Friday, October 17, 2014

Pennsylvania Hospitals Net Assets Up 100% Under Obama and the Affordable Care Act

From a review of the Electronic Municipal Market Access (EMMA) and financial statements in SEC filings, I found 16 Non-Profit Hospital Organizations and 2 Publicly-held Hospital Companies headquartered in the State of Pennsylvania 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 18 Pennsylvania Hospital Organizations 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
Non-Profit Hospital Organizations







UPMC Pittsburgh PA Jun 14        5,315
Jun 09        2,756 93%
Catholic Health East Newtown Square PA  Sep 13         3,789
Dec 08        1,978 92%
Children's Hospital Philadelphia Philadelphia PA Mar 14        3,252
Jun 09        1,938 68%
University Penn Health System Philadelphia PA Jun 14        2,603
Jun 09        1,163 124%
Geisinger Health System Danville PA Jun 14        2,521
Jun 09           901 180%
Main Line Health Paoli PA Jun 14        2,289
Jun 09        1,346 70%
Lehigh Valley Health Network Allentown PA Jun 14        1,291
Jun 09           590 119%
Reading Hospital West Reading PA Jun 14        1,095
Jun 09           730 50%
Lancaster General Health Lancaster PA Jun 14        1,059
Jun 09           622 70%
WellSpan Health York PA Mar 14           891
Jun 09           387 130%
Abington Health Abington PA Jun 14           846
Jun 09           518 63%
Guthrie Health Sayre PA Jun 14           701
Jun 09           375 87%
Pinnacle Health System Harrisburg PA Jun 14           651
Jun 09           304 114%
St Luke's University Health Network Bethlehem PA Jun 14           645
Jun 09           298 116%
Albert Einstein Healthcare Network Philadelphia PA Jun 14           544
Jun 09           401 36%
Susquehanna Health System Williamsport PA Jun 14           443
Jun 09           226 96%









Total all 16 Non-Profit Hospital Organizations

     27,935

     14,533 92%









Publicly-held Hospital Companies







Universal Health Services King of Prussia PA Jun 14        3,599
Dec 08        1,771 103%
Select Medical Holdings Mechanicsburg PA Jun 14           746
Dec 08          (186) NM









Total all 2 Publicly-held Hospital Companies

       4,345

       1,585 174%









Total all 18 Non-Profit & Publicly-held Hospital Organizations

     32,280

     16,118 100%

As you can see from the above chart, the Total Net Assets (Financial Strength) of these 18 Pennsylvania Hospital Organizations increased by a phenomenal 100% to $32.280 bil so far during the Obama Administration.

Very positively impacting this massive increase in the Net Assets (Financial Strength) of these 18 Pennsylvania 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 increase in Net Assets (Financial Strength) of these 18 Pennsylvania Hospital Organizations.

A remarkable thing is that these exceptional increases in Net Assets (Financial Strength) of these 18 Pennsylvania Hospital Organizations occurred when these 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 incredibly high Net Asset percentage increases of these 18 Pennsylvania Hospital Organizations, a key beneficiary of this has been and will continue to be Pennsylvania citizens electing to buy health insurance on the Health Insurance Exchange.  And since the 2 Publicly-held Pennsylvania Hospital Companies have Hospitals located all over the US, citizens in many US States electing to buy health insurance on the Health Insurance Exchange will also be key beneficiaries.  This massive Net Asset growth gives these Pennsylvania 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.  

The Severely Struggling West Penn Allegheny Health System

There are many struggling Pennsylvania Hospitals that are in desperate need of financial help, but none more so than the West Penn Allegheny Health System.

West Penn is located in the Pittsburgh Metro area, where the giant UPMC rules.  There is no way the smaller West Penn can compete with such a mega giant.

UPMC had Net Assets of $5.086 bil at December 31, 2013.  On the other hand, rather than a Net Asset position, West Penn had a Net Deficit position of $283 mil at September 30, 2013, with its Total Liabilities of $1.542 bil exceeding its Total Assets of $1.259 bil.

West Penn had an Operating Loss of $153 mil in its Fiscal Year Ended June 30, 2013.  Its Total Operating Losses were $412 mil for the 4 Fiscal Years Ended June 30, 2013.

Other So Many Pennsylvania Struggling Hospitals

From Pennsylania's excellent Dept of Health website, included was key 2012 financial information related to 168 Pennsylvania General Acute Care Hospitals.

Of these 168 Pennsylvania Hospitals, 37 of them, or 22% of them, had Operating Losses in 2012.

And of these 168 Pennsylvania Hospitals, 35 of them, or 21% of them, had Operating Income as a Percentage of Total Operating Revenues from 0.0% to 2.5%.

The chart below shows these 72 financially struggling Pennsylvania Hospitals, which is a huge 43% of the 168 Total Pennsylvania Hospitals:
Hospital Operating Income (thousands)
 FY12
Total Operating Revenue (thousands)
FY12
Operating Margin Percentage
FY12
Shriners/Philadelphia  -$26,565 $19,929 -133.3%
Sunbury Community  -$8,364 $25,479 -32.8%
Shamokin Area Community  -$3,425 $16,790 -20.4%
Surg Spec/Coordinated  -$7,316 $41,211 -17.8%
Western Pennsylvania  -$29,135 $165,731 -17.6%
Regional Scranton  -$21,318 $133,910 -15.9%
Tyler Memorial  -$2,860 $18,477 -15.5%
OSS Orthopaedic  -$3,399 $22,661 -15.0%
Brandywine  -$17,164 $117,492 -14.6%
Canonsburg General  -$4,056 $51,172 -7.9%
Bucktail  -$409 $5,542 -7.4%
Bloomsburg  -$2,814 $41,120 -6.8%
Memorial York  -$6,413 $100,152 -6.4%
Barix Clinics/PA  -$776 $12,995 -6.0%
Ohio Valley General  -$3,189 $55,151 -5.8%
St Luke's/Anderson -$2,263 $41,107 -5.5%
Jeanes5 -$8,263 $159,463 -5.2%
Clearfield  -$2,937 $59,306 -5.0%
Sharon Regional  -$8,000 $165,053 -4.8%
Punxsutawney Area  -$1,370 $30,149 -4.5%
Ellwood City  -$1,426 $32,017 -4.5%
Mid-Valley  -$273 $6,636 -4.1%
St Joseph's/Philadelphia  -$4,069 $99,396 -4.1%
Lock Haven  -$1,250 $30,979 -4.0%
Chestnut Hill  -$3,680 $97,483 -3.8%
Roxborough Memorial  -$2,021 $67,222 -3.0%
Jersey Shore  -$772 $30,447 -2.5%
Warren General  -$1,609 $70,646 -2.3%
DuBois Regional  -$3,865 $213,838 -1.8%
Heritage Valley Beaver  -$4,058 $225,543 -1.8%
Delaware County Memorial  -$2,632 $184,533 -1.4%
Good Samaritan/Lebanon  -$2,455 $173,995 -1.4%
Schuylkill-East Norwegian  -$789 $60,906 -1.3%
Albert Einstein  -$4,521 $622,435 -0.7%
Geisinger-Community  -$883 $159,556 -0.6%
Hahnemann University  -$761 $481,367 -0.2%
Corry Memorial -$26 $18,303 -0.1%




Total all 37 Experiencing Operating Losses -$195,126 $3,858,192 -5.1%




Grove City  $6 $44,379 0.0%
Montgomery  $42 $105,345 0.0%
UPMC Mercy  $1,754 $379,909 0.5%
Charles Cole Memorial  $365 $70,641 0.5%
Temple University  $4,490 $801,398 0.6%
Monongahela Valley  $811 $124,712 0.7%
Mercy Suburban  $827 $122,123 0.7%
Physicians Care  $68 $9,802 0.7%
Crozer Chester  $3,798 $545,030 0.7%
Memorial/Towanda  $274 $38,612 0.7%
Altoona Regional  $2,707 $326,047 0.8%
Fulton County  $291 $32,451 0.9%
Saint Vincent Health  $2,393 $247,462 1.0%
Uniontown  $1,253 $127,903 1.0%
Endless Mountains  $158 $15,285 1.0%
Holy Redeemer $2,150 $185,740 1.2%
Brookville  $345 $26,420 1.3%
Jefferson Regional  $3,038 $222,665 1.4%
Schuylkill-South Jackson  $1,340 $94,837 1.4%
Nazareth  $2,549 $172,248 1.5%
Chester County  $3,710 $248,933 1.5%
Tyrone  $346 $21,978 1.6%
Palmerton $491 $30,420 1.6%
Penn Presbyterian  $10,894 $566,978 1.9%
Jameson Memorial  $2,059 $106,116 1.9%
Mercy Philadelphia  $3,268 $167,793 1.9%
Somerset  $1,291 $65,034 2.0%
Windber  $1,042 $51,250 2.0%
Meyersdale Community  $251 $11,955 2.1%
Lewistown  $2,099 $95,811 2.2%
Indiana Regional  $3,026 $137,341 2.2%
Wayne Memorial $1,668 $75,367 2.2%
Pennsylvania $11,731 $514,932 2.3%
Meadville  $3,465 $149,666 2.3%
Doylestown  $5,095 $207,907 2.5%




Total all 35 with Very Modest Operating Profit $79,095 $6,144,490 1.3%

When you have so many struggling Pennsylvania Hospitals, the responsible thing to do is to deal with them and not ignore them.  After much lengthy resistance by the Republican State Governor of Pennsylvania, finally Pennsylvania has decided to expand Medicaid.

By far the best and only way to put a major dent in West Penn's devastating financial problems and that of the above 72 struggling Pennsylvania Hospitals is for the State of Pennsylvania to fully expand Medicaid and they finally did.  By doing this, with the resultant massive inflow of Patient Revenues from Medicaid expansion, West Penn's Hospitals and the many other struggling Pennsylvania Hospitals should be able to substantially reduce their huge Losses and perhaps even turn their substantial losses into profits.  And the Pennsylvania Hospitals with very modest Operating Income should also have their profits bolstered very robustly.

Because Pennsylvania finally decided to expand Medicaid, one of the key beneficiaries of the resultant very healthy profit improvement and thus also Total Net Assets improvement of not just West Penn Hospitals and of the many other struggling Pennsylvania Hospitals, but also of all Pennsylvania Hospitals, should be Pennsylvania citizens electing to buy health insurance on the Health Insurance Exchange.  This exceptional Net Asset growth from Medicaid expansion would give all Pennsylvania 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.