area Health Care Boscobel
            (262)         13,761 -1.9%
Oconto Hospital & Medical Center Oconto
            (157)           5,422 -2.9%
Mayo Clinic-Franciscan Health Sparta Sparta
            (381)         12,944 -2.9%
Indianhead Medical Center/Shell Lake Shell Lake
            (392)           6,314 -6.2%
St. Nicholas Hospital Sheboygan
         (3,860)         60,418 -6.4%
Southwest Health Center Platteville
         (1,821)         27,284 -6.7%
Chippewa Valley Hospital Durand
            (986)         14,480 -6.8%
Memorial Medical Center Neillsville
         (1,580)         20,230 -7.8%
Aurora Sinai Medical Center Milwaukee
       (15,622)       191,340 -8.2%
Edgerton Hospital & Health Edgerton
         (1,584)         17,827 -8.9%
Children's Hospital Wisconsin-Fox Valley Neenah
         (1,847)         19,658 -9.4%
St. Mary's Janesville Hospital Janesville
         (5,122)         50,883 -10.1%
Columbia Center Mequon
            (856)           6,506 -13.2%






Total all 22 Badger In-The-Red Hospitals

       (43,598)     1,698,000 -2.6%





Total all 129 Wisconsin Badger Hospitals

    1,373,610   16,786,713 8.2%

It is pretty clear to me that not just US Hospital Patients but also Health Insurance Companies should both be outraged by these extremely high Operating Profits of Hospitals like the ones in Wisconsin.  And the Bottom Line Profits of Hospital Organizations all across the country are substantially higher than the Operating Profits.

But this is very good for future Health Insurance Pricing on the Health Insurance Exchange.  This egregious Hospital Pricing is driving obnoxiously high Hospital Bottom Line Profits, year after year, especially during all of the Obama Administration where the stock market has continually been on fire.  But now loaded with a better understanding of this information, Health Insurance Companies can now exert substantially downward Hospital Pricing Pressure on the Hospital Industry, and especially so on Wisconsin Hospitals.

And given that there are 22 Wisconsin Hospitals posting Operating Losses and many more posting modest Operating Profits, it only makes sense that Wisconsin fully expand Medicaid.  The resultant higher Hospital Profits from Medicaid expansion should give Health Insurance Companies even more leverage to exert downward Hospital Pricing Pressure on Wisconsin Hospitals, which should drive down even more Health Insurance Premiums on the Health Insurance Exchange.