Becker's Hospital Review

14 CFO / FINANCE Zuckerberg hospital slashes $20,243 ER bill to $200 after media coverage By Morgan Haefner Z uckerberg San Francisco Gen- eral Hospital will lower a pa- tient's $20,243 emergency room bill after a Vox Media report re- vealed the hospital is out of network with all private health plans. Five things to know: 1. In early January, Vox reported pri- vately insured patients were being charged tens of thousands of dollars for ER services at Zuckerberg through balance billing. 2. One patient, Nina Dang, who suf- fered a bike accident and was trans- ported by ambulance to the hospi- tal's ER, was billed $20,243. Her care may have cost much less at other hos- pitals because Zuckerberg doesn't have any in-network contracts with private payers. 3. Following the Vox report, Zucker- berg hospital lowered Ms. Dang's bill to $200 to match her health plan's regular copayment for emergency care. In addition, the San Francisco Board of Supervisors, which oversees Zuckerberg hospital, will hold hear- ings on the hospital's billing practices. 4. Zuckerberg hospital did not tell Vox whether it will change its network pol- icies with private payers. A hospital spokesperson told the publication in an email, "We are focused on reduc- ing the number of people [like Ms. Dang] who could be in this predica- ment, through a variety of methods, including our own practices, insur- ance payments, and policy solutions." 5. Zuckerberg hospital — which un- derwent a name change after Face- book founder Mark Zuckerberg and his wife Priscilla Chan, MD, donat- ed $75 million to the hospital — is the city's largest public hospital and houses San Francisco's only top-tier trauma center. n HCA more than doubles profit in Q4 By Ayla Ellison N ashville, Tenn.-based HCA Healthcare's revenue and profit increased year over year in the fourth quarter of 2018. Five things to know: 1. HCA said revenues increased 6.2 percent year over year to $12.3 billion in the fourth quarter of 2018. The growth was partially attributable to higher patient volume. HCA said same-facility admissions increased 1.9 percent year over year. 2. HCA's earnings took a $31 million hit from Hurricane Michael in the fourth quarter of 2018. The company also recorded a benefit of $49 million from insur- ance recovery related to Hurricane Harvey. 3. The company's operating expenses totaled $9.8 billion in the fourth quarter of 2018, up from $9.2 billion in the same period of 2017. 4. After factoring in nonoperating income, one-time charges and a tax benefit of $236 million, HCA ended the fourth quarter of 2018 with a $1.1 billion profit. That's compared to the fourth quarter of 2017, when the company recorded a profit of $474 million. 5. Looking at full-year 2018 results, HCA recorded a profit of $3.8 billion on rev- enue of $46.7 billion. In 2017, HCA reported a profit of $2.2 billion on revenue of $43.6 billion. n UnitedHealth's Optum revenues surpass $100B for 1st time By Morgan Haefner G rowth in UnitedHealth Group's health services business Optum helped the health insurance company beat Wall Street estimates for the fourth quarter ended Dec. 31, according to Reuters. Five things to know: 1. Revenues for Optum, which is UnitedHealth's fastest-growing unit and includes an in- house pharmacy benefits manager, topped $100 billion for the first time in the year ended Dec. 31. Optum revenues grew by 11.1 percent year over year to $101.3 billion, the company said Jan. 15. 2. While Optum may face heightened competition this year aer Aetna and Cigna scored deals with large benefit managers, Piper Jaffray analyst Sarah James told Reuters: "We view [the Optum results] as a positive sign given the increasingly competitive nature of the phar- macy benefits management market. We believe 2019 could be a big year at OptumHealth ... and see potential for specialty [drugs] to double earnings by 2021." 3. For the fourth quarter, the country's largest health insurer posted $27.56 billion in revenues from its Optum unit, up 13 percent year over year. 4. Still, UnitedHealth's medical care ratio — or the amount of premiums used to cover med- ical expenses compared to overhead costs — fell short of expectations at 82.2 percent, ac- cording to Reuters. Higher costs in UnitedHealth's government-sponsored Medicaid business were partially to blame, analysts told the publication. 5. UnitedHealth's insurance business, UnitedHealthcare, increased sales by 11.1 percent in the fourth quarter, for a total of $46.2 billion. Net earnings to shareholders fell 16 percent to $3 billion in the fourth quarter, compared to $3.6 billion a year prior. n

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