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June 2020
Revenue by Region *
Net Patient Service Revenue (NPSR) per Adjusted Discharge was up year-over-year and to budget across all regions for the month. Hospitals in the Northeast/Mid-Atlantic saw the biggest increases, up 18% year-over-year and 13% above budget for this metric due to the large volume losses experienced.
All regions also were up year-over-year for NPSR per Adjusted Patient Day, but two regions fell below budget while three regions were at or above budget. Hospitals in the Midwest had the greatest year-over-year increase of 10%, while those in the Great Plains had the biggest increase to budget at 6%.
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 was down year-over-year and compared to budget in the West, Great Plains, and South. The Northeast/Mid-Atlantic was essentially flat for this metric year-over-year, but fell 11% below budget, while the Midwest jumped 28% both year-over-year and to budget.
All regions saw declines year-over-year and compared to budget for the IP/OP Adjustment Factor. The Northeast/Mid-Atlantic and Midwest saw the greatest decreases, with both regions down about 14% year-over-year and 13% below budget.
National Revenue Observations
Most revenue metrics continued to fall below budget and below prior year performance for hospitals nationwide, but increased month-over-month. Total Gross Revenue was up 29% compared to April, but down 14% compared to May 2019 and 16% below budget.
Outpatient Revenue saw the largest increase, up 39% month-over-month, but down 27% year-over-year and 28% below budget. Inpatient Revenue rose 19% month-over-month, but fell 12% year-over-year and 17% below budget.
The Inpatient/Outpatient (IP/OP) Adjustment Factor decreased 9% compared to the same period last year and fell 8% below budget, but rose 8% compared to April, as outpatient volumes slowly began to recover. Bad Debt and Charity as a Percent of Gross rose just 2% year-over-year, but fell 1% month-over-month and 6% below budget expectations.
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Total Gross Revenue
IP Revenue
OP Revenue
Bad Debt and Charity
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt and Charity as a % of Gross
Unless noted, figures are Actuals and Medians
Revenue by Bed Size
Looking at hospitals by size, five of six bed-size cohorts were up year-over-year and compared to budget for NPSR per Adjusted Discharge. Hospitals with 100-199 beds saw the biggest increases, up 14% year-over-year and 9% above budget. Smaller hospitals with 26-99 beds were an outlier, with NPSR per Adjusted Discharge up 7% year-over-year but falling 2% below budget.
NPSR per Adjusted Patient Day was up year-over-year across all six bed-size cohorts, but was below budget for three cohorts and above budget for the other three. The smallest hospitals of 0-25 beds had the biggest year-over-year increase of 6%, but was 3% below budget. Hospitals with 26-99 beds had the greatest variance to budget, falling 7% below budget, but up 3% year-over-year.
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
The IP/OP Adjustment Factor fell year-over-year and compared to budget across all bed-size cohorts. Hospitals with 100-199 and 200-299 beds saw the greatest year-over-year decreases of 11%. Hospitals with 200-299 beds also saw the greatest budget variance, at 9% below budget.
Bad Debt and Charity as a Percent of Gross rose year-over-year in five of six bed-size cohorts. The largest hospitals with 500 beds or more saw the greatest year-over-year increase at 13%, but also fell 13% below budget. Hospitals with 0-25 beds were the only cohort to see a year-over-year decrease at 30%, and fell 32% below budget.
©2020 Kaufman, Hall & Associates, LLC
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