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February 2020
Revenue
Revenue by Region *
NPSR per Adjusted Discharge was down year over year and compared to budget in the Midwest, South, and Great Plains, with the Great Plains seeing the biggest drops of -3.6 percent year over year and -3.8 percent to budget. The Northeast/Mid-Atlantic was up slightly, 0.2 percent year over year, but -1.0 percent to budget, while the West was up 4.2 percent year over year and 1.5 percent to budget.
Four of five regions saw year-over-year increases in NPSR per Adjusted Patient Day, with the Midwest seeing the biggest rise of 4.1 percent. The Great Plains was the only region to see a year-over-year decrease at -2.3 percent, falling -9.7 percent below budget.
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
Bad Debt and Charity as a Percent of Gross increased year over year and to budget in the South, Great Plains, and West. The Northeast/Mid-Atlantic saw a 2.5 percent year-over-year increase, but was -15.8 percent below budget for Bad Debt and Charity care, while the Midwest saw a -4.2 percent year-over-year decrease, and was -5.3 percent below budget.
The IP/OP Adjustment Factor increased year over year and compared to budget for hospitals across all regions. However, while year-over-year results were clustered between 1.7 percent and 2.1 percent for most regions, the Great Plains was an outlier, jumping 5.0 percent year over year and 4.4 percent above budget.
National Revenue Observations
Revenue performance for January was mixed year over year, but declined across all metrics month over month. Net Patient Service Revenue (NPSR) per Adjusted Discharge saw no change year over year, but was down -1.2 percent month over month and slightly above budget at 0.2 percent. NPSR per Adjusted Patient Day rose 1.8 percent year over year, but fell -2.5 percent month over month and was -1.5 percent below budget expectations.
The Inpatient/Outpatient (IP/OP) Adjustment Factor saw a 2.1 percent increase compared to January 2019, but was down -0.4 percent compared to December 2019, and close to budget at 0.7 percent. Bad Debt and Charity as a Percent of Gross declined -0.4 percent year over year and -2.5 percent month over month, and was -2.0 percent below budget.
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
NPSR per Adj. Discharge
0.2%
(1.2%)
0.0%
npsr_per_adj_discharge.svg
NPSR per Adj. Patient Day
(1.5%)
(2.5%)
1.8%
npsr_per_adj_patient_day.svg
IP/OP Adjustment Factor
0.7%
(0.4%)
2.1%
ipop_adjustment_factor.svg
Bad Debt and Charity as a % of Gross
(2.0%)
(2.5%)
(0.4%)
bad_debt_and_charity.svg
Unless noted, figures are Actuals and Medians
Revenue by Bed Size
Hospitals in four of the six bed-size cohorts saw year-over-year increases in NPSR per Adjusted Discharge. The smaller hospital cohorts were the exceptions. Hospitals with 26-99 beds saw the biggest drop, with NPSR per Adjusted Discharge down -2.1 percent year over year and -7.0 percent to budget. Hospitals with 0-25 beds were down -0.7 percent year over year, but 6.5 percent above budget.
NPSR per Adjusted Patient Day rose year over year for most bed-size cohorts, with 200-299 bed hospitals seeing the biggest increase at 6.8 percent compared to January 2019. Hospitals with 300-499 beds were the only cohort to see a year-over-year decrease at -1.9 percent, falling -5.2 percent below budget.
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
All bed-size cohorts were up year over year for the IP/OP Adjustment Factor, with the smallest hospitals of 0-25 beds experiencing the biggest increase of 5.5 percent, up 5.0 percent to budget. Hospitals with 300-499 beds were up 1.9 percent year over year, but was the only cohort to fall below budget at -0.3 percent.
Bad Debt and Charity as a Percent of Gross was down year over year and below budget for hospitals with 0-25, 26-99, 300-499, and 500 or more beds. The smallest hospitals saw the biggest decrease of -9.1 percent. Hospitals with 100-199 beds saw a 6.3 percent year-over-year increase, but fell -1.7 percent below budget, while hospitals with 200-299 beds were up 9.9 percent year over year and 9.6 percent above budget.
©2020 Kaufman, Hall & Associates, LLC
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