Update on Financial Health of Washington Community Hospitals

1. Update on Financial Health ofWashington Community Hospitals • Fiscal year 2006 data is now available for 90 community hospitals. • Financial measures are derived from publicly available data filed with the Washington State Department of Health. • Look at the Notes section below each slide for more information. • Questions about these data? Contact Jane Feldman (janef@wsha.org). Washington State Hospital Association Health Information Program Washington State Hospital Association Health Information Program

2. Operating margins have recovered from the 1998-2002 slump Hospital Operating Margins Data Source: Washington State Dept. of Health Hospital Fiscal Year-End Reports Washington State Hospital Association Health Information Program

3. The range of operating margins is very broad • For fiscal year 2006, • 26 hospitals have negative margins • 29 hospitals have positive margins between zero and 4 percent • 35 hospitals have margins above 4 percent • Median margin is 2.88 percent Washington State Hospital Association Health Information Program Washington State Hospital Association Health Information Program

4. Maintaining financial strength is difficult for many hospitals • From FY2005 to FY2006, • 37 hospitals improved margin • Of these hospitals, 7 moved from negative to positive territory • 53 hospitals lost margin • Of these hospitals, 9 dropped from positive to negative Washington State Hospital Association Health Information Program Washington State Hospital Association Health Information Program

5. About half of the hospitals have longer-term positive margins up to 5 percent Average Four-Year Operating Margins by Number of Hospitals Data Source: Washington State Dept. of Health Hospital Fiscal Year-End Reports Washington State Hospital Association Health Information Program

6. In Total Margin, rural hospitals have surpassed urban hospitals for the last three years Hospital Total Margins Data Source: Washington State Dept. of Health Hospital Fiscal Year-End Reports Washington State Hospital Association Health Information Program

7. Cost shifting from government to private payers continues to increase Percent of Costs Reimbursed by Payers Data Source: Washington State Dept. of Health Hospital Fiscal Year-End Reports Washington State Hospital Association Health Information Program

8. Charity care and bad debt as a percent of revenue remained flat over the last three years Uncompensated Care Charges as Percent of Total Patient Revenue Data Source: Washington State Dept. of Health Hospital Fiscal Year-End Reports Washington State Hospital Association Health Information Program

9. Rural hospitals are more dependent on government payers but the gap is narrowing Medicaid + Medicare as Percent of Total Revenue Data Source: Washington State Dept. of Health Hospital Fiscal Year-End Reports Washington State Hospital Association Health Information Program

10. Despite rural hospitals’ shift toward outpatient care, the relative size of outpatient business statewide has stagnated Hospital Outpatient Services as Percent of Total Patient Revenue Data Source: Washington State Dept. of Health Hospital Fiscal Year-End Reports Washington State Hospital Association Health Information Program