6/x There are lots of ways to define "payer mix" but one way would be to divide the number of bed days for each payer (eg. medicare) by the total number of bed days
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7/x If we do this, SF generals payer mix for the year was approximately... 30% medicare 52% mediCal (Medicaid in California) 16% private Negligible fraction of "other"
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8/x Another way to define payer mix would be to divide the income from one payer with the total income from all payers ... In other words, what fraction of income came from medicare, medical and private payers?
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9/x Overall, the hospital's net revenue (this is the actual amount received, not billed) was $634M Medicare paid 21% MediCal paid 62% Private paid 15%
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10/x Despite income of $634M, the hospital's expenses were $1.0B. As with most of healthcare, the majority of these expenses go towards staff and benefits (~65%) So, technically, the hospital's operating margin (or "profit") was -45%
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11/x The previous year (FY2015) was less devatasting... -14% And in FY2014 the hospital actually ran a "profit" of 2.9%
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12/x Takeaways: (1) SF general primarily cares for an underrepresented population (60% MediCal)
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13/x (2) They have a very small population of private patients (3) There is no evidence in their financials that private pay patients actually pay a disproportionate share relative to their bed days (4) As a result of their unfavorable payer mix --> they have dismal financials
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14/x Final thoughts... Nobody should be left with ridiculous medical bills that they cannot afford and put them at risk of financial ruin; perhaps worse are patients that do not even have access to healthcare...
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15/15 Many private hospitals/organizations do not accept government insurance at all. These patients often have nowhere to turn except for places like SF general. Mechanisms are needed to ensure these safety net hospitals remain financially viable.
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Replying to @kimmaicutler @Noahpinion and
Chris Childers Retweeted Chris Childers
See https://twitter.com/cchildersmd/status/1082675956207083520 … for a comparison of the financials to LAC/USC
Chris Childers added,
0 replies 0 retweets 1 likeThanks. Twitter will use this to make your timeline better. UndoUndo
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