Presbyterian Healthcare Services, an Albuquerque-based system with hospital and health plan operations, continued to see benefits from the state's revamped Medicaid managed-care program in the fourth quarter of 2014.
New Mexico replaced its previous Medicaid managed-care program, known as Salud, with an expanded program known as Centennial Care. Presbyterian was one of four health plans selected in 2013 to manage medical, behavioral health and long-term care for the state's Medicaid beneficiaries.
As a result, the system experienced an 18.1% increase in Medicaid members as part of an overall 7.7% growth in health plan membership. Premium revenue increased 49.2% to $425.8 million in the quarter.
The eight-hospital system also saw a 10.9% increase in patient-service revenue, which reached $195.1 million for the quarter. Presbyterian cut its provision for bad debts by 34.1% because it treated more Medicaid members and fewer self-pay patients in the Medicaid-expansion state.
In total, Presbyterian reported a fourth-quarter operating surplus of $52.9 million on $644.1 million in revenue, for an operating margin of 8.2%. In the prior-year period, its operating surplus was $4.2 million on $478.7 million in revenue, for an operating margin of 0.9%.
Inpatient admissions decreased 2.3% in the fourth quarter compared with the same period in 2013, but outpatient visits were up 13.6%. Presbyterian opened two new outpatient clinics in the Albuquerque and Rio Rancho markets as it delivers more care in outpatient settings.
Supply costs rose 16.7%, Presbyterian said, primarily because of rising drug costs; a shift to medical management of cancer and away from radiation treatment; and the cost of new information technology equipment.
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