Health systems are showing signs of a gradual and sustained financial recovery this year, despite ongoing challenges such as high costs for drugs and supplies and less-than-ideal rates from payers. According to data released by Kaufman Hall, hospitals’ median operating margin remained relatively stable at 4.2% for the first half of the year, dropping slightly to 4.1% in July. This is a significant improvement compared to previous years, with a median operating margin of 1.3% in July 2023 and -0.98% in July 2022.
Although there are positive signs of improvement in health systems’ financial status, the gap between financially successful institutions and struggling organizations continues to widen. To get back on track, struggling organizations will need to focus on operational efficiency and negotiate better rates with payers and suppliers.
Recent positive signs include increasing patient volumes and decreasing length of stay at hospitals. Outpatient and inpatient revenue grew by 9% and 8%, respectively, from July 2023, while discharges grew by 3% and average length of stay decreased by 2%. However, most hospitals are still facing significant challenges, including payer reimbursement rates not covering the increasing cost of care and administrative costs rising due to an influx of AI-driven denials.
Cost pressures are also continuing to rise, with hospitals experiencing increased labor and non-labor expenses. Total expenses per day grew by 6% from July 2023 to July 2024, with costs for drugs and supplies rising by nearly 10% and labor expenses increasing by 4%.
Successful hospitals are adopting new technologies and negotiating better deals with suppliers to reduce costs. However, the gap between financially strong hospitals and struggling ones is growing, with higher-performing hospitals focusing on outpatient services and patient throughput to improve financial performance.
For-profit hospitals have performed better this year, with large systems like HCA Healthcare and Tenet Healthcare showing improved profit margins and financial stability. Overall, while there are positive signs of financial recovery in health systems, challenges and disparities between organizations remain. Aunque el costo de hacer negocios, [como mano de obra y suministros], es más alto, parece haberse estancado, y los hospitales con fines de lucro están pasando gradualmente los costos aumentados a los pagadores mediante sus renegociaciones periódicas de tarifas contractuales”, dijo Kailash Chhaya, un vicepresidente de Moody’s Ratings, en un comunicado por correo electrónico.
La situación de los sistemas de salud sin fines de lucro no es tan positiva, aunque les está yendo mejor en general que el año pasado por esta época.
Algunos de los grandes sistemas sin fines de lucro están prosperando financieramente, como Mayo Clinic, con sede en Rochester, Minnesota, y Kaiser Permanente, con sede en Oakland. Mayo Clinic informó un ingreso operativo de $449 millones para el segundo trimestre, lo que representa un margen operativo del 8,9%. Kaiser Permanente registró un ingreso operativo de $908 millones, que representa un margen operativo del 3,1%.
Daniel Steingart, otro vicepresidente de Moody’s Ratings, señaló que solo alrededor del 10% de los hospitales sin fines de lucro calificados por Moody’s están produciendo márgenes de flujo de efectivo operativo de menos del 1% en la actualidad. En el segundo trimestre de 2022, este indicador era aproximadamente del 20%, según afirmó.
Incluso hubo algunos sistemas sin fines de lucro conocidos que terminaron el segundo trimestre en números rojos. Por ejemplo, el margen operativo del segundo trimestre fue de -1,6% para Providence, con sede en Washington, -2,9% para UPMC, con sede en Pittsburgh, y -7,9% para Tufts Medicine, con sede en Boston.
Las mejoras en el rendimiento de estos sistemas de salud dependerán en gran medida de tarifas de pagadores mejoradas, volúmenes aumentados y recortes de costos disciplinados”, dijo Steingart en su comunicado.
Imagen: Andrey Tolkachev, Getty Images