But HCPF also tried to address the impact of COVID-19 on hospital finances in a report looking at more than $1 billion in non-repayable federal stimulus money that went to Colorado hospital systems, those with three or more hospitals. That showed that hospital systems recorded “operating profits in 2020 and did not need to dip into their rainy day reserves, built from years of accumulated profits.”

 

That second report said: “While federal COVID-19 aid provided a lifeline to many rural hospitals, further analysis is needed to assess the scale of losses for these hospitals. Rural hospitals received a median of 84 days cash to operate from federal stimulus distribution. Still, some hospitals continued to struggle financially even after receiving a boost from federal COVID-19 aid.” That’s due in part to an executive order from Gov. Jared Polis that placed a moratorium on elective surgeries, which freed up hospital beds in urban settings but took a big chunk out of the finances of rural hospitals. Elective surgeries account for 30% of total inpatient hospital revenue, according to the Journal of the American Medical Association. 

 

According to the HCPF report:

• Colorado hospitals ranked first in the nation in?total profit margin. Colorado’s total profit per patient of $2,891 was approximately three times higher than the 2018 national median of $963. Colorado hospitals generated $1.5 billion in profits from patient services in 2018 but nearly the same amount, $1.4 billion, was generated?by?non-patient sources, such as investment income. This $2.9 billion in 2018 profits represents a 15.6% total profit margin?(15.3% when adjusted for cost of living),?the highest profits in the country?and significantly higher than the national median of 6.5%.
• Colorado hospital?prices?ranked sixth highest in the nation in 2018 while the rate of price increases?is outpacing the nation. In 2009, the average price per patient was 9.2% higher in Colorado than in the rest of the country. By 2018, the average price per patient in Colorado had increased to 22.8% higher than the national median.
• Colorado hospital costs?per patient in Colorado ranked ninth highest in the nation in 2018 and have consistently exceeded national averages for the previous nine years. Had Colorado hospitals incurred overhead at the national rate, operating expenses would have been $474 million less.

The report called hospitals “high cost, high price and high profit.”

In 2020, HCPF issued a similar report, accusing the hospitals of gouging patients on prices. The report – an analysis of Colorado hospital cost-shifting – claimed hospitals, primarily large for-profit and non-profit hospitals in the Front Range, have failed to reduce health care costs, despite state efforts going back more than a decade to reduce the burden of uncompensated care. The report is a final one that follows a draft report from January 2019.

The Colorado Hospital Association, in a statement Wednesday to Colorado Politics, said “the report, based on 2018 data, is a reminder of why Colorado hospitals have worked diligently to improve the affordability of health care for Coloradans. Our patients have the benefit of reinsurance, community-based purchasing alliances, public/private partnerships, out-of-network protection, and the Colorado Option – all made possible by hospitals – working to drive premiums and out-of-pocket costs down. These are the measures that matter to patients.” Citing a recent Connect for Health Colorado news release on affordability, the association said “three out of four customers on the individual market can find a health plan with a premium of $25 per month or less. Additionally, a recent insurance industry report revealed that Colorado now has the 6th lowest premiums on the individual market in the country – a clear sign that these efforts are moving us in the right direction.”

The association pointed out that the efforts by hospitals to improve affordability have come during the pandemic, when hospitals were caring for COVID-19 patients and providing vaccines, while at the same time taking care of other patients and managing emerging health concerns, such as behavioral health and substance use disorders.