Despite industry concerns over lower reimbursement and stagnant patient volumes, nonprofit health systems posted healthy financial medians in fiscal year 2012.
Standard & Poor's Ratings Services released nonprofit hospital and health system median reports this week. S&P analysts said health systems — especially those with higher credit ratings — are in a better position to "face the headwinds of a changing industry." Rising consolidation also favors health systems as they have been able to spread their costs over a broader reach.
Health systems continue to have higher credit ratings than standalone hospitals. Most of S&P's "AA" and high "A" organizations are health systems, whereas standalone hospitals dominate more of the low "A" and "BBB" ratings.
Here are 34 median statistics comparing various financial metrics at nonprofit health systems from FY 2011 to FY 2012.
Note: The following data are based on audited financial statements for 144 nonprofit health systems within S&P's database. A health system is defined as an organization with at least three hospitals. Examples of health systems within S&P's portfolio include OhioHealth in Columbus (rated "AA+"), Mayo Clinic in Rochester, Minn. (rated "AA"), Indiana University Health in Indianapolis (rated "AA-"), Catholic Health East in Newtown Square, Pa. (rated "A+"), Henry Ford Health System in Detroit (rated "A"), Lifespan in Providence, R.I. (rated "A-"), Barnabas Health in West Orange, N.J. (rated "BBB+"), and Temple University Health System in Philadelphia (rated "BB+").
Statement of operations
|
Category |
FY 2011 |
FY 2012 |
|
Net patient revenue |
$1.38 billion |
$1.47 billion |
|
EBIDA |
$192.4 million |
$198.1 million |
|
Debt burden |
2.8 percent |
2.7 percent |
|
EBIDA margin |
11.7 percent |
11.6 percent |
|
Operating EBIDA margin |
10.1 percent |
9.7 percent |
|
Operating margin |
2.9 percent |
2.9 percent |
|
Excess margin |
4.9 percent |
4.7 percent |
|
Maximum debt service coverage |
4.2x |
4.2x |
Balance sheet
|
Category |
FY 2011 |
FY 2012 |
|
Average age of plant |
10.2 years |
10.4 years |
|
Cushion ratio |
16.0x |
17.3x |
|
Days of cash on hand |
188.8 |
193.8 |
|
Days in accounts receivable |
49.5 |
50.8 |
|
Cash flow to total liabilities |
15.5 percent |
14.6 percent |
|
Unrestricted reserves |
$754.4 million |
$834.9 million |
|
Unrestricted reserves to long-term debt |
133.7 percent |
137.3 percent |
|
Long-term debt to capitalization |
38.1 percent |
39.2 percent |
|
Defined benefit pension funded status |
73.6 percent |
68.7 percent |
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