Dive Brief:
- Tenet Healthcare reported a $59 million loss for the 2016 first quarter, fueled by a hike in reserves for potential payouts to settle a whistleblower lawsuit alleging kickbacks to four Georgia hospitals, The Wall Street Journal reported.
- The reserve increase — to $407 million, from $238 million in February — alongside hospital buying and selling costs dimmed an otherwise healthy quarter, according to Modern Healthcare.
- During the quarter, patient revenue grew 6% to $4.02 billion, while uninsured and charity cases declined.
Dive Insight:
On a same-hospital basis, inpatients visits for the uninsured plus charity fell 3.8%, while those for outpatient visits inched up 1.5%. Among health exchange patients, same-hospital admissions and outpatient visits rose 28% and 46%, respectively.
Overall, revenue grew by 14% to $5.04 billion. That wasn’t enough, however, to counter the downward pull of the reserve to resolve the False Claims Act case, which alleges kickbacks for maternity referrals by former Tenet-owned hospitals.
In February, the company raised the reserve from $20 million to $238 million; however, the Justice Department and Georgia attorney general’s office rejected that figure — prompting the hospital chain to raise the amount again.
On the individual coverage front, Tenet company executives told Reuters this week it predicts other insurers will absorb whatever business UnitedHealth leaves behind as they leave ACA markets.
Fluctuation in the marketplaces is to be expected, suggests Tenet senior vice president of public affairs Daniel Waldmann, pointing to previous adjustments that took place when Medicare Advantage managed care plans were first introduced.
The hospital system has skin in the game and incentive to support the exchanges thanks to its boost in business. It reports admissions growth from ACA-insured patients to be up more than 27% in the first quarter of 2016 compared to last year.