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Grim future seen for Tenet and CHS

October 30, 2017by Robert Whitcomb in Uncategorized tagged Community Health Systems

— Photo by Anthony22 at en.wikipedia

Bloomberg News reports:

“President Donald Trump has slammed health insurers for the ‘fortunes’ they’ve made under Obamacare. For hospitals, the law hasn’t delivered the same sort of returns.

“Insurance stocks have almost tripled in value since the health law took full effect in 2013, helped by an expanding economy and growing demand for care for seniors. But those forces haven’t helped hospitals. A Bloomberg index of U.S. hospital stocks is near its lowest level in four years and the prognosis is grim for two of the largest for-profit chains.

“Tenet Healthcare Corp. and Community Health Systems Inc. {CHS},  which run or lease a total of more than 200 hospitals and employ more than 250,000 people around the U.S., have seen their shares plunge almost 40 percent in the past year. Both are mired in debt, with restless shareholders pushing for changes.”

To read more, please hit this link.


Fitch sees Feds as greatest threat to for-profit hospitals’ earnings

October 2, 2017by Robert Whitcomb in Uncategorized tagged Community Health Systems, HCA Healthcare, high-deductible health plans, hospital revenues, LifePoint Health, Tenet Healthcare and Universal Health Services, Tom Price

Healthcare Dive looked at the future of for-profit hospitals in light of a Fitch Ratings analysis of the sector.

The news service wrote:

“After reviewing the finances of Community Health Systems, HCA Healthcare, LifePoint Health, Tenet Healthcare and Universal Health Services, Fitch Ratings said federal and state government policy decisions — which are often politicized — create an unpredictable environment. Federal regulations and political decisions are the biggest risks to the industry’s operating profile, with 30%-40% of hospital revenues coming from Medicare and Medicaid, according to the report.”

“This is a concern for providers now, as HHS has proposed scaling back or eliminating some mandatory bundled payment models. The agency has pushed for deregulation, which can have a variety of effects but is forcing some hospitals to alter their course for transitioning to value-based payment models. The bundled payment decision and other proposals have angered some providers but also relieved others. With Tom Price out as HHS secretary, however, regulatory changes may slow down.”

“Fitch said hospital revenues are also affected by consumer finances through high-deductible health plans (HDHP) and health savings accounts. Insurers and employers have been able to slow premium increases by using HDHPs, but these plans have also saddled members with more out-of-pocket costs.”

To read more, please hit this link.


Moody’s see stable finances for for-profit hospitals

September 25, 2017by Robert Whitcomb in Uncategorized tagged CMS, Community Health Systems, Quorum Health, uncompensated care

Moody’s Investors Service sees the financial outlook for U.S. for-profit hospitals as stable.

Key to this forecast is the expectation that outpatient services will drive revenue and earnings growth. The ratings company sees outpatient service growth fueling a 2.5-3 percent earnings growth for for-profit hospitals over the next 18 months as much of American healthcare, under pressure from consumers and public and private insurers, seeks lower-cost settings. At the same time, Moody’s predicted,  higher patient costs and an increase in the number of uninsured Americans may lead to more bad debt for hospitals.

Moody’s noted that patients with high-deductible health plans will seek less costly settings than hospitals to save money. Also, the company said, the CMS’s proposal to let more orthopedic procedures be done on an outpatient basis could do more financial damage to hospitals.

Moody’s warned:

“Higher patient responsibility and fewer insured patients will lead to lower volumes, but also higher costs of uncompensated care. Even with strong cost controls, given the high fixed costs of operating hospitals, it will be difficult to expand margins in an environment of weak patient volumes and rising bad debt expense. At the same time, nursing shortages and rising fees associated with medical specialists (including outsourced emergency departments) will also pressure margins.’’

Still, profit margins of some for-profit systems may well widen in the coming months, Moody’s said. citing Quorum Health and Community Health Systems (CHS) benefiting from selling off less profitable facilities and LifePoint Health and HCA Healthcare improving efficiencies at recently acquired facilities.

Moody’s expects for-profit hospitals in Texas and Florida will recover quickly from losses associated with recent hurricane damage.

To read more, please hit this link.

 


After chains’ debt-fueled buying spree, some hospitals are left dirty and patients overcharged

June 5, 2017by Robert Whitcomb in Uncategorized tagged Community Health Systems, hospital chains, Lower Keys Medical Center, Lutheran Health Network, Sheryl Skolnick

Looks nice from the outside: Lower Keys Medical Center, owned by hugely indebted Community Health Systems and scene of patient overcharging.

Physicians are blaming the hospital takeover boom, which has been fueled by massive debt, for some leading hospitals to become dirty and dingy. A Bloomberg piece looks at for-profit Community Health System’s (CHS) neglect of an Indiana health system, Lutheran Health Network, and overcharged patients at CHS’s Lower Keys Medical Center, in Key West, Fla., as examples of the tendency to slash quality and raise prices to dig out of the debt hole.

For-profit hospital chains such Community have borrowed billions to buy up rivals and have been facing massive debt repayment challenges  just as the revenue benefits of the Affordable Care Act have waned.

Bloomberg noted: “Once the biggest U.S. for-profit hospital chain, Community is selling off other, poorly performing facilities to pay off $2 billion of its $15 billion in debt. Yet even as the company skimps on spending and patient satisfaction lags at key facilities  its bonds are rising in value — an indication that debt holders are betting that the chain will make a financial turnaround.”

Still, “If the chain can’t subdue the unrest at its most profitable locations, it’s not clear how successful the turnaround will be. Indiana and Key West represent just nine of Community’s about 150 hospitals, yet they contribute an estimated 16 percent of the company’s adjusted earnings before interest, taxes, depreciation and amortization,”  Mizuho Securities analyst Sheryl Skolnick told Bloomberg.

To read  the article, please hit this link.

 


Hospitals that overcharge can’t be shamed

October 24, 2016by Robert Whitcomb in Uncategorized tagged Community Health Systems, Hospital Corporation of America, Karoline Mortensen, Rick Scott

rodin

“Eve {Shamed} After the Fall,” by Rodin.

Overcharging of hospital patients and insurers, overwhelmingly concentrated in the for-profit sector, continues apace, with “shaming” not working, reports HealthcareDive and The Washington Post.

The news service referenced a  study last year  that outed 50 hospitals that were charging patients more than 10 times the actual cost of care, compared to the typical 3.4 times the cost of care markup.

With 20 of those hospitals  in Florida (perhaps the national epicenter of Medicare fraud),  a separate  study this year by researchers at the University of Miami looked into whether those Sunshine State hospitals lowered their prices in response to public pressure.

The study found that charges were  higher overall after the publicity. Good news for shareholders of  such hospital companies as HCA if not for patients and insurers!

HealthcareDave wrote: “The findings indicate any impacts from price shaming are fleeting and provide no controls over hospitals, which leaves them accountable to no one, study author Karoline Mortensen told The Washington Post.

“The study raises questions about how effective efforts toward price transparency will ultimately be if many hospitals don’t mind reputations for high costs due to factors including lack of competition, and lack of price regulation in all states but Maryland and West Virginia.”

“The hospitals may also be counting on patients to maintain an assumption that higher prices are tied to better care, but the study found the opposite to be true, concluding 20 hospitals studied were actually less likely than other Florida hospitals to earn three or more stars in CMS’s quality metrics system.”

Of the 20 Florida hospitals,  one was a nonprofit and the rest were part of the Hospital Corporation of America (HCA) system or linked with Community Health Systems.

Interestingly, some years ago, HCA pleaded guilty to 14 felony counts and paid out more than $2 billion to settle lawsuits arising from fraud. Then Chairman and CEO Rick Scott was forced to resign at the beginning of the federal investigation. He now, of course, is governor of Florida!

To read the HealthcareDive article, please hit this link.

To read The Washington Post article, please hit this link.


CHC looking into selling everything

September 19, 2016by Robert Whitcomb in Uncategorized tagged Community Health Systems, Larry Cash

 

Various media reports say that distressed Community Health Systems, based in Franklin, Tenn., is looking into selling the whole business.

Bloomberg said the hospital giant had hired advisers to consider options. Earlier this month, Modern Healthcare reported that CHS plans to sell more than the 12 hospitals it already has for sale, quoting CFO Larry Cash  at the Wells Fargo Securities Healthcare Conference in Boston.

Modern Healthcare reported: “Mr. Cash said they are getting interest in additional hospitals. And after examining its portfolio of 159 hospitals, it likely will see ‘other transactions’ before the end of the year….”

“The hospitals previously up for sale will likely be sold as part of five transactions. Not-for-profit hospital systems are among the prospective buyers, he said.”

CHS is not disclosing which hospitals it is negotiating to sell.

To read more on this developing story, please hit this link.


CHS will sell off more hospitals

September 9, 2016by Robert Whitcomb in Uncategorized tagged CHS, Community Health Systems

chs2

Franklin, Tenn.-based Community Health Systems will divest itself of more hospitals than previously announced, reports WFMJ.

CHS said  last month it would sell 12 hospitals, up from the 10 that it had originally expected to unload.  Now the system expects to sell more than 12 hospitals to cut its debt.

CHS had a second-quarter loss of  $1.4 billion,  compared with a profit of $117 million in the year-earlier quarter.

It has not disclosed which hospitals  it is negotiating to sell.

To read the full story, please hit this link.

 


CHS on a divestiture kick

June 1, 2016by Robert Whitcomb in Uncategorized tagged CHS, Community Health Systems

chs2

Giant for-profit Community Health Systems, based in Franklin, Tenn., plans to sell off at least 10 hospitals and perhaps as many as 30.

CFO Larry Cash  said  the chain would henceforth focus on  outpatient and other regional service lines in the 11 markets where it owns more than one hospital as well as boost such services as orthopedics and cardiology in  markets where it owns only one hospital. CHS has 73 hospitals around those 11 regional hubs.

The 10 unnamed hospitals currently being shopped by CHS have single-digit profit margins;  margins for CHS hospitals more traditionally average 15 percent.

“We will continue to divest hospital operations that cannot meet these criteria and they are not productive to our results,” he said.

CHS  now has 160 acute-care hospitals, which might drop to 130 to 140 hospitals by the end of next year.

Eight CHS hospitals  in Florida and two in Tennessee are at the center of CHS’s earnings decline.

Mr. Cash, meanwhile,  told investors that centralizing management of  CHS physician practices from Nashville should help with physician efficiency and retention. Read this link for more information.

 

 


Community Health Systems reports big loss

February 17, 2016by Robert Whitcomb in Uncategorized tagged Community Health Systems, Health Management Associates, Wayne T. Smith

 

Community Health Systems, the  big Franklin, Tenn., hospital chain, surprised analysts by reporting a big loss of $83 million in 2015’s fourth quarter. Lower hospitals admissions, slow benefits from its acquisition of Health Management Associates and impaired assets were cited.

Community Health’s $3.9 billion purchase in 2014 of HMA  merged 206 hospitals.

“It is taking longer than expected to achieve operational improvements in some of the former HMA markets,” Wayne T. Smith, Community Health’s chairman and chief executive, told The Wall Street Journal. “However, we continue to see opportunities in these markets and remain convinced that performance will improve over time.”

“In addition, Community Health said, the fourth quarter was hurt by weakness in patient volume in comparison with the strong year-ago quarter, which benefited from higher emergency-room visits and admissions attributed to respiratory illness and the flu,” the paper said.

 

 


Community Health Systems profit falls

October 22, 2015by Robert Whitcomb in Uncategorized tagged Community Health Systems

 

The Wall Street Journal reported that hospital  operator  Community Health Systems Inc. “reported preliminary third-quarter results well below analysts’ projections and cut its outlook for the year, citing a decline in admissions and a deterioration in payer mix.”
Is this a sign of things to come for other chains this year?

Based on preliminary figures for the quarter ended Sept. 30, Community Health, the largest operator in the U.S. by number of hospitals, reported total admissions fell 1.9 percent from the year earlier. “On a same-hospital basis, total admissions fell 2.1 percent, ” the WSJ reported.

Net operating revenue rose 1.4 percent.

“Overall, Community Health expects to report a profit of $60 million, or 51 cents a share, compared with $62 million, or 54 cents a share, a year earlier. Excluding one-time items, profit is projected to be 56 cents, compared with $1.01 a year earlier.”

 

 

 


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