A hospital's financials: should we care, and what #s should we look at?

Discussion in 'General Residency Issues' started by nychick, Dec 2, 2002.

  1. nychick

    nychick Senior Member
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    Presumably, a better funded hospital that is not bleeding money year after year is in a better position than one that is. But what metrics beyond the profit and loss would you look at and how would you interpret them? I found one source of financial info on the web, at http://www.ahd.com/freesearch.php3

    This provides AHA data (very general, not v. useful) and CMS (HCFA) data (very detailed stats, incl. financial metrics, as shown below). For example, for Georgetown Hospital, the following information is available (to non-subscribers):

    CMS (HCFA) Data:
    Hospital identification taken from the Medicare Provider of Services Listing as updated December, 2001.

    GEORGETOWN UNIVERSITY HOSPITAL
    3800 RESERVIOR RD
    WASHINGTON, DC 20007
    (202) 784-3000

    Medicare Provider Number: 090004

    Inpatient Utilization Statistics
    All information in this report is taken from
    The Medicare Provider Analysis and Review (MedPAR) file.
    Data are for the federal fiscal year ending 09/30/2001 .
    This report is consistent with CMS (HCFA) Data Release policies.


    Statistics by Medical Service
    # Avg Avg Medicare
    Medicare Length Charges Case Mix
    Inpatients of Stay Index (CMI)
    Cardiology 324 4.59 $19,400 1.0556
    Cardiovascular Surgery 288 7.27 $49,143 3.7188
    Gynecology 59 4.54 $25,322 1.2373
    Medicine 725 5.14 $19,578 0.8966
    Neurology 231 6.05 $24,249 1.0563
    Neurosurgery 85 11.72 $68,029 2.9176
    Oncology 120 9.10 $38,022 1.6667
    Orthopedics 413 7.62 $40,712 1.8838
    Psychiatry 78 9.42 $18,571 0.7051
    Pulmonology 340 12.35 $67,516 3.3735
    Surgery 333 11.48 $58,680 2.6366
    Surgery for Malignancy28 5.96 $35,407 2.1786
    Urology 214 6.70 $37,480 1.4159
    Vascular Surgery 152 7.26 $35,655 1.8947
    Total 3,396 7.57 $37,519 1.8684
    Note 1 - Medicare Case Mix index is based on the Medicare Prospective Payment System for the corresponding federal fiscal year.
    Note 2 - Click here for description of Medicare Prospective Payment System, DRGs, and case mix index.
    Patient Origin for Top 3 Zip Codes
    Data are from the Medicare Hospital Market Service Area File
    for the calendar year ending 12/31/2001.

    ZIP Code of Residence Admissions Days of Care Charges ($000)
    20007 187 1,398 $6,746,560
    20016 172 1,201 $5,088,409
    20008 127 736 $3,504,069

    Outpatient Utilization Statistics
    All information in the following report is taken from
    the Medicare Standard Analytical File (Outpatient).
    Data are for the calendar service year ending 12/31/1999 .
    Data are excluded for categorizations of ten or fewer patients.
    This report is consistent with CMS (HCFA) Data Release policies.
    Outpatient data prepared by
    Health Market Insights
    (888) 700-DATA
    email: [email protected]

    Statistics for the Top 20 Ambulatory Patient Classifications (APCs)
    Click here for a description of Medicare APCs.

    APC APCDesc. %/Charges #Pat.Visits AvgChrg/Visit NatAvgChrg
    0283 Level II Computerized Axial Tomography 12.75 1,787 $981 $816
    0284 Magnetic Resonance Imaging 9.35 783 $1,642 $1,270
    0301 Level II Radiation Therapy 7.01 2,439 $395 $736
    0260 Level I Plain Film Except Teeth 4.70 4,919 $131 $123
    0143 Lower GI Endoscopy 3.11 374 $1,142 $782
    0269 Echocardiogram Except Transesophageal 2.79 1,336 $287 $305
    0286 Myocardial Scans 2.36 799 $406 $690
    0612 High Level Emergency Visits 2.36 726 $446 $338
    0343 Level II Pathology 2.35 1,361 $237 $129
    0080 Diagnostic Cardiac Catheterization 2.04 101 $2,777 $2,351
    0141 Upper GI Procedures 1.90 227 $1,150 $748
    0169 Lithotripsy 1.70 55 $4,242 $4,728
    0100 Continuous ECG 1.68 449 $514 $317
    0117 Chemotherapy Administration by Infusion Only 1.62 647 $344 $303
    0028 1.48 87 $2,343 $1,177
    0303 Treatment Device Construction 1.47 188 $1,074 $712
    0305 Level II Therapeutic Radiation Treatment Preparation 1.45 300 $662 $577
    0292 Level II Diagnostic Nuclear Medicine Excluding Myocardial Scans 1.40 280 $685 $605
    0246 Cataract Procedures with IOL Insert 1.31 74 $2,434 $1,305
    0026 Level III Skin Repair 1.29 55 $3,219 $1,324
    All other 35.88 14,438 $341 $241
    TOTAL 31,425
    Note 1 - APC classifications are based on FR 9/8/99 as modified through 6/30/99

    Financial and Statistical Information
    All information in the following report is taken from Medicare Cost Reports per the Hospital Cost Report Systems Master File.
    For period ending 06/30/2000 .

    Beds and Patient Days by Unit
    Available Beds Inpatient Days
    HOSPITAL
    (incl swing beds)
    Routine Services 211 54,060
    Special Care 100 20,475
    Nursery 17 2,502
    Total Hospital 328 77,038

    Financial Statistics $ %
    Gross Patient Revenue $508,382,781 99.45
    Non-Patient Revenue $2,798,368 0.55
    Total Revenue $511,181,149
    Net Income (or Loss) $-13,643,245 -2.67
     
  2. Annette

    Annette gainfully employed
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    One thing I would definately like to know is the hospital in trouble with Medicare in anyway. If Medicare pulls out, that is pretty much the death knell for any hospital. I don't know off hand where you can get this information, and the hospitals may not be willing to disclose the information.
     
  3. Caldoc

    Caldoc New Member

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    It's not just the hospital financials...i am thinking of priv practice groups. A lot of docs are looking at other revenue streams (can anyone say Amyway - ugggh.) I don't want to sell vitamins. Two docs told me to learn about reimbursement and insurers and payors - any help ???
     
  4. Celiac Plexus

    Celiac Plexus Senior Member
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    NyChick,

    Well, you pose an intersting question: "But what metrics beyond the profit and loss would you look at and how would you interpret them?"

    Unfortunately the numbers that you posted are out of context and therefore meaningless. Perhaps, a physician with some business background, say a doctor with an MBA might be able to give you the answers that you're seeking vis a vis "financial metrics"....

    CP
     
  5. Annette

    Annette gainfully employed
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    The reason payors and insurance are important is that determines if the hospital is going to be flush with cash or dirt poor. A large percent of private insurers is good, because they reimburse fairly quickly, and the hospital will get most of its cost back. Medicare is nortoriously slow to reimburse, sometimes taking a year or so. Could you live a year with out a paycheck? Most hospitals can't survive like that either. A large percentage of self-pay is not a good marker. Self-pay~=no pay.

    The mix of insurance types is also important. If HMO's predominate in the area, the hospitals have to negotiate to get business. There was a recent spat in the Chicago area between Advocate and Blue Cross. Neither liked how the negotiations were going, and decided, temporarily, to not do business with each other. Well, this was during open enrollement for many companies, and both parties have lost business.

    NYChick, you posted alot of numbers about different procedures and such. Something that might be interesting is how much your particular department brings to the hospital in terms of revenue. If your department is bringing in alot, they will have more political clout. I don't know how much this would affect residency training, though. But power is always nice to have.
     

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