March 2020
Revenue
Revenue by Region *
NPSR per Adjusted Discharge was up year over year and compared to budget in four of five regions across the country in February. The South saw the biggest year-over-year increase at 4.5 percent, but was just 0.2 percent to budget. The Great Plains was the outlier, falling -4.0 percent year over year and -7.4 percent to budget.
NPSR per Adjusted Patient Day rose year over year in the Midwest, South, and Great Plains, with the Great Plains seeing the biggest increase at 3.9 percent. The West was essentially flat at -0.2 percent compared to the same period last year, while the Northeast/Mid-Atlantic was down -6.8 percent.
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
Bad Debt and Charity as a Percent of Gross rose year over year and compared to budget in the West and Great Plains, was up year over year but below budget in the Midwest, and fell year over year and to budget in the South and Northeast/Mid-Atlantic. The Great Plains saw the biggest year-over-year increase at 17.5 percent, while the Northeast/Mid-Atlantic saw the biggest year-over-year decrease at -13.1 percent.
IP/OP Adjustment Factor rose year over year and compared to budget across all regions. Performance was relatively clustered, ranging from about 1.2 percent to 2.6 percent year over year for four of five regions. The Great Plains was an outlier, with IP/OP Adjustment Factor up 10.0 percent year over year and 5.8 percent to budget, which likely is driving the NPSR per Adjusted Discharge and Adjusted Patient Day results for the region.
National Revenue Observations
Revenues were up year over year and month over month for most metrics. Net Patient Service Revenue (NPSR) per Adjusted Discharge rose 3.0 percent year over year and 0.7 percent month over month, and was slightly above budget at 0.2 percent.
NPSR per Adjusted Patient Day rose just 0.1 percent year over year and 0.9 percent month over month, but was -3.0 percent below budget. Inpatient/Outpatient (IP/OP) Adjustment Factor rose 2.5 percent year over year and 0.7 percent month over month, and was up 1.1 percent to budget.
Bad Debt and Charity as a Percent of Gross rose 1.5 percent compared to February 2019, but was the only metric to fall -0.7 percent compared to January 2020, performing -2.1 percent to budget.
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
NPSR per Adj. Discharge
0.2%
0.7%
3.0%
npsr_per_adj_discharge.svg
NPSR per Adj. Patient Day
(3.0%)
0.9%
0.1%
npsr_per_adj_patient_day.svg
IP/OP Adjustment Factor
1.1%
0.7%
2.5%
ipop_adjustment_factor.svg
Bad Debt and Charity as a % of Gross
(2.1%)
(0.7%)
1.5%
bad_debt_and_charity.svg
Unless noted, figures are Actuals and Medians
Revenue by Bed Size
NPSR per Adjusted Discharge rose year over year for five of six bed-size cohorts. Hospitals with 100-199 beds saw the biggest increase at 4.1 percent year over year, while those with 300-499 beds saw the least increase at 1.0 percent. The nation’s smallest hospitals of 0-25 beds were the only cohort to see a year-over-year decrease at -2.0 percent. Four of six cohorts performed favorable to budget, with bed-size cohorts 26-99 and 100-199 falling below budget.
NPSR per Adjusted Patient Day fell below budget in all but one bed-size cohort. Hospitals with 200-299 beds saw the biggest year-over-year increase at 2.9 percent, but was -1.0 percent to budget. Hospitals with 0-25 beds were the only cohort to perform above budget at 3.0 percent, but saw the biggest year-over-year decrease at -2.7 percent.
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
The IP/OP Adjustment Factor was up from February 2019 levels and compared to budget for four of six bed-size cohorts, indicating continued growth in outpatient volume across each cohort. The smallest hospitals of 0-25 beds saw the biggest increases, up 9.4 percent year over year and 11.2 percent to budget. Hospitals with 200-299 and 500 or more beds both were up just about 0.1 percent year over year, but fell -0.6 percent below budget.

Bad Debt and Charity as a Percent of Gross was up year over year for hospitals with 100-199, 300-499, and 500 beds or more, but down year over year for those with 0-25, 26-99, and 200-299 beds. Hospitals with 100-199 beds saw the biggest year-over-year increase at 8.1 percent, while those with 200-299 beds saw the biggest year-over-year decrease at -3.8 percent.
©2020 Kaufman, Hall & Associates, LLC
scroll_up.svg
kha_logo.svg
National Hospital Flash Report
menu_icon.svg
mail.svg
Share article
Sign up now for access to the latest news and reports
SUBMIT