Tag Archives: finance

Panel will discuss newly released 990 data on hospitals #ahcj13

Karl Stark

About Karl Stark

Karl Stark, the assistant managing editor for business, health and science at The Philadelphia Inquirer, serves as president of the AHCJ board of directors.

AHCJ has just released a new trove of information from GuideStar on the finances of nonprofit U.S. hospitals. This information – from tax years 2009 and 2010 – contains carefully selected highlights from the hospital’s IRS 990 forms, which nonprofits must file to maintain their mostly tax-free status.

Reporters can use this AHCJ spreadsheet to get:

  • detailed salary info on top executives
  • the institution’s charity care and community benefit numbers
  • a hospital’s lobbying expenses
  • and the business relationships of board members, among other things.

This data will be discussed at the Health Journalism 2013 session, “Diving into documents: Using 990s and more to cover hospital finances,” on Sunday at 10:40 am. Howard Rivenson, senior lecturer on health management, Harvard School of Public Health, will join me to help demystify hospital finances.

The newest material from 2010 is here and here are last year’s data.

Investigation finds hospital’s leader spent public money on personal interests

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Reese Dunklin and Sue Goetinck Ambrose of The Dallas Morning News document how Kern Wildenthal, the former UT Southwestern Medical Center president and its current chief fundraiser, spent hundreds of thousands in public dollars in recent years to build campus wine cellars, pay for his opera interests and travel to paradises around the world.

The investigation details a collapse in controls over taxpayer dollars and triggered a University of Texas System internal inquiry that found many of the same problems. Two auditors were jettisoned in response, Wildenthal will be forced to pay restitution and reforms are being considered. Continue reading

Comprehensive series on N.C. hospitals includes national context, effects of reform

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

The (Raleigh, N.C.) News & Observer and The Charlotte (N.C.) Observer just combined forces to do a terrific five-part series on hospitals called “Prognosis: Profits.”

It’s not just a great expose/explainer/data analysis/narrative that tells readers about the state of the hospital industry in North Carolina and its national context. With lots of examples, data and sidebars that break down some complex policy ideas, it’s also a great primer for anyone who wants an easy to understand but multifaceted Hospitals 101 (without being Hospitals for Dummies). For you multimedia fans out there, it also has a video component.

In a nutshell, the series – a collaboration of investigative and health care writers – found that some of the hospitals make a ton of money and charge more than hospitals elsewhere and that the charity care many of them provide is worth less than the tax-breaks they get ostensibly for providing care to the community. And yes, it gets into many of the complexities of charity care versus community benefit versus cost-shifting versus bad debt. (We’ve written about some of that on this blog.)

They write:

During the Great Recession, their profits have stayed strong, and they’ve raised their prices. Top executives enjoy million-dollar compensation packages as they expand, buy expensive technology and build lavish facilities. Their customers buy the services before they know the cost, and they often don’t understand the bills.

And the hospitals enjoy a perk worth millions each year: They pay no income, property or sales taxes.

The series describes what it’s like to be poor and sick and have a collection agency come after what little you have to pay a big bill for a medical emergency. It describes the million-dollar plus compensation packages of hospital execs. (One got $8.7 million, including a big retirement trust payment.)

The articles blend individual patient stories with policy context and a lot of hospital financial data (which readers can search in an online database that includes total and operating margins for every hospital in the state). The fifth and final installment (as well as some of the fourth) looks at some of the solutions that have been put forth, by state legislators and patient and consumer advocates.
Health Reform core topic

The series avoids one of the pitfalls that drives me crazy in some otherwise good hard-hitting reporting. It describes a problem – deeply and accessibly. But it also goes beyond looking at a snapshot of where things stand today. It connects today’s reality, today’s system, to the many underreported provisions of the Affordable Care Act that may create new tools and forces and legal and financial and cultural shifts that can bring about change – depending on the Supreme Court, the politicians, and on how much the health sector (and patients) embraces versus resists change. (That’s a sidebar in part 3.) Among the relevant elements of the health law it identifies (and the sidebar gives more specifics than I’m including here):

  • Hospitals must develop financial assistance policies and the criteria for receiving the help.
  • An end to the widespread practice of charging the uninsured who qualify for financial assistance more than they charge the insured
  • A ban on nonprofits engaging in “extraordinary collection actions”
  • A requirement that they assess community health needs every three years, and devise a plan to meet them

The series has gotten the attention of federal and state legislators. We’ll see if they stay engaged. And how that matters.

Joanne Kenen (@JoanneKenen) is AHCJ’s health reform topic leader. If you have questions or suggestions for future resources, please send them to joanne@healthjournalism.org.

Defaulted doctors: Hundreds fail to pay on loans

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

More than 300 health care providers who received Health Education Assistance Loans made no payments during 2008, despite having earned income that year, according to a new report from the Office of the Inspector General of the Department of Health and Human Services.

These 312 HEAL defaulters earned $13.4 million and owed $47.5 million on their loans in FY 2008. Ninety-eight of these defaulters (31 percent) earned $50,000 or more. These 98 defaulters were responsible for nearly $15 million of the $47.5 million owed.

The program, known by the acronym HEAL, provided federal insurance for educational loans made by private lenders to more than 156,000 graduate health professions students between 1978 and 1998. Loans were available to students in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, public health, pharmacy, chiropractic, health administration or clinical psychology.

The names of borrowers who are in default on their loans are published online in a searchable database quarterly. Information available includes the borrower’s name, discipline, state, amount due, school and date of graduation or separation.

The site says it lists borrowers who:

  • had one or more default claims paid by the Department of Health and Human Services (DHHS);
  • been excluded from the Medicare program as a result of his or her HEAL default; and
  • not had the Medicare exclusion stayed, or lifted, by the Office of Inspector General as a result of entering a settlement agreement.

The site says it was last updated in November 2009, so reporters will need to verify any information found on the site. But it could be a starting place for stories about local health care providers.

Credit crisis, IRS changes affect hospital finances (#ahcj09)

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

If ever there was a time to dig into your local hospital’s finances, this is it, Karl Stark told journalists Friday morning.

The Internal Revenue Service has made the first significant change to its 990 form in 30 years, providing more details about charity care and community benefits.

“And there are all these financial pressures coming down on hospitals this year,” said Stark, health and science editor of The Philadelphia Inquirer. That may result in a new wave of closures and mergers.

“One of the issues that has been undercovered, in my opinion, is the effect of the credit meltdown on hospitals,” he said.

During a presentation at Health Journalism 2009, Stark provided advice on how to demystify the financial numbers.

Sandy Kleffman of the Contra Costa Times writes about some key points from Stark’s presentation.

Wis. nonprofit hospitals provide less charity care

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

David Wahlberg of the Wisconsin State Journal looked into the state’s nonprofit hospitals and found they “provided significantly less free health care and made more money than the national average in recent years.” Ninety-eight percent of Wisconsin’s hospitals are nonprofit, though the national average is closer to 59 percent, not including the 25 percent of hospitals that are run by the government and also tax-exempt.

Wahlberg focused on the budget surpluses and charity-care obligations of these nonprofit hospitals, reporting that the issues is “likely to take on more relevance this year in the state and the nation as unemployment soars and tax revenues plummet.”

Wahlberg reports: “The amounts of help provided by hospitals can vary greatly, according to an IRS survey of nonprofit hospitals released in 2007. Nearly half of the hospitals said they spent less than 3 percent of their budgets on charity care and bad debt; a fifth said they spent more than 10 percent of their budgets on those benefits.”

In part two of the series, Wahlberg looks at the question of whether a nonprofit hospital become too much like a business, focusing on St. Mary’s Hospital, which made a lot of money and gave relatively little charity care in recent years.

In part three, Wahlberg reports that some public officials are making nonprofit hospitals contribute more to their communities and that the troubled economy could expand this trend.