Top South Carolina Hospitals by Revenue
We’ve discussed how many beds the hospitals have, how many Inpatient days they reported, and how many Docs they are training. Now, we will see if they are making any money doing any of this.
Welcome to healthcare. Even though costs are exorbitant, some hospitals are losing money. How can this be when they charge $20 for a bandaid? Well, unfortunately, only people with no insurance or really bad insurance are paying the $20 for the bandaid. And truthfully, most self pay patients aren’t able to pay anything for the bandaid.
Hospitals like to report how much revenue they are making. “Hey, we make 30 gazillion dollars providing healthcare to this community. Aren’t we awesome?” Well, yeah, they are awesome, but that revenue number is basically meaningless when it comes to hospital finances.
Gross Revenue
Gross revenue would be total charges before any contractuals or other revenue deductions are applied.
Let’s take a look at the top 15 hospitals in South Carolina by Gross Revenue.
| # | Hospital | City | CR YE | Beds | Revenue |
|---|---|---|---|---|---|
| 1 | MEDICAL UNIVERSITY OF SOUTH CAROLINA | CHARLESTON | 06/30/18 | 682 | 4,414,099,028 |
| 2 | LEXINGTON MEDICAL CENTER | WEST COLUMBIA | 09/30/18 | 436 | 3,766,374,908 |
| 3 | TRIDENT REGIONAL MEDICAL CENTER | CHARLESTON | 03/31/18 | 404 | 3,619,162,431 |
| 4 | GHS GREENVILLE MEMORIAL HOSPITAL | GREENVILLE | 09/30/18 | 682 | 3,500,341,303 |
| 5 | ST. FRANCIS HOSPITAL INC | GREENVILLE | 08/31/18 | 319 | 3,331,721,448 |
| 6 | PALMETTO RICHLAND | COLUMBIA | 09/30/18 | 672 | 3,275,462,061 |
| 7 | MCLEOD REGIONAL MEDICAL CENTER | FLORENCE | 09/30/18 | 509 | 3,066,183,050 |
| 8 | GRAND STRAND REGIONAL MEDICAL CENTER | MYRTLE BEACH | 04/30/18 | 369 | 2,780,425,320 |
| 9 | SPARTANBURG REGIONAL MEDICAL CENTER | SPARTANBURG | 09/30/18 | 493 | 2,772,596,796 |
| 10 | ANMED HEALTH | ANDERSON | 12/31/18 | 367 | 2,376,179,078 |
| 11 | PIEDMONT MEDICAL CENTER | ROCK HILL | 05/31/18 | 268 | 1,379,309,551 |
| 12 | CAROLINAS HOSPITAL SYSTEM | FLORENCE | 02/28/19 | 354 | 1,320,297,813 |
| 13 | PALMETTO BAPTIST | COLUMBIA | 09/30/18 | 278 | 1,175,331,337 |
| 14 | ROPER HOSPITAL | CHARLESTON | 12/31/18 | 316 | 1,164,986,945 |
| 15 | AIKEN REGIONAL MEDICAL CENTER | AIKEN | 12/31/18 | 204 | 1,118,237,994 |
Top spot for beds, Inpatient days, Interns & Residents, AND revenue goes to Medical University of South Carolina (MUSC). Ok, so they are top dog.
Interestingly though, GHS Greenville actually ties with MUSC for beds, but is #4 for revenue. And Lexington Medical Center is #2 for revenue, but #6 for beds.
There could be lots of reasons for these changes in rank. Probably the biggest is beds are for Inpatients. If the hospital has a huge Outpatient service line for a procedure, it won’t be reflected in the bed count.
The other potential reason would be the charge structure for the hospital. There’s no law that says all hospitals have to charge $20 for a bandaid. One hospital could charge $18, whereas the hospital across the street could charge $30.
Net Revenue
Hospital may charge $30 for a bandaid, but if you have insurance, the insurance company is not going to pay $30 for the bandaid. Each insurance company has a contract with the hospital and in the contract, they may say they are going to pay $5 for a bandaid. On the hospital’s books, the revenue for the bandaid is $30, but net revenue for the bandaid is $5. The $25 difference is a contractual allowance (or revenue deduction). The $25 is adjusted off the books such that the expected $5 is all that remains.
| # | Hospital | Revenue | Net Revenue | Net Rev / Rev |
|---|---|---|---|---|
| 1 | MEDICAL UNIVERSITY OF SOUTH CAROLINA | 4,414,099,028 | 1,425,364,381 | 32% |
| 2 | LEXINGTON MEDICAL CENTER | 3,766,374,908 | 1,005,515,351 | 27% |
| 3 | TRIDENT REGIONAL MEDICAL CENTER | 3,619,162,431 | 506,104,421 | 14% |
| 4 | GHS GREENVILLE MEMORIAL HOSPITAL | 3,500,341,303 | 1,252,811,697 | 36% |
| 5 | ST. FRANCIS HOSPITAL INC | 3,331,721,448 | 592,956,547 | 18% |
| 6 | PALMETTO RICHLAND | 3,275,462,061 | 860,721,215 | 26% |
| 7 | MCLEOD REGIONAL MEDICAL CENTER | 3,066,183,050 | 689,414,493 | 22% |
| 8 | GRAND STRAND REGIONAL MEDICAL CENTER | 2,780,425,320 | 415,330,721 | 15% |
| 9 | SPARTANBURG REGIONAL MEDICAL CENTER | 2,772,596,796 | 742,780,796 | 27% |
| 10 | ANMED HEALTH | 2,376,179,078 | 595,563,766 | 25% |
| 11 | PIEDMONT MEDICAL CENTER | 1,379,309,551 | 288,915,464 | 21% |
| 12 | CAROLINAS HOSPITAL SYSTEM | 1,320,297,813 | 122,639,998 | 9% |
| 13 | PALMETTO BAPTIST | 1,175,331,337 | 359,873,622 | 31% |
| 14 | ROPER HOSPITAL | 1,164,986,945 | 377,420,843 | 32% |
| 15 | AIKEN REGIONAL MEDICAL CENTER | 1,118,237,994 | 226,256,124 | 20% |
In the data above, the average for net revenue to revenue percentage is 24%. This means that on average, revenue for these hospitals is netted down 76% with insurance contractuals and other write-offs, like bad debts or charity.
Net Patient Income
Revenue less contractuals equals net revenue. When you remove expenses, you get net patient income. Hospitals can generate non-patient income. Some usual non-patient income is parking fees, vending machine revenue, charging for medical record copies, or baby pictures. Non-patient income is included in net income, but not net “patient” income.
Let’s take a look at the hospital’s net patient income.
| # | Hospital | Revenue | Net Revenue | Net Patient Income |
|---|---|---|---|---|
| 1 | GRAND STRAND REGIONAL MEDICAL CENTER | 2,780,425,320 | 415,330,721 | 89,925,499 |
| 2 | TRIDENT REGIONAL MEDICAL CENTER | 3,619,162,431 | 506,104,421 | 89,664,773 |
| 3 | ST. FRANCIS HOSPITAL INC | 3,331,721,448 | 592,956,547 | 76,244,519 |
| 4 | ANMED HEALTH | 2,376,179,078 | 595,563,766 | 60,280,491 |
| 5 | MCLEOD REGIONAL MEDICAL CENTER | 3,066,183,050 | 689,414,493 | 59,267,452 |
| 6 | PIEDMONT MEDICAL CENTER | 1,379,309,551 | 288,915,464 | 48,863,691 |
| 7 | ROPER HOSPITAL | 1,164,986,945 | 377,420,843 | 28,145,943 |
| 8 | AIKEN REGIONAL MEDICAL CENTER | 1,118,237,994 | 226,256,124 | 21,090,573 |
| 9 | LEXINGTON MEDICAL CENTER | 3,766,374,908 | 1,005,515,351 | 10,760,346 |
| 10 | PALMETTO BAPTIST | 1,175,331,337 | 359,873,622 | 1,184,919 |
| 11 | SPARTANBURG REGIONAL MEDICAL CENTER | 2,772,596,796 | 742,780,796 | -6,088,605 |
| 12 | PALMETTO RICHLAND | 3,275,462,061 | 860,721,215 | -17,176,489 |
| 13 | GHS GREENVILLE MEMORIAL HOSPITAL | 3,500,341,303 | 1,252,811,697 | -17,632,068 |
| 14 | MEDICAL UNIVERSITY OF SOUTH CAROLINA | 4,414,099,028 | 1,425,364,381 | -44,213,392 |
| 15 | CAROLINAS HOSPITAL SYSTEM | 1,320,297,813 | 122,639,998 | -82,883,092 |
Uh oh. What happened to Medical University of South Carolina? They have dropped from the top spot in every table to number #14. How can they still be open? Well, they have $74 million in non-patient income. Their net income is $30 million. They didn’t detail out their non-patient income, but they did list $25 million in governmental appropriations.
Musing Revelation
Looking at this data is always interesting. It is a huge struggle to stay in business in the hospital industry. Hospitals are so vital to our lives though, as one never knows when you’ll need medical care. Having access to a hospital could be what saves your life.
It’s just crazy to look at revenue vs net revenue. And then net patient income. Wow. It’s so hard to remain competitive or even open in this industry. Yes, in spite of charging crazy amounts for a bandaid, it’s a tough industry to be profitable in.