Most profitable hospitals

[nimbus]

Interesting list. For residents coming out, it matters where you end up. It can mean the difference between have the support and supplies you need vs hanging high and dry.

http://www.modernhealthcare.com/article/20160502/NEWS/160509991

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[Ignatius J]

I've noticed an inverse relationship between most profitable and most equipped. Yeah, that hospital doesn't make money by buying you fancy stuff.

 

[gasdoc77]

I've noticed an inverse relationship between most profitable and most equipped. Yeah, that hospital doesn't make money by buying you fancy stuff.

I would take this a step farther and say that your less profitable community hospitals may have a CEO that is an older former physician there (maybe semi-retired) and is supportive of his/her medical staff, while the most successful "for profit" and "non-profit" hospitals are run by cut-throat MBA's who see healthcare through a lens of metrics alone: financial metrics first and foremost.

 

[caligas]

If the hospital is making money, it's because it is run by cut-throat tight wads. If they are losing money, it will soon be run by cut-throat tight wads.

So you're screwed either way.

 

[nimbus]

There are several hospitals on the list in my community. For the most part they are the ones with brand new towers, video moniters, robots, cappuccino machines, etc. They also outpay and poach the best, most experienced ancillary staff.

 

[G-Man82]

There's one community hospital that I recognize because I cover it remotely. I wouldn't send my worst enemy there.


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[secants]

Coney island hopsital? You have to be joking, not even imgs want to match there...

 

[GravelRider]

Yeah, seeing Coney Island hospital on this list seemed fishy.

A quick google search: http://nypost.com/2016/03/04/hospital-execs-ousted-after-e-r-patients-controversial-death/

Apparently, by June 30 they "will be $65 million “in the red...Problems range from insect infestations to patient overcrowding, that source said." I guess their run at brief glory will come to an end.

 

[nimbus]

Yeah, seeing Coney Island hospital on this list seemed fishy.

A quick google search: http://nypost.com/2016/03/04/hospital-execs-ousted-after-e-r-patients-controversial-death/

Apparently, by June 30 they "will be $65 million “in the red...Problems range from insect infestations to patient overcrowding, that source said." I guess their run at brief glory will come to an end.

The list is a little dated, from 2013. Things have changed.

But the point is if you are working at or take a job at a facility that is chronically in the red year to year, things are going to be ugly.

 

[pjl]

Ha, I interviewed at 4 of the places on that list. 3/4 had no lack of resources given back toward buying of equipment/wages, the fourth was "average." All were decent places for care.
Just for the sake of dispelling internet fallacy, I can tell you for certain the numbers are low for at least one institution on that list.

I can imagine how a place could join that list in the short term by limiting the resources steered towards care, but you dont remain there for long with that strategy. Better than average care requires better than average people, and those dont stay without some sort of incentive. Unless you have a captive audience you need a better than average level of care to achieve better than average profits over the long term.

To say that is not to say that a better level of care always earns a higher profit, I dont believe that for a second. There are plenty of low profit places that are providing great care.

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[Ezekiel2517]

If the hospital is making money, it's because it is run by cut-throat tight wads. If they are losing money, it will soon be run by cut-throat tight wads.

So you're screwed either way.

Guess you gotta look at each place individually. Maybe some of these places are just smart. Stanford isn't managed by a bunch of cheapo's. Also weird not seeing CCF on this list. It seems like every year I see some article about how they made a billion dollars that year. Absolutely beautiful hospital too with all the goodies. First time I've seen a portable CT scanner is when I visited CCF, I was kinda blown away.

 

[Random Anesthesiologist]

I know one of those hospitals turfs a lot of really sick Medicaid/Medicare patients to the academic centers in the region.

 

[Mman]

Better than average care requires better than average people, and those dont stay without some sort of incentive. Unless you have a captive audience you need a better than average level of care to achieve better than average profits over the long term.

I'd say the only things that matter in terms of hospital profitability are payor mix, patient mix (surgeries vs medicine admissions, length of stay, etc), and conservative fiscal planning. Quality of care is a minor component at best IMHO. Show me a hospital in a ritzy suburb with a busy surgical service and I'll show you a hospital raking in the cash.

 

[pjl]

I'd say the only things that matter in terms of hospital profitability are payor mix, patient mix (surgeries vs medicine admissions, length of stay, etc), and conservative fiscal planning. Quality of care is a minor component at best IMHO. Show me a hospital in a ritzy suburb with a busy surgical service and I'll show you a hospital raking in the cash.

But show me a hospital that is in a ritzy suburb providing crap care for 5-10 years that is not losing market share. You have to have good care to remain on that list is my only point.
Maybe I am completely wrong though, and some of those places have been around forever, treating people poorly, but for some reason continue to excel financially. Not the case with the ones on that list that I saw, but maybe some of the others.


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[Man o War]

I have friends/former classmates who work at 3 of the hospitals on this list and they are all making 90% plus MGMA. Very generous subsidies.

 

[GravelRider]

But show me a hospital that is in a ritzy suburb providing crap care for 5-10 years that is not losing market share. You have to have good care to remain on that list is my only point.
Maybe I am completely wrong though, and some of those places have been around forever, treating people poorly, but for some reason continue to excel financially. Not the case with the ones on that list that I saw, but maybe some of the others.


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Most of the hospitals I know that are like that cherry pick. Any patient remotely sick or complicated gets turfed to your local city academic institution. They also turf the no insurance or bad insurance to the academic places...I've seen that a number of times. It's a lot easier to provide "good care" to a compliant population that is well-off and has a good support structure in the community.

 

[Mman]

But show me a hospital that is in a ritzy suburb providing crap care for 5-10 years that is not losing market share. You have to have good care to remain on that list is my only point.
Maybe I am completely wrong though, and some of those places have been around forever, treating people poorly, but for some reason continue to excel financially. Not the case with the ones on that list that I saw, but maybe some of the others.


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1) how do you measure "crap care"?
2) how much are the outcomes you measured influenced by taking care of a healthier population?


If I give you a hospital in a ritzy area with insured patients, those patients are probably far healthier to start with than most and hence any measure of outcomes will find they are providing better care. Risk adjusting accurately is almost impossible at the health system level.