Becker's Hospital Review

21 CFO / FINANCE 20 largest healthcare companies in the world for 2021 By Alia Paavola F orbes in May released its 19th an- nual list of the 2,000 largest public companies in the world, with 20 healthcare companies in the top 200. For the list, Forbes ranked companies using a composite score of market val- ue, sales, profits and assets during the 12 months ended April 16. e Industrial and Commercial Bank of China was the No. 1 company on the list in 2021, with $4.9 trillion in assets. Here are the 20 biggest publicly traded companies in the healthcare industry ac- companied by their ranking: 21. UnitedHealth Group 34. Johnson & Johnson 37. CVS Health 53. Cigna 58. Pfizer 60. Roche 65. Novartis 72. Sanofi 74. AbbVie 84. Merck 89. Anthem 97. GlaxoSmithKline 121. Abbott Laboratories 124. ermo Fisher Scientific 131. Medtronic 150. Amgen 161. AstraZeneca 186. Eli Lilly 192. HCA Healthcare 195. Takeda Pharmaceuticals n Kansas hospital closes all inpatient beds, ER By Morgan Haefner C ommunity HealthCare System on June 4 closed the emergency room and all inpatient beds at its hospital facility in St. Marys, Kan. The health system's board of directors voted to close the services April 23. Todd Willert, CEO of Community HealthCare, said in an April 27 news release that the decision came after a decline in hospital and emergency service use and difficulty recruiting staff over the last several years. Additionally, the hospital's in- frastructure, including call light and telemetry systems, needs updates that aren't feasible for the financially strapped system, he said. The hospital's clinic remains open, and physical, occupational and speech thera- py, X-ray, laboratory and home health services and others are still available. Community HealthCare, based in Onaga, Kan., is licensed for a 25-bed critical access hospital, with eight of the beds being at St. Marys and the rest at Onaga Community Hospital. Six staff positions were eliminated because of the closure. Affected staff can apply for other positions within CommunityHealthCare. n Private equity-acquired hospitals saw higher margins, study finds By Alia Paavola H ospitals acquired by private equity firms had higher charge-to-cost ratios and higher operating margins than those not owned by a private equity firm, according to a study published May 3 in Health Affairs. For the study, researchers identified private equity transactions compiled by market intelligence firm Pitchbook and used data from the CMS provider cost reporting information system or the American Hospital Association annual sur- vey. The researchers sought to compare the financial and operational differenc- es between private equity-backed hospitals and facilities not backed by private equity from 2003 to 2017. Five takeaways from the study: 1. A total of 42 private equity deals occurred during the study period, including 282 unique hospitals across 36 states. 2. Hospitals that were acquired by private equity firms had larger bed sizes, more discharges and more full-time equivalent staff positions in 2003 relative to hospi- tals that were not acquired by private equity firms. 3. Private equity-acquired hospitals also had higher charge-to-cost ratios. In 2003, the charge-to-cost ratio for private equity-acquired hospitals was 3.8, and for hospitals not acquired by private equity, the ratio was 3.1. By 2017, the charge-to-cost ratio rose for private equity-owned hospitals to 7.7, and rose to 4.8 for facilities not owned by private equity. 4. Private equity-owned hospitals also had higher operating margins. In 2013, private equity-owned hospitals had a 4.4 percent operating margin, whereas non-acquired facilities had a minus 1.2 percent margin. In 2017, private equi- ty-owned hospitals saw a 7.4 percent margin versus minus 1.2 percent for hospi- tals that were not backed by private equity. 5. "These findings certainly invite further examination of differences between hospital markets and the extent to which hospital operations are affected by the anticipation of private equity acquisition," the study authors said. n

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