Becker's Hospital Review

35 CFO / FINANCE 10 states with the most rural hospitals at high financial risk By Kelly Gooch M ississippi is the state with the most rural hospi- tals at high financial risk, according to an analy- sis from management consultancy Navigant. The analysis — which examined the financial viability (operating margin, days cash on hand and debt-to-cap- italization ratio) and community essentiality of more than 2,000 of the nation's rural hospitals — suggests 21 percent or 430 rural hospitals in 43 states are at high risk of closing. Here are the 10 states with the most rural hospitals at high financial risk, based on the analysis: 1. Mississippi — 31 2. Kansas — 29 3. Georgia — 26 4. Alabama — 21 5. Minnesota — 19 6. Michigan — 18 7. Arkansas — 18 8. Iowa — 17 9. Oklahoma — 17 10. Kentucky — 16 n Dignity Health reports $33M operating loss in most recent quarter By Morgan Haefner S an Francisco-based Dignity Health, now part of Com- monSpirit Health with Catholic Health Initiatives in En- glewood, Colo., posted an operating loss in the quarter ended Dec. 31. For the three-month period, Dignity Health recorded an op- erating loss of $33 million, according to unaudited financial documents. That's compared to an operating gain of $470 million in the same period a year prior. Dignity Health said the change was related to California's provider fee programs. In the most recent quarter, the health system recognized net provider fee income of $108 million, down from $441 million in the same quarter a year prior. A $744 million year-over-year dip in patient and premium revenue also affected Dignity Health's results in the most recent quarter. The health system posted total unrestricted revenues of $3.4 billion in the three months ended Dec. 31, down 18 percent from $4.2 billion during the same period a year prior. At the same time, expenses fell 6.9 percent year over year to $3.4 billion in the most recent quarter. A $269 million invest- ment loss also affected the health system's bottom line in the most recent quarter. Dignity Health recorded a $318 million net loss in the three months ended Dec. 31, compared to net income of $609 million in the same period a year prior. In combination with Catholic Health Initiatives, the two organi- zations reported $29.2 billion in revenues in fiscal year 2018. n Patient cost largely unrelated to procedure price or insurance coverage, study finds By Morgan Haefner L ittle correlation exists between what a pa- tient pays for a service and the amount an insurer pays or the overall price of a procedure, according to a new study from right-leaning think tank Pioneer Institute. e study, which examines data from the Massachusetts Center for Health Informa- tion and Analysis and its all-payer claims database, analyzed the cost of knee MRIs at 14 Massachusetts hospitals in May 2015. Researchers found the total price of a knee MRI without contrast, which included insurance payment and patient contribu- tion, ranged from $1,423 at Boston Chil- dren's Hospital to $476 at Worcester-based St. Vincent's Hospital. At the same time, patient out-of-pocket prices ranged from $206 at South Shore Hospital in South Weymouth to $55 at Cambridge-based Mt. Auburn Hospital. Insurer payments var- ied from $1,236 at Children's to $352 at New England Baptist Hospital in Boston. "Even though patients paid $55 for an MRI at Mt. Auburn Hospital and $206 at South Shore, the total price of the procedure was very similar at the two hospitals," the re- searchers said. "New England Baptist patients paid about 30 percent of the price of the MRI, while patients at Tus New England Medical Center [in Boston] and Mt. Auburn paid less than 10 percent of the total." e study authors suggested linking trans- parency with financial incentives for con- sumers to select high-value providers with the lowest cost. n

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