Weird day today. Since I’m doing research, I’ve been handed some light assignments, such as press releases, and what I got was one from Altru Health System about the "recently compiled" 2008 annual report.
I don’t know when that report came out, but the audited financial statements, which is different than the glossy annual report and usually comes out after, is dated April 20. We use to have the manpower to keep track of these things, but not these days.
Anyway, even though the press release lead with the fact that there was this annual report that just came out, it spent the next six paragraphs assiduously avoiding the topic of revenues and expenses, focusing, instead on the $23 million spent on "community benefit programs," mostly in the form of charity care.
I mentioned that in my story, but I really had to focus on the bottom line and it didn’t look so hot, though that had to be expected. Look at page 20 in the audited financial statements and you’ll get these numbers:
| 2008 | 2007 | |
|---|---|---|
| Revenues | $373,928,274 | $353,110,842 |
| Expenses | $380,600,644 | $358,581,535 |
| Operational losses | -$6,672,370 | -$5,470,693 |
|
Investment income and other financial activities |
$3,018,759 | $5,636,559 |
| Profit/loss | -$3,653,611 | $165,866 |
Revenues went up 5.9 percent and expenses went up 6.1 percent. Altru was admitting more patients and doing more procedures. Go to page 8 of the annual report and you’ll see this:
| 2008 | 2007 | |
|---|---|---|
| Inpatient | 12,830 | 12,287 |
| Outpatient | 267,901 | 262,568 |
| Total patients | 280,731 | 274,855 |
| Patient days | 52,719 | 50,809 |
| Patient days per patient | 0.19 | 0.18 |
| Total RVUs | 1,698,354 | 1,604,512 |
| RVUs per patient | 6.05 | 5.84 |
You can see the total number of patients went up 2.1 percent.
By the way, an RVU is a relative value unit, which is just a way to compare one procedure to another for purposes of determining how much to charge for each procedure. I’m totally making this up, but, it’s like 1 RVU for "take an aspirin and call me in the morning" and 100 RVUs for a heart bypass.
I’m not sure how much caring for more patients affects the whole charity care angle, but, it you do the math, you can see that every dollar in expenses fetched 98.2 cents in revenue in 2008 where in 2007 it was more like 98.5 cents.
While I’m at it, let me take a peek at how MeritCare in Fargo did. Here’s the annual report:
| 2008 | 2007 | |
|---|---|---|
| Revenues | $819,228,000 | $757,240,000 |
| Expenses | $830,455,000 | $737,193,000 |
| Operational losses/profits | -$11,227,000 | $20,047,000 |
| Transfers from restricted assets | $1,062,000 | $1,417,000 |
| Profit/loss | -$10,165,000 | $21,464,000 |
I don’t know what the transfers mean. Perhaps they’re somewhat comparable to the investments that Altru uses. Like Altru, revenues and and expenses went up, but at a faster rate. Revenues were up 8.2 percent while expenses were up 12.7 percent. The difference between the rate of increase of the two are higher than Altru’s (5.9 and 6.1 percent, respectively).
Now look at the patient report for MeritCare (Note the data is not as detailed as :
| 2008 | 2007 | |
|---|---|---|
| Hospital admissions | 26,638 | 25,867 |
| Clinic appointments | 1,422,180 | 1,300,633 |
| Total admissions | 1,448,818 | 1,326,500 |
You can see total admissions went up 9.2 percent, as befitting the biggest hospital in the fastest growing city in the state.
Like Altru, MeritCare had to provide community benefits, which totaled $61.1 million in 2008, up 22.5 percent over 2007.
I wonder if they count bad debts as charity care.
So goes our shitty health care system.