North Shore Medical Center in Salem, one of the hardest hit. Credit: Google Street View
Acute care hospitals in Massachusetts are turning a profit for the most part, but in many cases those profits are less than robust. The state's Center for Health Care Information and Analysis found that many are in a financially precarious position.
According to the report, about 65 percent of the commonwealth's hospitals have operating margins below three percent. Overall, hospitals' operating margins hovered around 1.6 percent. That's down from 2.8 percent during the previous fiscal year.
While 49 of 62 hospitals were profitable in the fiscal year ending Sept. 30, many low margins low enough not to be considered financially healthy.
Hit especially hard were Massachusetts' community hospitals, with median operating margins plunging to 0.9 percent -- down two full percentage points from the previous year.
The northeastern part of the state saw the lowest margins geographically, at 1.6 percent, with some facilities operating on negative margins and hemorrhaging cash. North Shore Medical Center in Salem was among the hardest hit, seeing $57.7 million evaporate in fiscal year 2017.
Not all Massachusetts hospitals are feeling those kinds of pressures. Northeast Hospital enjoyed a 9 percent operating margin during the past fiscal year, translating into a $33.1 million surplus.
That the state's rural hospitals are struggling isn't surprising, given the national trend. A recent report found that nearly half are operating at negative margins, fueled largely by a high rate of uninsured patients. Eighty rural hospitals closed from 2010 to 2016, and more have shut their doors since.
Aside from the high uninsured rate, a payer mix heavy on Medicare and Medicaid with lower claims reimbursement rates is a contributing factor. More patients are seeking care outside rural areas, which isn't helping, and many areas see a dearth of employer-sponsored health coverage due to lower employment rates. Many markets are also besieged by a shortage of primary care providers, and tighter payer-negotiated reimbursement rates.