Hospital Uncompensated Care and Net Operating Profits , HFY 2011 -2017 ($ in Millions) 1000 919 886 900
Report on Uncompensated Hospital Costs and Hospital Profitability October 2018 Director, Tom Betlach 1 EXECUTIVE SUMMARY From Hospital Fiscal Year (HFY) 2011 to HFY 2013, hospital uncompensated care grew from $500 million to almost $900 million. This increase was followed by a sharp decline from HFY 2013 to HFY 2015. By HFY 2015, uncompensated care fell below its HFY 2011 levels and has continued at this lower rate. These fluctuations were due in part to state budgetary changes implemented during this time period. Of particular importance was the imposition of a freeze on childless adult enrollment effective July 2011, and its restoration and Medicaid expansion in January 2014. Despite large increases in uncompensated care, total net operating profit remained relatively stable, fluctuating between $554 million and $765 million from HFY 2011 to HFY 2016. This was achieved with the help of the AHCCCS Safety Net Care Pool program, a temporary program designed to help mitigate the increase in uncompensated care associated with the enrollment freeze. In HFY 2017, net operating profit increased to $919 million, the highest level observed since AHCCCS began writing these reports. Operating profitability continues to vary considerably by hospital type. Both net operating margin and total margins for rehabilitation, short-term specialty, and psychiatric hospitals exceeded 12% in HFY 2017, but margins were negative for long term acute care hospitals. In HFY 2017, net operating and total margins for critical access and general acute care hospitals were between 3.6% and 6.5%. It is important to note that there are a number of factors that influence hospital profitability and uncompensated care, including long-term and short-term business decisions made by hospitals, occupancy rates (which average approximately 60% statewide), the economy, federal and state policies, and changes in the healthcare industry as a whole.
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