Small nonprofit hospitals at tipping point, says rating service

Small and stand-alone nonprofit hospitals are facing mounting pressure from weak operating margins and lower patient volumes, according to a report from Standard & Poor's Rating Services. Meanwhile, hospitals cope with the changing health care landscape by exploring ways to help low-income consumers pay their Obamacare premiums and offering no-interest payment plans for those with high-deductible insurance policies.

Reuters: Nonprofit Hospitals At A Tipping Point From Mounting Challenges
Small and stand-alone nonprofit hospitals are facing mounting pressure from weak operating margins and lower patient volumes, with more signals of stress on the way, according a report released Wednesday from Standard & Poor's Rating Services. The rating agency warned the healthcare sector was at "a tipping point where negative forces have started to outweigh many providers' ability to implement sufficient countermeasures." Beginning in 2013 and continuing into this year, credit downgrades outpaced upgrades at an accelerating rate. In particular, stand-alone providers are under greater pressure from physician departures, rising bad debt, and higher employee benefit costs (Respaut, 8/13).

Marketplace: What's Behind No-Interest Medical Credit
A bigger and bigger chunk of the money hospitals get comes from you and me, thanks to a rise in what are known as deductible health plans, in which consumers are spending more out-of-pocket for their own care. With millions more newly insured under the Affordable Care Act holding those plans, hospitals are thinking hard about the best way to collect from us when we can't pay our bills. In some cases, that means no-interest payment plans (Gorenstein, 8/13).

Kaiser Health News: Hospitals Seek To Help Consumers With Obamacare Premiums
Some hospitals in New York, Florida and Wisconsin are exploring ways to help individuals and families pay their share of the costs of government-subsidized policies purchased though the health law's marketplaces – at least partly to guarantee the hospitals get paid when the consumers seek care. But the hospitals' efforts have set up a conflict with insurers, who worry that premium assistance programs will skew their enrollee pools by expanding the number of sicker people who need more services (Appleby, 8/14).