CHI records $483M operating loss as labor costs grow, patient volume declines

http://www.beckershospitalreview.com/finance/chi-records-483m-operating-loss-as-labor-costs-grow-patient-volume-declines.html

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Catholic Health Initiatives, a nonprofit 103-hospital system based in Englewood, Colo., recorded an operating loss of $483.3 million in fiscal year 2016, compared to an operating surplus of $23.9 million in the year prior.

CHI reported revenue of $15.9 billion in FY 2016, up 7.4 percent from $14.8 billion in FY 2015.

However, rising expenses offset the system’s revenue gains. CHI said expenses increased 10.2 percent year over year to $16.1 billion in FY 2016.

“Lower patient volumes, higher labor costs, increased pharmacy prices and reduced reimbursement in Medicare and Medicaid all contributed to CHI’s financial performance in the 2016 fiscal year,” the system said in a written statement.

CHI ended FY 2016 with a net loss of $703.2 million, compared to a net gain of $113.6 million in FY 2015.

CHI officials expect financial performance to improve in FY 2017. “CHI is focused on several key areas for increased efficiency and expense reduction — including labor, supply chain, administrative overhead, revenue cycle and pharmacy services,” the system said. “We are confident these efforts will yield substantial improvement in overall operating and financial performance as we progress through the current fiscal year.”

California Braces For Medi-Cal’s Future Under Trump And The GOP

California Braces For Medi-Cal’s Future Under Trump And The GOP

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California grabbed the first opportunity to expand Medicaid and ran with it, helping cut the number of uninsured people in half in a few short years.

Thanks in part to billions of dollars in federal funding, a third of California’s residents — including half its children — are insured by Medi-Cal, the state’s version of Medicaid.

Now, with the election of Donald Trump and a Republican-controlled Congress, the state that bet so heavily on the Medicaid expansion is bracing to see how much of its work will be undone. While no one knows yet exactly what will happen, many policymakers and advocates fear the federal government will end or severely limit funding for the expansion.

“There are no easy cuts in Medi-Cal,” said Stan Rosenstein, a former Medi-Cal administrator. Reduced federal funding “could have a major impact on the uninsurance rate, on the viability of our hospitals, and it could have a very negative impact on the economy.”

Medi-Cal cuts could restrict who is eligible for coverage, slash health care benefits, limit access to doctors and reduce payment rates to medical providers — already among the lowest in the nation, health policy experts and advocates said. Medi-Cal covers a host of services for low-income residents, including maternity care, prescription drugs, long-term care services, mental health treatment and hospital stays.

Laurel Lucia, a health care program manager at the University of California, Berkeley Labor Center, said a well-funded Medicaid program benefits everyone, not just those currently on the program.

“A lot of people are just a layoff away from needing Medicaid,” she said. “The Republican plans for Medicaid threaten to undermine that safety net.”

Fitch: ACA repeal would be credit negative for hospitals

http://www.beckershospitalreview.com/finance/fitch-aca-repeal-would-be-credit-negative-for-hospitals.html

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http://www.businesswire.com/news/home/20161109006033/en/Fitch-Trump-Victory-Rattles-Healthcare-Industry

 

8 key strategies for improving a hospital’s margins

http://www.beckershospitalreview.com/hospital-management-administration/8-key-strategies-for-improving-a-hospital-s-margins.html

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As healthcare shifts toward value-based care, hospitals are looking for new ways to improve quality without unnecessarily increasing the cost of care.

“We think less about cost cutting and more about margin improvement,” says Allen Miller, CEO of COPE Health Solutions. “Folks are going to be more successful taking a strategic approach and focusing on improving margins by taking risks and building the type of infrastructure that will support value based contracts through which they take financial risk instead of the traditional cost-cutting approach.”

Here are some key strategies for financial success:

California Dreamin’ in a post-Trump healthcare world

http://www.fiercehealthcare.com/finance/suddenly-it-s-much-darker-california-dreaming-may-be-one-silver-lining?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTmpjd1pURm1NR0ZqTlRWbSIsInQiOiI5MkdaMWJlaGV4dlppeWNkY1NqNTNtTFJ1MFlrcWtQQWxcL2hvYWVUK3lmNEJRT1lCVTJLQTFwdGFcL0dLWWlGMnBzbGNQbXhDdnFDVUdsdkthR3Y4UzJIVm5sT25iNHJmYWd2aGlFXC9ycVNDST0ifQ%3D%3D

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The consensus among policymakers and observers: Not good.

“At risk is insurance coverage for literally millions of Americans,” said Anthony Wright, executive director of the advocacy group Health Access California.

Jim Lott, who teaches healthcare policy at USC and Cal State Long Beach and was the longtime executive vice president of the Hospital Association of Southern California, noted that even if parts of the law are preserved the way Trump suggests, it would still be imperiled.

“If you don’t have an employer mandate and an individual mandate, the market would self-destruct,” Lott said. “It will create havoc.”

Barcellona, an attorney by training, concurred with Lott. “The law matters and these federal programs are conditioned on the act being implemented in a certain way,” he said.

Barcellona also brought up a consequence that would be utterly disastrous for millions of middle-class Americans: If the ACA is eliminated in the middle of a calendar year, it could put them on the hook for repaying billions of dollars in premium tax credits.

CHS selling 17 hospitals in 7 deals

http://www.healthcaredive.com/news/chs-selling-17-hospitals-in-7-deals/429651/

The divestitures of the 17 hospitals follow a previous announcement of the sale of a four-hospital joint venture and an April deal in which CHS spun off 38 of its hospitals into a separate entity–Quorum Health Corp.

The system has previously indicated it may sell up to 30 of its hospitals in a strategy to streamline its operation to focus on its regional hospital hubs, and that the company might even put itself on the block.

The company has been struggling to bring down its debt of $15 billion, which has also involved the sale of its majority stake in its home health division. CHS has been in trouble since acquiring Health Management Associates in 2014 that owned 23 hospitals and some clinics in Florida.

Just last week, a grim preview of its third quarter earnings resulted in CHS’ common stock dropping from $10.03 at the close of business Wednesday to $5.08 at the close of business Thursday. This week its finalized numbers indicated a third quarter net loss of $79 million compared to a net income of $52 million for the quarter last year.

CHS stock plummets nearly 50% on Q3 losses

http://www.modernhealthcare.com/article/20161027/NEWS/161029917

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Investor confidence in Community Health Systems plummeted Thursday as losses in the third quarter previewed by the company after the close of markets Wednesday caused its stock to fall nearly 50%.

CHS’ stock closed the day at $5.05 per share, down $4.98 per share or 49.65%.

In a preview of third-quarter results to be announced next week, Franklin, Tenn.-based CHS Wednesday reported a loss from continuing operations before income taxes of $83 million compared with income from continuing operations of $121 million in the third quarter of 2015.

Hospital divestitures, lower-than-expected volumes and reductions to reimbursement from state supplemental programs combined to cause revenue to fall in the quarter to $4.4 billion from $4.8 billion in the year-earlier quarter, the company said.

CHS for the third straight quarter lowered its EBITDA guidance. It is now saying that earnings before income tax, depreciation and amortization in 2016 are expected to be in a range of $2.2 billion to $2.8 billion compared with last quarter’s estimate of $2.4 billion to $2.6 billion. The chain is the nation’s second-largest investor-owned hospital company with 159 hospitals.

A CHS spokeswoman did not respond to a request for comment about Thursday’s stock losses.

Trinity Health revenue increases, but operating margin shrinks

http://www.beckershospitalreview.com/finance/trinity-health-revenue-increases-but-operating-margin-shrinks.html

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Trinity Health saw revenue increase in fiscal year 2016, but higher expenses caused the Livonia, Mich.-based system’s operating margin to decline.

Trinity reported revenue of $16.3 billion in FY 2016, a 14 percent year-over-year increase from revenue of $14.3 billion in FY 2015, according to recently released audited financial documents.

Higher expenses offset the system’s revenue growth. Trinity reported operating expenses of $16.2 billion in FY 2016, up 16.7 percent from FY 2015. The system’s acquisitions of Syracuse, N.Y.-based based Saint Joseph’s Hospital Health Center and Hartford, Conn.-based Saint Francis Care accounted for $1.4 billion, or 10.3 percent, of the year-over-year growth in expenses. Trinity also reported higher costs related to salaries and wages, supplies and purchased services.

The system ended FY 2016 with operating income of $46.4 million, down from $457.7 million in the year prior. Excluding asset impairment charges and a premium revenue adjustment, Trinity recorded operating income of $151.3 million in FY 2016, down from operating income of $470 million in FY 2015. Trinity recorded an operating margin of .9 percent in the most recent fiscal year, compared to an operating margin of 3.3 percent in FY 2015.

5 hospitals with strong finances

http://www.beckershospitalreview.com/finance/5-hospitals-with-strong-finances-october20.html

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Here are five hospitals and health systems with strong operational metrics and solid financial positions based on recent reports from Moody’s Investors Service, Fitch Ratings and S&P Global Ratings.

Note: This is not an exhaustive list. Health system names were compiled from recent credit rating reports. Systems are listed in alphabetical order.

1. University of Chicago Medical Center has an “Aa3” rating and stable outlook with Moody’s. The hospital’s cash flow is growing and its market share is increasing. Moody’s expects UCMC to continue to produce improved cash flow margins and maintain its solid liquidity position.

2. Carolinas HealthCare System has an “Aa3” rating and stable outlook with Moody’s. The Charlotte, N.C.-based system has solid operating performance and cash flow diversity, according to Moody’s.

3. Parkview Health System has an “Aa3” rating and stable outlook with Moody’s. The Fort Wayne, Ind.-based system has solid financial performance and strong debt service coverage. Moody’s expects Parkview’s solid operating performance to continue.

4. Memorial Healthcare System has an “AA” rating and stable outlook with S&P. The Hollywood, Fla.-based system has strong cash flow, high unrestricted reserves and light pro forma debt. S&P expects MHS to maintain its solid enterprise profile and continue to generate strong earnings and cash flow.

5. Banner Health has an “AA-” rating and stable outlook with Fitch and an “AA-” rating and stable outlook with S&P. The Phoenix-based system has strong enterprise profile and good revenue diversity across its hospitals, according to S&P.