North Carolina Non-Profit Hospitals Net Assets Up 66% Under Obama and the Affordable Care Act.....Kay Hagan Has Been Spot on On Health Care Including Medicaid Expansion

From a review of the Electronic Municipal Market Access (EMMA), I found 15 Non-Profit Hospital Organizations headquartered in the State of North Carolina 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 15 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
Carolinas Health Care System	Charlotte	NC	Jun 14	4,232		Dec 08	2,340	81%
Duke University Health System	Durham	NC	Jun 14	3,013		Jun 09	1,392	116%
Novant Health	Winston-Salem	NC	Jun 14	2,645		Dec 08	1,557	70%
Cone Health	Greensboro	NC	Jun 14	1,502		Sep 09	894	68%
Mission Health System	Asheville	NC	Jun 14	1,406		Sep 09	882	59%
University North Carolina Hospitals	Chapel Hill	NC	Jun 14	1,280		Jun 09	911	41%
Vidant Health	Greenville	NC	Jun 14	1,032		Sep 09	587	76%
North Carolina Baptist Hospital	Winston-Salem	NC	Jun 14	1,009		Jun 09	715	41%
WakeMed Health	Raleigh	NC	Jun 14	910		Sep 09	719	27%
CaroMont Health	Gastonia	NC	Jun 14	716		Jun 09	386	85%
FirstHealth of the Carolinas	Pinehurst	NC	Jun 14	674		Sep 09	458	47%
Wake Forest Univ Health Sciences	Winston-Salem	NC	Jun 14	647		Jun 09	510	27%
New Hanover Regional Medical Center	Wilmington	NC	Jun 14	605		Sep 09	450	34%
Rex Healthcare	Raleigh	NC	Jun 14	480		Jun 09	297	62%
Cape Fear Valley Health System	Fayetteville	NC	Jun 14	445		Sep 09	315	41%
Total all 15				20,596			12,413	66%

As you can see from the above chart, the Total Net Assets (Financial Strength) of these 15 North Carolina Non-Profit Hospital Organizations increased by an impressive 66% to a massive $20.596 bil so far during the Obama Administration.

Very positively impacting this impressive increase in the Net Assets (Financial Strength) of these 15 North Carolina 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 15 North Carolina 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, and especially the North Carolina 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 impressive Net Asset percentage increases of these 15 North Carolina Hospitals, a key beneficiary of this has been and will continue to be North Carolina citizens electing to buy health insurance on the Health Insurance Exchange.  This strong Net Asset growth gives these North Carolina 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.    

North Carolina Struggling Hospitals

North Carolina has some excellent Non-Profit Hospital Organizations connected with Universities.  And they are also doing very well on the Operating Income front, as you can see in the below chart:

					Most
					Recent
				Operating	Annual
		Operating	Total	Income	Fiscal
	City	Income	Operating	(Loss)	Year
	HQs	(Loss)	Revenues	Margin	End
		mils $s	mils $s	%
North Carolina University Non-Profit Hospital Organizations
Univ North Carolina Hosps	Chapel Hill	113.9	1,212	9.4%	Jun 13
Duke University Health	Durham	184.1	2,539	7.3%	Jun 13
Vidant Health	Greenville	94.3	1,601	5.9%	Sep 13
Total all 3		392.3	5,352.0	7.3%

However, there are many North Carolina Hospital Organizations which are really suffering financially.

From EMMA, I found 29 North Carolina Non-Profit Hospital Organizations with Total Operating Revenues in excess of $10 mil each in their most recent fiscal year.  Of those 29, a very high 17 of them, or 59% of them, generated Operating Income as a Percentage of Total Operating Revenues of less than 2.0% in their most recent fiscal year.   These 17 Hospital Organizations generated Total Operating Losses of $115 mil in their most recent fiscal year, which was a negative 1.7% of their Total Operating Revenues, as you can see in the below chart:

					Most
					Recent
				Operating	Annual
		Operating	Total	Income	Fiscal
	City	Income	Operating	(Loss)	Year
	HQs	(Loss)	Revenues	Margin	End
		mils $s	mils $s	%
North Carolina Non-Profit Hospital Organizations
Chatham Memorial Hospital	Elkin	(6.3)	82	-7.7%	Sep 13
Cone Health	Greensboro	(44.1)	1,140	-3.9%	Sep 13
Nash Health Care	Rocky Mount	(7.5)	218	-3.4%	Dec 13
Wake Forest Baptist Hosp	Winston-Salem	(56.6)	1,895	-3.0%	Jun 13
Stanley Health Services	Albemarle	(3.1)	130	-2.4%	Sep 13
High Point Regional Health	High Point	(6.2)	275	-2.3%	Sep 12
Halifax Regional Med Ctr	Roanoke Rapids	(1.3)	90	-1.4%	Sep 13
WakeMed Health	Raleigh	(14.4)	1,023	-1.4%	Sep 13
Columbus Regional Healthcare	Whiteville	(0.6)	80	-0.8%	Sep 13
Scotland Healthcare	Laurinburg	(0.1)	125	-0.1%	Sep 13
Wayne Health	Goldsboro	0.7	216	0.3%	Sep 13
Southeastern Regnl Med Ctr	Lumberton	2.5	288	0.9%	Sep 13
Catawba Valley Medical Center	Hickory	2.1	203	1.0%	Jun 13
Harnett Health	Dunn	1.1	87	1.3%	Sep 12
Wilson Medical Center	Wilson	1.8	137	1.3%	Sep 12
Cape Fear Valley Health	Fayetteville	12.3	657	1.9%	Sep 13
ARMC Health Care	Burlington	4.8	251	1.9%	Dec 12
Total all 17		(114.9)	6,897	-1.7%

Of these 29 North Carolina Hospital Organizations, 10 of them posted Operating Losses in the most recent year.

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

A key side benefit to North Carolina citizens of North Carolina Medicaid expansion is that the resultant profit enhancements and thus Net Asset enhancements to all of North Carolina's Hospitals would 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. 

Also from a review of audited annual financial statements shown at Electronic Municipal Market Access (EMMA), I found 12 North Carolina Non-Profit Hospital Organizations with Net Assets above $400 mil each and which had or will very shortly have audited financial statements in each of the most recent 4 years.

One of these 12 North Carolina Non-Profit Hospitals.....the huge Carolina's Health Care System.... hadn't published its December 2013 financial statements when I did this study and thus I only included for 2013 below its 9 months ended September 30, 2013 operating data.  

These 12 North Carolina Non-Profit Hospital Organizations generated Total Bottom Line Net Income of a superb 10.0% of Total Operating Revenues in 2013 and of a similar superb 9.0% in the most recent 4 years combined.

The main contributor to these outstanding operating results was the huge renown Duke University Health System which posted a Net Income Margin of 18.9% for the most recent 4 years combined and of 17.3% in 2013.

The only problem with these exceptional operating results was that instead of taking the high road and responsibly reducing their Patient Service Pricing, these North Carolina Non-Profit Hospital Organizations elected to retain these excessively high Bottom Line Profits, which also added to both their Net Assets and treasure chest of Investments in Stocks and Bonds.

Below are the Bottom Line Net Income and Total Operating Revenues for each of these 12 North Carolina Non-Profit Hospital Organizations for 2013, for 2012 and for the most recent 4 years combined:

											4 Year
		Most	2013				2012				2010-13	4 Year	4 Year
		Recent	Bottom	2013	2013		Bottom	2012	2012		Bottom	2010-13	2010-13
		Fiscal	Line	Total	Net		Line	Total	Net		Line	Total	Net
		Year	Net	Operating	Income		Net	Operating	Income		Net	Operating	Income
North Carolina Hospital Organ	City HQs	End	Income	Revenues	Margin		Income	Revenues	Margin		Income	Revenues	Margin
			mil $s	mil $s	%		mil $s	mil $s	%		mil $s	mil $s	%
Non-Profit Hospitals
Cone Health	Greensboro	Sep 13	263	1,140	23.1%		83	1,023	8.1%		435	3,901	11.2%
Duke University Health System	Durham	Jun 13	440	2,539	17.3%		173	2,478	7.0%		1,778	9,407	18.9%
CaroMont Health	Gastonia	Jun 13	66	484	13.6%		13	489	2.7%		238	1,885	12.6%
Univ North Carolina Hosps	Chapel Hill	Jun 13	152	1,212	12.5%		121	1,185	10.2%		619	4,399	14.1%
Mission Health System	Asheville	Sep 13	132	1,233	10.7%		81	1,054	7.7%		341	4,111	8.3%
Novant Health	Winston-Salem	Dec 13	273	3,593	7.6%		274	3,555	7.7%		710	13,616	5.2%
Vidant Health	Greenville	Sep 13	120	1,601	7.5%		136	1,551	8.8%		354	5,651	6.3%
New Hanover Regional Med Ctr	Wilmington	Sep 13	53	718	7.4%		41	667	6.1%		158	2,676	5.9%
Rex Healthcare	Raleigh	Jun 13	46	731	6.3%		50	707	7.1%		219	2,638	8.3%
FirstHealth of the Carolinas	Pinehurst	Sep 13	31	565	5.5%		28	524	5.3%		94	2,023	4.6%
Carolinas Health Care System	Charlotte	Dec 13	181	3,412	5.3%		375	4,194	8.9%		1,016	14,669	6.9%
Cape Fear Valley Health System	Fayetteville	Sep 13	32	657	4.9%		45	674	6.7%		118	2,558	4.6%
Total all 12			1,789	17,885	10.0%		1,420	18,101	7.8%		6,080	67,534	9.0%

There is a very positive aspect to these excessively high Bottom Line Profits in the most recent 4 years of these North Carolina Non-Profit Hospital Organizations.  These incredibly high Profits are getting added to the Net Assets (Financial Strength) of these North Carolina Hospital Organizations.

Thus a key beneficiary of this should be North Carolina citizens electing to buy health insurance on the Health Insurance Exchange.  This exceptional Net Asset growth driven by these exceedingly high Bottom Line Profits gives these North Carolina Hospital Organizations 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.

And armed with audited financial data concerning the excessively high profits earned by these large North Carolina Non-Profit Hospital Organizations in the past 4 years, Health Insurance Companies should be able to do a much better job in representing their policy holders, including those getting Health Insurance on the Health Insurance Exchange.