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June 2019
Revenue
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Revenue by Region ?
Net Patient Service Revenue (NPSR) for Adjusted Discharges and Adjusted Patient Days showed year-over-year increases for all regions. In contrast, Bad Debt and Charity as a Percent of Gross Revenue was mixed—up year over year in the South and West regions, and also above budget in the West. For the Great Plains, Northeast/Mid-Atlantic, and Midwest regions, it is notable that all were under budget and down year over year for Bad Debt and Charity. All regions showed IP/OP Adjustment Factors exceeding budget, but year-over-year performance for this indicator was mixed.
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 indicators continued mixed performance in May. Revenue per-unit of service for the month fell short of budget expectations, despite growth in Adjusted Discharges and Adjusted Patient Days. With Adjusted Discharges up 3.6 percent compared to budget, lower-cost outpatient volume growth appears to temper the per-unit revenue growth relative to budgets. Once again, the Inpatient/Outpatient (IP/OP) Adjustment Factor exceeded expectations and was up slightly compared to April’s performance. This indicates that the trend of outpatient volume increases continues, and is growing faster than expected. Bad Debt and Charity was variable, increasing only slightly month over month, but down -4.5 percent year over year and -2.4 percent compared to budget.
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
NPSR per Adj. Discharge
(2.4%)
(0.5%)
3.6%
npsr_per_adj_discharge.svg
NPSR per Adj. Patient Day
(3.2%)
(0.6%)
2.2%
npsr_per_adj_patient_day.svg
IP/OP Adjustment Factor
3.3%
0.6%
0.1%
ip_op.svg
Bad Debt and Charity as a % of Gross
(2.4%)
0.7%
(4.5%)
bad_debt.svg
Unless noted, figures are Actuals and Medians
By Region
By Bed Size
National Observations
Revenue by Bed Size
Most bed-size cohorts showed positive year-over-year performance for NPSR per Adjusted Discharge. Large hospitals with 500 beds or more, and mid-sized hospitals with 100-199 beds were the exceptions, with NPSR per Adjusted Discharge essentially flat year over year. Only 300-499 bed-size institutions demonstrated performance positive to budget for this metric. NPSR per Adjusted Patient Days were below budgets for all bed-size cohorts in May. The IP/OP Adjustment Factor was above budget for all bed-size cohorts, but was down for most regions year over year. Bad Debt and Charity as a Percent of Gross performance was mixed by bed-size cohorts. Hospitals with 0-25 beds, 100-199 beds, 200-299 beds, and more than 500 beds all saw Bad Debt and Charity care decrease year over year, and perform below budget expectations. Hospitals with 26-99 beds were the only cohort to see above-budget performance for Bad Debt and Charity care.
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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