Colorado Health Market Review 2015
- ID: 3498727
- October 2015
- Region: United States
- Allan Baumgarten
In the 2015 report for Colorado, the author finds:
Denver area hospital systems improved their profits again in 2014:
- Based on an analysis of Medicare cost reports, hospitals in the Denver area had pre-tax net income of $1.224 billion in 2014, or 15.6% of net patient revenue of $7.826 billion.
- They had operating income of $230.5 million plus other revenues from philanthropy, investments and government grants of $1 billion.
- HealthOne/HCA is the largest and most profitable system in the region, with 26.3% of the hospital market, based on patient revenues.
- HealthOne/HCA had net income before taxes of $676.5 million, or 32.7%% of net patient revenue, almost all from operations.
- Other hospital systems were less profitable from their operations but benefited from significant other revenues.
- The Centura hospitals in the Denver area had net income of $80.7 million (5.4% of net patient revenues) while the three SLC/Exempla hospitals had net income of $68.3 million, or 6.3% of net patient revenues.
Through a series of mergers and new hospital construction, two hospital systems now are approaching a statewide presence:
- Centura Health is adding Longmont United hospital to its large system this year.
- The University of Colorado Health System, the second most profitable system in the state, added the Poudre Valley hospitals in northern Colorado and the Memorial hospital in Colorado Springs in recent years.
Inpatient occupancy rates have declined for Denver area hospitals:
- Inpatient occupancy averaged 63.5% in 2014, down from 65.6% in 2012 and 69.2% in 2008.
- Eight new or replacement hospitals have been built in the past ten years and several hundred inpatient beds have been added, but inpatient days have grown only slightly.
- Medicare and other payers are pressing hospitals to improve care management and avoid some hospital admissions. Still, new construction of hospital wings, specialty centers and freestanding emergency departments continues at a brisk pace.
Average margins for Colorado HMOs dropped below 3% in 2014, for the first time since 2015:
- Colorado HMOs reported net income of $117.8 million in 2014, or 2.3% of net revenues. That is down from 3.5% in 2013 and 4.2% in 2012.
- Even after taxes, PacifiCare (a UnitedHealth Group company) had the highest margin at 4.8%, almost all from its Medicare plans, while Kaiser Permanente had the highest net income at $78.7 million, almost all from its commercial business.
The Affordable Care Act has helped to increase insurance coverage in the state:
- Colorado expanded Medicaid eligibility under the Affordable Care Act, and enrollment has increased by 30%.
- Many of them are enrolled in HMOs, though only for care coordination in parts of the state.
- And the number of persons with individual coverage has increased by about 80% in the last 18 months.
- A Colorado Health Institute study reported that the number of people without insurance in the state dropped from 741.000 in 2013 to 353,000 in 2015. SHOW LESS READ MORE >
2. Market Structure
3. Health Insurance and Health Plans
4. Provider Systems
5. Trend Review
6. Health Plan Enrollment
7. Medicare and Medicaid Plans
8. Revenues and Net Income
9. Health Plan Spending and Payment
10. Health Plan Capital
11. Measures of Care Utilization and Effectiveness
12. Hospitals and Hospital Systems
13. Denver Area Hospitals
14. Revenues and Net Income
15. Occupancy and Payer Mix
16. Other Major Hospitals
17. Revenues and Net Income
18. Occupancy and Payer Mix
19. A Look Ahead