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July 2019
Revenue
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Revenue by Region ?
The Midwest was a relatively consistent outlier for revenue performance by region in June. The region experienced the largest increase in Bad Debt and Charity over both prior year and budget. The Midwest’s NPSR per Adjusted Patient Day fell well below last year’s performance and budget, while NPSR per Adjusted Discharge for the region fell slightly below budget expectations and was mostly flat compared to prior year performance. Contributing to the Midwest’s mostly poor performance in June was an approximately -3 percent decline in IP/OP Adjustment Factor compared to prior year. The decline in the IP/OP Adjustment Factor year over year aligns with the decline in the region’s NPSR per Adjusted Patient Day over the same period.
NPSR per Adj. Discharge
NPSR per Adj. Patient Day
IP/OP
Bad Debt and Charity
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
National Revenue Observations
Revenue performance for June fell short of budget expectations, while performance over prior year and May was mixed. Revenue per unit of service for the month fell short of budget expectations and was mostly flat, with the exception of NPSR per Adjusted Discharge, which increased 2.6 percent over prior year. This is somewhat surprising and indicates that while NPSR declined at the pace of volume declines compared to May, NPSR growth outperformed volume declines compared to prior year. Once again, the IP/OP factor exceeded budget expectations but fell slightly short of prior month and prior year performance. Bad Debt and Charity increased both month over month and year over year.
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
NPSR per Adj. Discharge
(2.1%)
0.3%
2.6%
npsr_per_adj_discharge.svg
NPSR per Adj. Patient Day
(2.9%)
0.0%
0.4%
npsr_per_adj_patient_day.svg
IP/OP Adjustment Factor
2.7%
(1.0%)
(0.6%)
ip_op.svg
Bad Debt and Charity as a % of Gross
5.4%
6.7%
1.5%
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Unless noted, figures are Actuals and Medians
By Region
By Bed Size
National Observations
Revenue by Bed Size
Both year-over-year performance and performance relative to budget by bed-size cohort were mixed. NPSR per Adjusted Discharge and Adjusted Patient Day showed mostly positive year over year. However, the 26-99 bed-size cohort outperformed based on Adjusted Patient Day but underperformed based on Adjusted Discharge. Conversely, the 100-199 and 200-299 bed-size cohorts experienced the opposite phenomenon, with positive year-over-year performance per Adjusted Discharge and negative performance based on year-over-year Adjusted Patient Days. This may indicate that while revenue increases were in line or ahead of volume for these cohorts, the length of stay increased at a greater pace. Results in IP/OP Adjustment Factor show all bed-size cohorts increasing over budget in June, with no cohort performing better than an approximate 0.5 percent increase over prior year. Bad Debt and Charity increases were mostly unfavorable compared to prior year and mixed compared to budget expectations.
NPSR per Adj. Discharge
NPSR per Adj. Patient Day
IP/OP
Bad Debt and Charity
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
By Region
By Bed Size
National Observations
©2019 Kaufman, Hall & Associates, LLC
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