New York state's largest health system grew in 2015, but Northwell Health's investments have chipped away at its margins.
Last year, Northwell Health, formerly known as North Shore-LIJ Health System, earned $89.7 million in operating surplus with an operating margin of 1%—underscoring how difficult it is for an organization, even of Northwell's size, to thrive. That margin is down from 1.2% in 2014. Net income was $29 million, down from $190.8 million in 2014, according to audited financial statements. Operating income at the system's largest hospitals boosted results.
Though the 21-hospital not-for-profit system has grown much larger than many of its regional peers, competitors have reported higher margins. NYU Langone Medical Center, for example, reported an 8.8% operating margin for fiscal 2015, which ended Aug. 31, 2015.
Northwell's margins are weighed down by having a greater number of patients who are Medicaid beneficiaries. The government program reimburses healthcare providers at a lower rate than commercial insurers. Northwell's commitment to the Feinstein Institute for Medical Research also diminished its surplus, resulting in a $39.4 million operating loss last year.
Higher patient volume and payment rates drove the system's operating revenue to $8.7 billion, up 17.3% from the prior year. Management also attributed higher revenue to the acquisition of Phelps Memorial and Northern Westchester hospitals; expansion of its ambulatory network; investments in joint ventures; and higher enrollment at its insurance companies.
However, operating expenses increased at a faster clip of 17.5%. The growth in expenses was fueled by higher patient volume, and by investments in capacity, infrastructure and strategies that will prepare Northwell for the shift toward a payment system that rewards quality of care rather than quantity of services provided.
Last year, Northwell lost $41.4 million on its insurance products, 25.6% more than the year prior. But the system is still counting on health insurance as a long-term moneymaker. —Jonathan LaMantia, Crain's New York Business