Hospitals' Reform Deal Could Benefit Industry In The Longer Term
July 08 2009 - 4:23PM
Dow Jones News
The U.S. hospital industry's agreement to provide $155 billion
of savings on health care over 10 years may carry near-term risks
but could benefit the sector in the longer term.
Hospital groups, which negotiated with the Senate Finance
Committee, agreed to reduced Medicare and Medicaid payments while
apparently receiving promises about the proposed federal overhaul
to the health-care system that made the pill easier to swallow.
While $155 billion in cuts over a decade may spell dire trouble
for many struggling hospitals - particularly trauma centers and
smaller standalone facilities - analysts expect the deal could
bring positive results for the industry, notably the addition of
millions of paying patients.
"In the short run it makes me nervous. I am concerned there will
be cuts (to hospitals) before (they benefit from expanded)
coverage. In the long run I think it's probably a pretty good
deal," said CRT Capital Group health-care stock and bond analyst
Sheryl Skolnick.
The deal is certainly better than the estimated $220 billion in
hospital cuts the Obama administration earlier proposed, she
said.
Hospital stocks rose Tuesday on reports of a deal but retreated
a bit Wednesday, except for urban hospital operator Tenet
Healthcare Corp. (THC), whose shares rose 7.3% to $3.07. Shares
were up more than 15% over the past two days.
U.S. Vice President Joe Biden announced the agreement Wednesday,
calling it a step toward achieving deficit-neutral health-care
overhaul legislation. That change aims to expand health coverage to
more than 45 million uninsured Americans, a goal that should
benefit hospitals, which for years have cared for high numbers of
nonpaying patients.
However, the deal remains tricky to analyze because many
specifics have yet to be revealed.
Skolnick said it appears that hospitals agreed to the deal if
$40 billion to $50 billion in payments they receive for caring for
the poor are phased out over time, as more Americans become
insured. She warned, however, that another big chunk of the cuts
might occur before hospitals benefit from expanded health
coverage.
The industry notably appeared to win assurances that should
there be a public health plan option of some sort, payments to
hospitals under such a plan would be higher than Medicare rates,
she said.
Much of the savings are expected to come from reductions in the
inflation-related increases hospitals receive each year for
treating Medicare patients, and other funding cuts. Historically,
those increases have been in the 3% range, and some analysts
believe they'll now be closer to 1%. Skolnick said if these yearly
rate changes actually cut total hospital Medicare reimbursements
rather than reduce the increase in payments, hospitals would take a
bigger hit.
A.J. Rice, Soleil Securities health-care services analyst, said
he believes there's a general sense that the agreement "will be
positive on the market for hospitals," that with this amount of
cuts and the addition of newly insured patients, they will come out
ahead.
As for Tenet's stock spike, Rice speculated that investors may
believe that in the long term, the health overhaul will benefit
urban hospitals by mitigating the economy-related volatility in
uninsured patients.
Skolnick does expect Tenet to become more profitabile once
significantly more Americans are insured, although she sees another
possible factor at work in the stock price.
A national health-care overhaul, she speculated, should set the
stage for industry bellwether HCA Inc. to become public again and
pay down its debt through an initial public offering. Should that
happen, debt-burdened Tenet and other publicly traded hospital
companies should be able to recapitalize as well through follow-on
offerings, she said.
-By Dinah Wisenberg Brin, Dow Jones Newswires, 215-656-8285;
dinah.brin@dowjones.com