Becker's Hospital Review

20 CFO / FINANCE Las Vegas hospital doesn't contract with any payers By Morgan Haefner E lite Medical Center, a Las Vegas-based acute care hospital that some experts say is operating similarly to a 24/7 freestand- ing emergency room, doesn't contract with any payers, according to the Milbank News. EMC is a state-licensed hospital. It is an un- accredited hospital that has no agreements with insurers, meaning patients have to pay out-of-network prices for care. Under state law, EMC isn't required to be accredited by CMS or accept public or private insurance. On EMC's website, the medical center states, "is facility is not a participating provider in any health benefit plan provider network. However, under the [ACA], your health in- surance company is required to process your emergency visit at in-network benefit lev- els. e physician providing medical care at this facility may bill separately from the fa- cility for the medical care provided to you." While Nevada doesn't provide licenses for freestanding ERs — though hospitals can open satellite ERs at other locations — EMC obtained a state license to operate as a hos- pital. As a result, it has to be able to admit patients for 48 hours. Bill Welch, president and CEO of the Neva- da Hospital Association, told Milbank News: "We think that Elite Medical Center, if they want to operate as a hospital in the state, that they should operate as a CMS-certi- fied center and they should be accredited and Medicare participating. Without those things, we're concerned." EMC CEO Butch Frazier defended the hospi- tal in an emailed statement to the publication, saying it oen has higher online patient ratings than University Medical Center in Las Vegas. "EMC tries hard to make sure that the ulti- mate charges paid by the patients and by the insurers to EMC are in line with what they are paying for the same services at other hospitals in the area," Mr. Frazier said. He added that EMC is seeking CMS accreditation. n Activist investor targets HCA: 5 things to know By Ayla Ellison A n activist investor is urging HCA Healthcare's corporate governance committee chairwoman to help pass a propos- al that would get rid of the company's supermajority voting requirements, according to the Nashville Business Journal. Five things to know: 1. The supermajority voting rule requires affirmative votes by the owners of 75 percent of HCA's shares to make changes related to certain matters, such as the size of the board, according to Nash- ville, Tenn.-based HCA's proxy statement. 2. In a filing with the Securities and Exchange Commission, activ- ist investor John Chevedden says the proposal brought by share- holders to eliminate the supermajority voting rule is the most important proposal on the ballot at the company's upcoming annual meeting because it is the only item that may not obtain the necessary votes. "Due to the antiquated corporate governance of HCA Holdings, Proposal 4 needs 75 percent of the vote from every last forgotten share of HCA stock in the attic," Mr. Chevedden said in the SEC filing. "A share that is not voted is the same as a share that votes against." 3. A similar shareholder proposal failed in 2017. It received 72 per- cent of the vote, when a 75 percent approval vote was needed. 4. While some activist investors are solely focused on maximizing shareholder value, that is not the case with Mr. Chevedden, ac- cording to the Nashville Business Journal. He pushes for better corporate governance. 5. In its proxy statement, HCA's board explained the poten- tial benefits of supermajority voting rules, but ultimately asked shareholders to ax the requirements. n UnitedHealth posts $3.5B profit in Q1 By Morgan Haefner U nitedHealth Group recorded strong fi- nancial results in the first quarter of fis- cal year 2019, ending the period with a $3.5 billion profit. The company recorded revenues of $60.3 bil- lion for the three months ended March 31, up 9.3 percent from $55.2 billion reported in the same period a year earlier. Revenue gains were led by growth across its UnitedHealthcare Medicare and Retirement, OptumRx, and OptumHealth lines. The company's health insurance arm, United- Healthcare, added 880,000 members in the past year. This helped increase the unit's first-quarter revenue by $3.4 billion to $48.9 billion. UnitedHealth's Optum unit continued to be a sig- nificant source of revenue growth for the com- pany. Optum's revenue climbed by 11.7 percent year over year to $26.4 billion in the first quarter of this year, up from $23.6 billion recorded in the same quarter a year prior. Overall, UnitedHealth saw its operating expenses increase year over year to $55.5 billion in the first quarter of this year, up 8.5 percent year over year from $51.1 billion. UnitedHealth ended the first quarter with net earnings attributable to shareholders of $3.5 bil- lion, up 22 percent from a profit of $2.8 billion re- ported in the first quarter of 2018. n

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