Vanguard Health Systems, Inc. (NYSE: VHS) today announced
financial and operating results for its first fiscal quarter of
2013 and confirmed its outlook for fiscal year 2013.
First Quarter Fiscal 2013 Key
Metrics (all percentage changes compare Q1 FY2013 to Q1
FY2012):
Consolidated:
- Net income attributable to Vanguard
Health Systems, Inc. stockholders was $13.9 million, or $0.17 per
diluted share, compared to a net loss of $21.7 million, or $(0.29)
per diluted share, during the prior year period
- Adjusted EBITDA increased 12.2 percent
to $133.2 million
Same Store:
- Patient revenue per adjusted discharge
increased 2.0 percent
- Discharges decreased 1.9 percent
- Adjusted discharges decreased 0.8
percent
A reconciliation of Adjusted EBITDA, a non-GAAP financial
measure, to net income (loss) attributable to Vanguard Health
Systems, Inc. stockholders for the quarters ended September 30,
2011 and 2012 is included in this release.
First Quarter Analysis
Consolidated total revenues increased $34.4 million during the
first quarter of fiscal 2013 compared to the prior year period,
primarily due to the acquisition of Valley Baptist Health System in
September 2011. Same store net patient service revenues increased
0.6 percent during the first quarter of fiscal 2013 resulting from
a 2.0 percent increase in patient revenue per adjusted discharge
combined with a 0.8 percent decrease in adjusted discharges. Health
plan premium revenues, on a same store basis, decreased 21.5
percent during the first quarter of fiscal 2013 due to the impact
on Phoenix Health Plan of a combination of capitation rate
decreases, program eligibility cuts and health plan profitability
limitations for certain groups of covered members adopted by the
Arizona Health Care Cost Containment System (“AHCCCS”) during
fiscal 2012.
Same store uncompensated care as a percentage of net patient
revenues (prior to the uncompensated care deductions) increased
from 17.9 percent during the first quarter of fiscal 2012 to 20.8
percent during the first quarter of fiscal 2013 primarily due to an
increase in uninsured discharges as a percentage of total
discharges.
Balance Sheet and Cash
Flows
As of September 30, 2012, we had cash of $330.2 million and
total debt of $2,704.6 million.
Cash flows from operating activities improved by $31.4 million
during the first quarter of fiscal 2013 compared to the prior year
period. Changes in net operating assets and liabilities negatively
impacted operating cash flows by $144.6 million during the first
quarter of fiscal 2013 compared to a negative impact of $166.5
million during the prior year period. We made $89.0 million of
interest and income tax payments during the first quarter of fiscal
2013, which was $17.9 million higher than these payments during the
prior year period. Cash flows from operations during the first
quarter of fiscal 2013 were negatively impacted by the timing of
payments of accounts payable and certain accrued expenses and
significant employer contributions to The Detroit Medical Center
(“DMC”) defined benefit pension plan, but were positively impacted
by improved cash collections of accounts receivable and the receipt
of certain settlement receivables from the federal government.
Capital expenditures increased 30.4 percent to $82.7 million
during the first quarter of fiscal 2013 compared to the prior year
period due to increased spending related to the DMC specified
capital project commitments and the start of construction of a new
hospital in New Braunfels, Texas.
Outlook for Fiscal Year
2013
We are confirming our previously issued fiscal year 2013 outlook
for ranges of projected Adjusted EBITDA, projected net income
attributable to Vanguard Health Systems, Inc. stockholders,
projected diluted earnings per share and projected capital
expenditures.
Earnings Conference Call
We will host a conference call at 11:00 a.m. EDT on October 31,
2012. All interested parties are invited to access a live webcast
of the conference call on the Investor Relations Section of our
website at http://vanguardhealth.com. If you are
unable to participate during the live webcast, the webcast will be
available on a replay basis for 90 days.
We own and operate 28 acute care and specialty hospitals and
complementary facilities and services in metropolitan Chicago,
Illinois; metropolitan Detroit, Michigan; metropolitan Phoenix,
Arizona; San Antonio, Texas; Harlingen and Brownsville, Texas; and
Worcester and metropolitan Boston, Massachusetts. Our strategy is
to develop locally branded, comprehensive health care delivery
networks in urban markets.
Cautionary Statement about Forward-Looking Information
This press release contains “forward-looking statements” within
the meaning of the federal securities laws that are intended to be
covered by safe harbors created thereby. Forward-looking statements
are those statements that are based upon management’s plans,
objectives, goals, strategies, future events, future revenue or
performance, capital expenditures, financing needs, plans or
intentions relating to acquisitions, business trends and other
information that is not historical information. These statements
are based upon estimates and assumptions made by our management
that, although believed to be reasonable, are subject to numerous
factors, risks and uncertainties that could cause actual outcomes
and results to be materially different from those projected. When
used in this press release, the words “estimates,” “expects,”
“anticipates,” “projects,” “plans,” “intends,” “believes,”
“forecasts,” “continues” or future or conditional verbs, such as
“will,” “should,” “could” or “may,” and variations of such words or
similar expressions are intended to identify forward-looking
statements. These factors, risks and uncertainties include, among
others, the following: our high degree of leverage and interest
rate risk; our ability to incur substantially more debt; operating
and financial restrictions in our debt agreements; our ability to
generate cash necessary to service our debt; weakened economic
conditions and volatile capital markets; potential liability
related to disclosures of relationships between physicians and our
hospitals; potential adverse impact of pre-payment and post-payment
claims reviews by governmental agencies; our ability to grow our
business and successfully implement our business strategies,
including growing our ambulatory care services platform; our
ability to successfully integrate hospitals or ambulatory care
facilities acquired in the future or to recognize expected
synergies from such acquisitions; potential acquisitions could be
costly, unsuccessful or subject us to unexpected liabilities;
conflicts of interest that may arise as a result of our control by
a small number of stockholders; the highly competitive nature of
the health care industry; the geographic concentration of our
operations; governmental regulation of the health care industry,
including Medicare and Medicaid reimbursement levels in general and
with respect to the impact of the Budget Control Act of 2011 and
other future deficit reduction plans; a reduction or elimination of
supplemental Medicare and Medicaid payments on which we depend,
including disproportionate share payments, indirect medical
education/graduate medical education payments, upper payment limit
programs and other similar payments; pressures to contain costs by
managed care organizations and other insurers and our ability to
negotiate acceptable terms with these third party payers; our
ability to attract and retain qualified management and health care
professionals, including physicians and nurses; the currently
unknown effect on us of the major federal health care reforms
enacted by Congress in March 2010, including the Patient Protection
and Affordable Care Act, as amended by the Health Care and
Education Reconciliation Act of 2010, or other potential additional
federal or state health care reforms, including that states may opt
out of the Medicaid expansion; potential adverse impact of known
and unknown governmental investigations and audits; increased
compliance costs from further government regulation of the health
care industry and our failure to comply, or allegations of our
failure to comply, with applicable laws and regulations; our
failure to adequately enhance our facilities with technologically
advanced equipment; the availability of capital to fund our
corporate growth strategy and improvements to our existing
facilities; potential lawsuits or other claims asserted against us;
our ability to maintain or increase patient membership in and to
control the costs of our managed health care plans; failure of
AHCCCS to renew its contract with, or award future contracts to,
Phoenix Health Plan; Phoenix Health Plan’s ability to comply with
the terms of its contract with AHCCCS; our inability to manage
health plan claims expense within our health plans; reductions in
the enrollment of our health plans; changes in general economic
conditions nationally and regionally in our markets; our exposure
to the increased amounts of and collection risks associated with
uninsured accounts and the co-pay and deductible portions of
insured accounts; dependence on our senior management team and
local management personnel; volatility of professional and general
liability insurance for us and the physicians who practice at our
hospitals and increases in the quantity and severity of
professional liability claims; our ability to achieve operating and
financial targets and to maintain and increase patient volumes and
control the costs of providing services, including salaries and
benefits, supplies and other operating expenses; technological and
pharmaceutical improvements that increase the cost of providing, or
reduce the demand for, health care services and shift demand for
inpatient services to outpatient settings; a failure of our
information systems; delays in receiving payments for services
provided, especially from governmental payers; changes in revenue
mix, including changes in Medicaid eligibility criteria and
potential declines in the population covered under managed care
agreements; costs and compliance risks associated with
Section 404 of the Sarbanes-Oxley Act of 2002; material
non-cash charges to earnings from impairment of goodwill associated
with declines in the fair market value of our reporting units; cash
payments that may be necessary to fund an underfunded defined
benefit pension plan of the DMC; volatility of materials and labor
costs for, or state efforts to regulate, potential construction
projects that may be necessary for future growth; our reliance on
payments from our subsidiaries, which may be restricted by our
credit agreement and the indentures governing our senior notes;
changes in accounting practices; our ability to demonstrate
meaningful use of certified electronic health record technology and
to receive the related Medicare or Medicaid incentive payments; and
other risk factors described in our Annual Report on Form 10-K and
other filings with the Securities and Exchange Commission.
Our forward-looking statements speak only as of the date made.
Except as required by law, we undertake no obligation to publicly
update or revise any forward-looking statements contained herein,
whether as a result of new information, future events or otherwise.
You are cautioned not to rely on such forward-looking statements
when evaluating the information contained in this press release. In
light of significant uncertainties inherent in the forward-looking
statements included in this press release, you should not regard
the inclusion of such information as a representation by us that
the objectives and plans anticipated by the forward-looking
statements will occur or be achieved or, if any of them do, what
impact they will have on our financial condition, results of
operations or cash flows.
We use our company website to provide important information
to investors about the company, including the posting of important
announcements regarding financial performance and corporate
developments.
VANGUARD HEALTH SYSTEMS, INC. Condensed
Consolidated Statements of Operations (Unaudited) (In
millions, except share and per share amounts)
Quarter ended September 30, 2011
2012 Patient service revenues $ 1,351.5
94.1 % $ 1,463.9 99.5 % Less: Provision for
doubtful accounts (126.2 ) (8.8 ) (169.6 ) (11.5 )
Patient service revenues, net 1,225.3 85.3 1,294.3 88.0 Premium
revenues 211.0 14.7 176.4 12.0
Total revenues 1,436.3 100.0 1,470.7 100.0 Costs and
expenses: Salaries and benefits (includes stock compensation) 665.0
46.3 680.2 46.3 Health plan claims expense 164.7 11.5 134.3 9.1
Supplies 213.6 14.9 226.1 15.4 Purchased services 127.0 8.8 147.2
10.0 Non-income taxes 34.5 2.4 34.9 2.4 Rents and leases 18.0 1.3
19.0 1.3 Other operating expenses 98.6 6.9 109.3 7.4 Medicare and
Medicaid EHR incentives (3.1 ) (0.2 ) (11.3 ) (0.8 ) Depreciation
and amortization 62.6 4.4 65.6 4.5 Interest, net 45.8 3.2 50.8 3.5
Debt extinguishment costs 38.9 2.7 — — Acquisition related expenses
12.2 0.8 — — Other (2.4 ) (0.2 ) (5.1 ) (0.3 ) Total
costs and expenses 1,475.4 102.7 1,451.0 98.7
Income (loss) from continuing operations
before income taxes
(39.1 ) (2.7 ) 19.7 1.3 Income tax benefit (expense) 15.2
1.1 (4.9 ) (0.3 ) Income (loss) from
continuing operations (23.9 ) (1.7 ) 14.8 1.0 Income (loss) from
discontinued operations, net of taxes (0.1 ) —
0.1 — Net income (loss) (24.0 ) (1.7 ) 14.9 1.0 Net
loss (income) attributable to non-controlling interests 2.3
0.2 (1.0 ) (0.1 )
Net income (loss) attributable to Vanguard
Health Systems, Inc. stockholders
$ (21.7 ) (1.5 )% $ 13.9 0.9 % Earnings (loss) per
share attributable to Vanguard Health Systems, Inc. stockholders
Basic earnings (loss) per share $ (0.29 ) $ 0.18 Diluted
earnings (loss) per share $ (0.29 ) $ 0.17 Weighted
average shares outstanding (in thousands): Basic 74,854
75,697 Diluted 74,854
78,813
VANGUARD HEALTH SYSTEMS, INC.
Supplemental Financial Information (Unaudited)
Reconciliation of Adjusted EBITDA to Net Income (Loss)
Attributable to Vanguard Health Systems, Inc. Stockholders
(In millions) Quarter
ended September 30, 2011
2012
Net income (loss) attributable to Vanguard
Health Systems, Inc. stockholders
$ (21.7 ) $ 13.9 Interest, net 45.8 50.8 Income tax expense
(benefit) (15.2 ) 4.9 Depreciation and amortization 62.6 65.6
Non-controlling interests (2.3 ) 1.0 Gain on disposal of assets
(1.2 ) (0.9 ) Equity method income (0.1 ) (0.6 ) Stock compensation
0.7 2.2 Realized losses on investments — 0.2 Acquisition related
expenses 12.2 — Debt extinguishment costs 38.9 — Impairment and
restructuring charges (0.1 ) — Pension credits (1.0 ) (3.8 )
Discontinued operations, net of taxes 0.1 (0.1
) Adjusted EBITDA (1) $ 118.7 $ 133.2
____________________
(1) Adjusted EBITDA is defined as income (loss) before interest
expense (net of interest income), income taxes, depreciation and
amortization, non-controlling interests, gain or loss on disposal
of assets, equity method income or loss, stock compensation,
monitoring fees and expenses, realized gains or losses on
investments, acquisition related expenses, debt extinguishment
costs, impairment and restructuring charges, pension expense
(credits) and discontinued operations, net of taxes. Adjusted
EBITDA is not intended as a substitute for net income (loss)
attributable to Vanguard Health Systems, Inc. stockholders,
operating cash flows or other cash flow data determined in
accordance with accounting principles generally accepted in the
United States. Due to varying methods of calculation, Adjusted
EBITDA as presented may not be comparable to similarly titled
measures of other companies.
VANGUARD HEALTH SYSTEMS, INC. Condensed
Consolidated Balance Sheets (Unaudited) (In millions)
ASSETS June 30,
2012 September 30, 2012 Current assets:
Cash and cash equivalents $ 455.5 $ 330.2 Restricted cash 2.4 3.9
Accounts receivable, net of allowance for
doubtful accounts of approximately $366.5 and $363.8,
respectively
702.1 672.4 Inventories 97.0 96.8 Deferred tax assets 89.6 89.8
Prepaid expenses and other current assets 236.4
214.8 Total current assets 1,583.0 1,407.9 Property,
plant and equipment, net of accumulated depreciation 2,110.1
2,106.7 Goodwill 768.4 768.4 Intangible assets, net of accumulated
amortization 89.0 87.5 Deferred tax assets, noncurrent 71.2 67.9
Investments in securities 51.8 56.8 Escrowed cash for capital
commitments 20.3 — Other assets 94.3 96.2
Total assets $ 4,788.1 $ 4,591.4
LIABILITIES AND EQUITY Current liabilities: Accounts payable
$ 390.6 $ 343.2 Accrued salaries and benefits 226.0 216.4 Accrued
health plan claims and settlements 67.8 66.4 Accrued interest 73.2
35.8 Other accrued expenses and current liabilities 219.9 152.3
Current maturities of long-term debt 11.2 12.5
Total current liabilities 988.7 826.6 Professional and
general liability and workers compensation reserves 304.8 303.7
Unfunded pension liability 269.9 234.1 Other liabilities 174.7
161.5 Long-term debt, less current maturities 2,695.4 2,692.1
Commitments and contingencies Redeemable non-controlling interests
53.1 54.2 Equity:
Vanguard Health Systems, Inc.
stockholders’ equity:
Common stock 0.8 0.8 Additional paid-in capital 403.3 403.9
Accumulated other comprehensive loss (48.4 ) (47.2 ) Retained
deficit (60.6 ) (46.7 )
Total Vanguard Health Systems, Inc.
stockholders’ equity
295.1 310.8 Non-controlling interests 6.4 8.4
Total equity 301.5 319.2 Total
liabilities and equity $ 4,788.1 $ 4,591.4
VANGUARD HEALTH SYSTEMS, INC. Condensed
Consolidated Statements of Cash Flows (Unaudited) (In
millions) Quarter
ended September 30, 2011
2012 Operating activities: Net income (loss) $ (24.0
) $ 14.9 Adjustments to reconcile net income (loss) to net cash
used in operating activities: Loss (income) from discontinued
operations 0.1 (0.1 ) Depreciation and amortization 62.6 65.6
Amortization of loan costs and accretion of principal on notes 5.7
3.3 Debt extinguishment costs 38.9 — Acquisition related expenses
12.2 — Stock compensation 0.7 2.2 Deferred income taxes (16.1 ) 2.9
Other (1.3 ) (0.7 ) Changes in operating assets and liabilities
(166.5 ) (144.6 ) Net cash used in operating
activities - continuing operations (87.7 ) (56.5 ) Net cash
provided by (used in) operating activities - discontinued
operations (0.1 ) 0.1 Net cash used in
operating activities (87.8 ) (56.4 )
Investing
activities: Acquisitions and related expenses, net of cash
acquired (210.1 ) (0.4 ) Capital expenditures (63.4 ) (82.7 )
Proceeds from sales of investments in securities 22.7 27.1
Purchases of investments in securities (21.0 ) (30.1 ) Net
reimbursements from restricted cash and escrow fund — 18.8 Other
2.2 1.5 Net cash used in investing
activities (269.6 ) (65.8 )
Financing activities:
Payments of long-term debt and capital leases (456.5 ) (3.1 )
Payments of debt issuance costs — (0.2 ) Proceeds from the issuance
of common stock 67.5 — Payments of IPO costs (6.9 ) — Payments of
tender premiums on note redemptions (27.6 ) — Distributions paid to
non-controlling interests and other (1.0 ) 0.2
Net cash used in financing activities (424.5 ) (3.1 )
Net decrease in cash and cash equivalents (781.9 ) (125.3 ) Cash
and cash equivalents, beginning of period 936.6
455.5 Cash and cash equivalents, end of period $
154.7 $ 330.2
Supplemental cash flow
information: Net cash paid for interest $ 70.8 $ 85.0
Net cash paid for income taxes $ 0.3 $ 4.0
VANGUARD HEALTH SYSTEMS, INC. Segment
Information (Unaudited) (In millions)
Quarter ended September 30, 2011
Acute Care % of
Health % of
Services Revenues Plans Revenues
Eliminations Consolidated Patient service revenues,
net (1) $ 1,233.9 100.0 % $ — — % $ (8.6 ) $ 1,225.3 Premium
revenues — — 211.0 100.0
— 211.0 Total revenues 1,233.9 100.0
211.0 100.0 (8.6 ) 1,436.3
Salaries and benefits (excludes stock
compensation)
655.2 53.1 9.1 4.3 — 664.3 Health plan claims expense (1) — — 173.3
82.1 (8.6 ) 164.7 Supplies 213.6 17.3 — — — 213.6 Other operating
expenses 267.4 21.7 10.7 5.1 — 278.1
Medicare and Medicaid EHR incentives
(3.1 ) (0.3 ) — — —
(3.1 ) Segment EBITDA (2) 100.8 8.2 17.9 8.5 — 118.7 Less:
Interest, net 46.1 3.7 (0.3 ) (0.1 ) — 45.8 Depreciation and
amortization 61.4 5.0 1.2 0.6 — 62.6 Equity method income (0.1 ) —
— — — (0.1 ) Stock compensation 0.7 0.1 — — — 0.7 Gain on disposal
of assets (1.2 ) (0.1 ) — — — (1.2 ) Debt extinguishment costs 38.9
3.2 — — — 38.9 Acquisition related expenses 12.2 1.0 — — — 12.2
Impairment and restructuring charges (0.1 ) — — — — (0.1 ) Pension
credits (1.0 ) (0.1 ) — — —
(1.0 )
Income (loss) from continuing operations
before income taxes
$ (56.1 ) (4.4 )% $ 17.0 8.1 % $ — $ (39.1 )
____________________
(1) We eliminate in consolidation those patient service revenues
earned by our health care facilities attributable to services
provided to enrollees in our owned health plans and eliminate the
corresponding medical claims expenses incurred by our health plans
for those services.
(2) Segment EBITDA is defined as income (loss) from continuing
operations before income taxes less interest expense (net of
interest income), depreciation and amortization, equity method
income or loss, stock compensation, gain or loss on disposal of
assets, realized gains or losses on investments, monitoring fees
and expenses, acquisition related expenses, debt extinguishment
costs, impairment and restructuring charges and pension expense
(credits). Management uses Segment EBITDA to measure the
performance of our segments and develop strategic objectives and
operating plans for those segments. Segment EBITDA eliminates the
uneven effect of non-cash depreciation of tangible assets and
amortization of intangible assets, much of which results from
acquisitions accounted for under the purchase method of accounting.
Segment EBITDA also eliminates the effects of changes in interest
rates, which management believes relate to general trends in global
capital markets, but are not necessarily indicative of the
operating performance of our segments. Management believes that
Segment EBITDA provides useful information to investors, lenders,
financial analysts and rating agencies about the financial
performance of our segments. Additionally, management believes that
investors and lenders view Segment EBITDA as an important factor in
making investment decisions concerning us. Segment EBITDA is not a
substitute for net income (loss), operating cash flows or other
cash flow statement data determined in accordance with accounting
principles generally accepted in the United States. Segment EBITDA,
as presented, may not be comparable to similar measures of other
companies.
VANGUARD HEALTH SYSTEMS, INC. Segment Information
(Unaudited) (continued) (In millions)
Quarter ended September 30, 2012
Acute Care % of
Health % of
Services Revenues Plans Revenues
Eliminations Consolidated Patient service revenues,
net (1) $ 1,304.5 100.0 % $ — — % $ (10.2 ) $ 1,294.3 Premium
revenues — — 176.4 100.0
— 176.4 Total revenues 1,304.5 100.0
176.4 100.0 (10.2 ) 1,470.7
Salaries and benefits (excludes stock
compensation)
669.1 51.3 8.9 5.0 — 678.0 Health plan claims expense (1) — — 144.5
81.9 (10.2 ) 134.3 Supplies 226.1 17.3 — — — 226.1 Other operating
expenses 299.2 22.9 11.2 6.3 — 310.4
Medicare and Medicaid EHR incentives
(11.3 ) (0.9 ) — — —
(11.3 ) Segment EBITDA (2) 121.4 9.3 11.8 6.7 — 133.2 Less:
Interest, net 51.3 3.9 (0.5 ) (0.3 ) — 50.8 Depreciation and
amortization 64.6 5.0 1.0 0.6 — 65.6 Equity method income (0.6 ) —
— — — (0.6 ) Stock compensation 2.2 0.2 — — — 2.2 Gain on disposal
of assets (0.9 ) (0.1 ) — — — (0.9 ) Realized losses on investments
0.2 — — — — 0.2 Pension credits (3.8 ) (0.3 ) —
— — (3.8 )
Income from continuing operations before
income taxes
$ 8.4 0.6 % $ 11.3 6.5 % $ — $ 19.7
____________________
(1) We eliminate in consolidation those patient service revenues
earned by our health care facilities attributable to services
provided to enrollees in our owned health plans and eliminate the
corresponding medical claims expenses incurred by our health plans
for those services.
(2) Segment EBITDA is defined as income (loss) from continuing
operations before income taxes less interest expense (net of
interest income), depreciation and amortization, equity method
income or loss, stock compensation, gain or loss on disposal of
assets, realized gains or losses on investments, monitoring fees
and expenses, acquisition related expenses, debt extinguishment
costs, impairment and restructuring charges and pension expense
(credits). Management uses Segment EBITDA to measure the
performance of our segments and develop strategic objectives and
operating plans for those segments. Segment EBITDA eliminates the
uneven effect of non-cash depreciation of tangible assets and
amortization of intangible assets, much of which results from
acquisitions accounted for under the purchase method of accounting.
Segment EBITDA also eliminates the effects of changes in interest
rates, which management believes relate to general trends in global
capital markets, but are not necessarily indicative of the
operating performance of our segments. Management believes that
Segment EBITDA provides useful information to investors, lenders,
financial analysts and rating agencies about the financial
performance of our segments. Additionally, management believes that
investors and lenders view Segment EBITDA as an important factor in
making investment decisions concerning us. Segment EBITDA is not a
substitute for net income (loss), operating cash flows or other
cash flow statement data determined in accordance with accounting
principles generally accepted in the United States. Segment EBITDA,
as presented, may not be comparable to similar measures of other
companies.
VANGUARD HEALTH SYSTEMS, INC. Selected Operating
Statistics (Unaudited)
Quarter ended
CONSOLIDATED:
September 30, 2011 2012 %
Change Number of hospitals at end of period 28 28 Licensed beds
at end of period 7,064 7,064 Discharges 68,161 71,481 4.9 %
Adjusted discharges 125,320 131,502 4.9 Average length of stay 4.34
4.41 1.6 Patient days 296,079 315,555 6.6 Adjusted patient days
544,366 580,521 6.6 Patient revenue per adjusted discharge $ 9,279
$ 9,403 1.3 Inpatient surgeries 16,077 16,592 3.2 Outpatient
surgeries 29,976 31,131 3.9 Observation cases 16,357 19,228 17.6
Emergency room visits 292,839 315,035 7.6 Health plan member lives
245,000 235,800 (3.8 ) Health plan claims expense percentage 78.1 %
76.1 %
Uncompensated care as a percent of net
patient revenues (prior to these uncompensated care
adjustments)
17.9 % 21.8 % Net patient revenue payer mix: Medicare 26.6 %
27.5 % Medicaid 14.7 13.5 Managed Medicare 10.2 11.3 Managed
Medicaid 10.6 10.0 Managed care 35.1 34.2 Commercial 1.4 1.5
Self-pay 1.4 2.0 Total 100.0 %
100.0 % Discharges by payer: Medicare 28.3 % 27.9 %
Medicaid 10.4 9.6 Managed Medicare 12.3 12.2 Managed Medicaid 17.8
18.6 Managed care 23.2 22.7 Commercial 0.5 0.5 Self-pay 7.5
8.5 Total 100.0 % 100.0 %
VANGUARD HEALTH SYSTEMS, INC. Selected Operating
Statistics (Unaudited) (continued)
Quarter ended
SAME
STORE:
September 30, 2011 2012 %
Change Number of hospitals at end of period 26 26 Licensed beds
at end of period 6,198 6,198 Total revenues, including health plan
revenues (in millions) $ 1,404.0 $ 1,365.7 (2.7 )% Net patient
service revenues (in millions) $ 1,193.0 $ 1,200.0 0.6 Discharges
65,890 64,669 (1.9 ) Adjusted discharges 121,870 120,871 (0.8 )
Average length of stay 4.33 4.39 1.4 Patient days 285,479 283,825
(0.6 ) Adjusted patient days 528,021 530,488 0.5 Patient revenue
per adjusted discharge $ 9,285 $ 9,471 2.0 Inpatient surgeries
15,415 14,583 (5.4 ) Outpatient surgeries 29,509 28,593 (3.1 )
Observation cases 15,792 17,416 10.3 Emergency room visits 286,126
293,163 2.5 Health plan member lives 245,000 225,300 (8.0 )
Uncompensated care as a percent of net
patient revenues (prior to these uncompensated care
adjustments)
17.9 % 20.8 % Net patient revenue payer mix: Medicare 26.3 %
26.0 % Medicaid 13.9 13.3 Managed Medicare 10.4 11.6 Managed
Medicaid 10.8 10.7 Managed care 35.6 35.1 Commercial 1.3 1.4
Self-pay 1.7 1.9 Total 100.0 %
100.0 % Discharges by payer: Medicare 28.1 % 27.8 %
Medicaid 9.9 9.2 Managed Medicare 12.6 12.8 Managed Medicaid 18.3
18.2 Managed care 23.4 23.1 Commercial 0.6 0.5 Self-pay 7.1
8.4 Total 100.0 % 100.0 %
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