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Vanderbilt University Medical Center points to Epic rollout for 68% drop in operating income
Nashville, Tenn.-based Vanderbilt University Medical Center saw revenues increase in fiscal year 2018, but the hospital ended the period with lower operating income, according to recently released unaudited financial documents.
Here are five things to know about the hospital’s most recent financial results:
1. VUMC reported operating revenues of $4.1 billion in the 12 months ended June 30, up from $3.9 billion in the same period a year earlier. The hospital said the financial boost was largely attributable to higher net patient service revenue, which climbed 3.4 percent year over year.
2. VUMC’s operating expenses increased 8.3 percent year over year to $4 billion in fiscal year 2018. The hospital saw expenses across several categories rise, including a 7.2 percent year-over-year increase in expenses related to salaries, wages and benefits.
3. “The increase in salaries, wages and benefits is primarily due to increased staffing to meet additional demand associated with higher net patient service revenue, research contracts, along with training costs and post-live ramp up related to our EMR system implementation,” VUMC said. Higher consulting and management fees related to the Epic EMR implementation and an increase in subcontract expenses related to increased grant and contract revenue also caused the hospital’s expenses to rise.
4. VUMC ended fiscal year 2018 with operating income of $56.2 million, down 68.5 percent from $178.5 million in the same period a year earlier. The decline was largely attributable to the rollout of the new EMR system. VUMC said it had planned for future operating income reductions due to the implementation.
5. “We successfully completed our EMR implementation in November and we anticipate the new system will yield future efficiencies,” VUMC said. “However, in the year of implementation, increased operating expenses related to implementation caused a reduction in operating income. The EMR implementation put pressure on clinical volumes in the post-live period. Although we have achieved net patient services revenue in excess of our budget, the implementation has muted procedural volumes.”
UnitedHealth stock hits all-time high
https://www.beckershospitalreview.com/payer-issues/unitedhealth-stock-hits-all-time-high.html
UnitedHealth Group’s stock hit a 52-week high of $269.14 on Aug. 28.
Over the past month, UnitedHealth’s stock has increased 2.8 percent, according to Zacks.com. Since the beginning of the year, the health insurer has gained 19.9 percent.
UnitedHealth’s stock has outperformed its sector due to consistently positive earnings. The health insurer has not missed Zacks.com’s earnings consensus in the last four quarters. By the end of this fiscal year, UnitedHealth is projected to record earnings of $12.72 per share on $224.86 billion in revenues.
The uninsured rate remains plateaued
The Centers for Disease Control and Prevention is out with its latest health insurance coverage data this morning, and the nation’s uninsured rate isn’t really changing a whole lot.
By the numbers: As of March 2018, 8.8% of all Americans, or about 28.3 million people, had no health insurance.
- Those numbers are almost identical to the CDC’s 2017 report, when 28.1 million people were uninsured as of March 2017.
- It’s also worth noting that 47% of people younger than 65 are in a high-deductible plan, up from 42.3% recorded at the same point last year.
The big picture: The federal and state exchanges established by the ACA are treading water when it comes to enrollment, and no new states have expanded Medicaid. (Notably, Maine Gov. Paul LePage is still resisting his state’s voter-approved Medicaid expansion.)
The bottom line: Don’t expect the uninsured rate to fluctuate a lot until more states expand Medicaid or the ACA exchanges get more federal support.
Looking ahead: The U.S. Census Bureau will unveil its 2017 health insurance numbers on Sept. 12.
1 big thing: Pre-existing conditions as a political hammer
The number of people with pre-existing medical conditions varies substantially between metropolitan areas, according to Kaiser Family Foundation data. That means even within a single state, different locations would see different results under legislation that erodes the Affordable Care Act’s protections, my colleague Caitlin Owens reports.
Why it matters: The more people who have a pre-existing condition, the more likely health care is to resonate as an issue in the midterm elections in that state or district.
- Democrats have been making the case that Republicans threaten pre-existing conditions protections — through legislation, executive action and the courts — and have made this a dominant theme of the midterms.
- Some of the areas with the highest number of people with pre-existing conditions are in states with competitive Senate races, such as West Virginia, Tennessee and Indiana.
The issue makes for absolutely brutal ads, and Democrats know it. They believe one of their most potent lines of attack against Brett Kavanaugh, President Trump’s Supreme Court nominee, is arguing he could be the deciding vote against these protections.
- Protect Our Care has a new TV ad out today, provided to Axios, that depicts an imaginary broadcast in 2019 or 2020 announcing SCOTUS has struck down the ACA’s pre-existing conditions regulations.
- The ad targets Sen. Susan Collins of Maine, who voted against the GOP health care bill last year. The pro-ACA group is airing radio ads tying Kavanaugh to pre-existing conditions in both Maine and Alaska.
- Kavanaugh’s Senate hearing begins Sept. 4, the day before oral arguments in the court case that would strike down the ACA regulations.
GOP eyes another shot at ObamaCare repeal after McCain’s death
GOP eyes another shot at ObamaCare repeal after McCain’s death
Senate Republicans say they would like Arizona Gov. Doug Ducey (R) to appoint a successor to the late Sen. John McCain (R-Ariz.) who, unlike McCain, would support GOP legislation to repeal ObamaCare.
Republican lawmakers say they won’t have time to hold another vote to repeal the law in 2018 but vow to try again next year if they manage to keep their Senate and House majorities.
“If we re-engage in that discussion in some point in the future, it would be nice to have members who enable us to pass it,” Senate Republican Conference Chairman John Thune (S.D.) said when asked about the possibility of ObamaCare repeal legislation coming up for a future vote.
Sen. Ron Johnson (R-Wis.) said he hopes the next senator from Arizona will be a “strong ally” who “recognizes that ObamaCare is not a proper solution.”
“It hasn’t worked. It’s created a lot of harm and damage to real people,” he added.
A senior Senate GOP aide said the chamber would “absolutely” vote again to repeal ObamaCare but cautioned it would depend on “if we keep the House.”
“McCain was personally conservative but ideologically inconsistent,” the aide said. “I think Ducey is going to pick someone more like himself. He’s a more reliable conservative.”
McCain’s surprise vote to reject legislation that would repeal core pillars of the 2010 Patient Protection and Affordable Care Act — also known as ObamaCare — was the most impactful decision of his final year in the Senate.
It quashed the GOP’s eight-year quest to repeal the law and forced party leaders to drop major health-care legislation for the rest of the 115th Congress.
McCain’s vote remained a point of contention with President Trump for months afterward.
The president mocked McCain at a Nevada rally in June for voting “no” on the repeal measure with a thumbs-down gesture.
The vote caught Trump and GOP leaders completely by surprise.
“Nobody knew he was going to do that. He campaigned on repeal and replace,” Trump told the Nevada audience. “Nobody talked to him. Nobody needed to, and then he walked in: thumbs down.”
More generally, GOP senators say they would like the new senator from Arizona to have a better working relationship with Trump.
“I think it would serve a useful purpose to get along with the president,” Sen. James Inhofe (R-Okla.) said. “By having a sincere appreciation, admiration and respect, you can get a lot more done than [by being] adversarial.”
“It’s hard to imagine he could pick anyone more antagonistic,” quipped a GOP senator who requested anonymity, referring to Ducey.
Republican senators say they don’t want similar surprises from McCain’s successor.
“I’d love to have somebody to take care of that,” Sen. David Perdue (R-Ga.) said of repealing ObamaCare.
Republicans repealed a main component of ObamaCare last year when they eliminated the law’s requirement that individuals obtain health insurance or pay a fine.
But GOP lawmakers say they can do more.
“Can we make insurance more affordable? Absolutely,” said Sen. Bill Cassidy (R-La.). “More needs to be done.”
Cassidy said he doesn’t know whether the Senate will move another comprehensive health-care reform package, but he expects Republican leaders will push “piecemeal efforts to make affordable once more that which has not been affordable since ObamaCare passed.”
GOP senators think they have a good chance to increase their Senate majority because Democrats have to defend 24 seats, including seats in 10 states that Trump won in the 2016 presidential election.
There is only one Republican running for reelection in a state that voted for Democratic nominee Hillary Clinton, while five Democrats are running in states that Trump won by double digits: Indiana, Missouri, Montana, North Dakota and West Virginia.
Future Republican control of the House is more in doubt.
House Republicans need to defend 25 seats carried by Clinton in 2016, and Democrats need to flip only 23 to capture the majority.
Republicans want Ducey to appoint someone who will be a more reliable vote on health care in case they retain their congressional majorities.
“I want somebody who is for affordable health care, and right now ObamaCare is not affordable, nor is health care, which is a direct result of ObamaCare,” Cassidy said.
Ducey, who was governor when the Senate debated ObamaCare repeal legislation in 2017, initially had serious reservations about the GOP bill.
Arizona was a state that opted to expand Medicaid coverage under ObamaCare, which enabled almost 500,000 residents in the state to gain health coverage.
But in a phone call with McCain shortly before his dramatic “no” vote, Ducey recommended that the senator vote for it, McCain recalled in his book “The Restless Wave.”
“On balance he thought it was worth voting for,” McCain wrote.
A Republican senator who requested anonymity to discuss Ducey’s choice said he expects the governor will tap someone who is more aligned with his political views.
“I think he’s going to pick someone where he knows the answers to those questions,” the senator said.
Senate Majority Leader Mitch McConnell (R-Ky.) is keeping his agenda for next year secret.
He declined on Tuesday to say whether Republicans would make another push to repeal ObamaCare if they keep control of Congress.
“I’m concerned about September,” McConnell told reporters, emphasizing that he’s more focused on the remaining 2018 agenda. “We have, I hope, three conference reports on minibuses; I hope a conference report on the farm bill; I hope an up-or-down vote on a bipartisan opioid agreement.
“We have a full plate for September, and I’m not willing to speculate beyond the end of September,” he added.
Cartoon – Let Me Tell You How this will go down
Cartoon – An Endless Variety of Data Gathering Expeditions
HENRY KOTULA 