It costs too much, not in the budget

[Youda]

For my own amusement and research (I love research), I decided to see just how impoverished the healthcare industry is. How valid is the response, "It isn't in the budget?"

A stroll around the internet will educate you how healthcare costs are rising, services and expenses are being cut, but profits are soaring. Do your own search, then never again accept, "It isn't in the budget" or "It costs too much" as an excuse.

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http://www.levinassociates.com/publications/jenks/jenksheadlines/02%20jenkshead/02jenkshead02.htm

"In the health care services segment, hospital company financial results continue to be strong across the board. It doesn't hurt that managed care companies have opened up the purse strings in the past few years, resulting in back-to-back double-digit premium increases for consumers. The largest hospital company, HCA, Inc. (NYSE: HCA), beat estimates for fourth quarter earnings by two pennies per share with a 25% increase on just an 8.7% rise in revenues. For hospitals owned for more than a year, fourth quarter admissions rose 1.8%, but the revenue per admission jumped by 9.8%. Cash flow from operations in the quarter increased 37% to $592 million compared to last year's fourth quarter."

"Health Management Associates' (NYSE: HMA) profits for its first quarter ended December 31, 2001 rose 26% on net revenues of $495.8 million"

"LifePoint Hospitals (NASDAQ: LPNT), which was spun out of HCA, posted a 68% increase in earnings per share for the fourth quarter. "

"Universal Health Services (NYSE: UHS) expects to report a 32% increase in earnings per share for the fourth quarter"

"Humana (NYSE: HUM) slightly beat estimates with a 32% fourth quarter increase to $35.1 million."

"UnitedHealth Group (NYSE:UNH), the second largest health insurer after Aetna (NYSE: AET), reported a 28% rise in fourth quarter profits and beat estimates by three pennies per share."

http://www.diffenbaughassociates.com/newsletter/current.html

UnitedHealth Earnings Jump 46-%

UnitedHealth Group Inc. , the managed health care company, said on Thursday quarterly profits rose

HCA Profits Up 25-%

HCA Inc. , the largest U.S. hospital chain, said quarterly profits rose 25-% from last year...

UHS Q2 Earnings Up 35-%

Universal Health Services, Inc. announced that its net income and earnings per share (diluted) were $44.3 million...

HMA Posts Record Q3 Earnings Growth

Health Management Associates, Inc. announced that its net patient service revenue grew a robust 25-% to $592.5 million...

Humana Profits Up 19-%

Humana Inc. reported earnings of $45.4 million, or 27 cents per diluted share, up 19-% from the same period a year ago . . .

Anthem, Inc. is an Indiana-domiciled publicly traded company that, through its subsidiary companies, provides health care benefits and services to more than 10 million members. Anthem is the fifth largest publicly traded health benefits company in the United States and is the Blue Cross and Blue Shield licensee for Indiana, Kentucky, Ohio, Connecticut, New Hampshire, Colorado, Nevada, Maine and now Trigon in Virginia (excluding suburbs adjacent to Washington, D.C.). As of December 31, 2001, Anthem had assets of $6 billion and operating revenues of $10 billion . . .

UnitedHealth, based in Minneapolis, also raised earnings expectations for the full year and is now estimating profit growth in excess of 30-% over 2001. The company said second-quarter earnings rose to $325 million, or $1.01 per share, from $223 million, or 68 cents a share, a year earlier. Wall Street analysts had expected earnings of 93 cents to 97 cents, with a mean estimate of 95 cents, according to research firm Thomson First Call. The results marked UnitedHealth's 15th consecutive quarter of double-digit profit growth, according to Lehman Brothers, a trend analysts expect will continue through at least 2004. . . .

Health Management Associates Reports Record 3rd Quarter EPS Growth of 24-%

Health Management Associates, Inc. announced that its net patient service revenue grew a robust 25-% to $592.5 million for its third quarter ended June 30, 2002, up $119.3 million from $473.2 million for the same period a year ago. The Company's net income for the quarter increased similarly, up 23-% to $66.6 million, an increase of $12.5 million from $54.1 million for the same quarter a year ago. Earnings per share (diluted) for the quarter were $.26 per share, up 24-% from $.21 per share for the prior year's quarter. . .

HCA Profits Up 25-%

HCA Inc. , the largest U.S. hospital chain, said quarterly profits rose 25-% from last year on higher occupancy and patient fees, and controlled labor costs. Second-quarter net income rose to $350 million, or 66 cents a share, from last year's $281 million, or 52 cents a share. . . In controlling costs, company executives said on a conference call that they reduced their use of agencies that provide temporary nurses. As such, salary and benefits costs fell slightly to 40-% of total second quarter revenues from 40.7-% a year ago.

LifePoint Hospitals Reports 54.5-% Increase in 2nd Quarter 2002 EPS

http://atlanta.bizjournals.com/atlanta/stories/2002/06/03/story3.html

HMO profits rise in first quarter

Other Georgia HMOs, including CIGNA Healthcare of Georgia, United Healthcare of Georgia and the Kaiser Foundation Health Plan of Georgia also had dramatic profit increases.

http://www.newsfactor.com/perl/story/7701.html

IBM and Lawson Target Health Insurance Market

The goal is to provide a management system that reduces healthcare costs, increases profits, and forges stronger customer loyalty and satisfaction, the companies said.

http://www.newsday.com/news/columnists/ny-reno2953733oct06,0,43712.column?coll=ny%2Dnews%2Dcolumnists

Perversely, the explosion in health care costs and in the number of uninsured is occurring at a time when overall inflation has fallen to some of the lowest levels experienced in 30 years. Meanwhile, it seems more than a coincidence that shares in managed-care companies are doing quite nicely. The Standard & Poor's managed health care index has doubled since 1999, a period when the broad S&P 500 stock index fell by one-third.

[Youda]

I spend too much time reading. I ought to get a life! :)

In RN Magazine, October 1988, there is a very interesting article entitled "When profit motive threatens patient care," by Helen Lippman Collins. Excellent article if you can dig it up somewhere.

Picking out some interesting data:

74% of nurses (in 1987-1988) felt that cost cutting made it impossible to have a caring attitude.

The percentage of nurses. . .

76% of ER nurses felt there was a deterioration of care.

86% of geriatric nurses felt there was no time for a caring attitude.

45% of psych nurses felt patients needing treatment were turned away.

The higher number of years of experience in nursing resulted in a more informed recognition of problems, and the more time as a nurse meant a higher percentage of nurses who believed there was a deterioration of care.

The biggest cuts in staffing were reported by proprietary, public, and non-profit hospitals, respectively.

The article recommends (p.79):

". . .urges nurses to keep documenting dangerous conditions -- short-staffing, lack of proper equipment, inappropriate discharges, or whatever. . .acknowledges that it's hard to do this when nobody seems to listen . . . nurses can build on that by digging out hard data and sharing soltuions. The new law is to do your homework. Somebody somewhere has already invented the wheel. . . .write nurses where they addressed that problem. . .it's true that many of these problems are not going to change today or tomorrow, but we've got to use these issues to get some kind of dialogue going and to get nurses on those hospital policy-making committees. . .if you're waiting for someone to come along and hand you a basket of power, it's not going to happen.. . .the battles of cost over quality can be resolved ethically with a large dose of the basic nursing tenet that puts patients first -- and only nurses can inject this solution into the health-care system." (snipping and paraphrasing mine).

Good article. It was written in 1988, but very apropo for today.

[sjoe]

Youda--pleasant to see how much things have improved since 1988, isn't it?

[Youda]

Yeah, that's what I thought, too, sjoe. Discouraging.

[abrenrn]

Thee problem with documenting in our work environments is that we are encouraged to leave these environments when we do.

Who will listen to nurses? Where can we document these things so that eventually they are seen. I know it takes time, I don't expect change to happen overnight. But how long should it take? Where do we document?

Just curious.

[booboo]

I am betting on the passage - eventually - of the nurse/patient ratios by the state legislatures. How is it working in CA? We are working on it here in Fla. That is the only thing that is keeping me going - my personal satisfaction that the administrators and managers will "finally get theirs" when they will HAVE to have enough nurses on the floor - or face thousands of dollars in fines daily until they do. JCAHO can determine the temperature of the refrigerator, but can't tell them to have more nurses...go figure. Sounds like the fast food workers in the book "Fast Food Nation" - corporate tells them how many pickles to put on the burgers - but not how to treat employees. As a matter of fact, fast food workers are a lot like nurses - high turnover, workplace violence, little decision-making over their workplace. Scary...

[rncountry]

Youda, check out the Hunter Group. That will too make you gag.