summary of operating results september 30, 2009. 2 adult admissions (rolling 12 months) fy2010 ytd...

SUMMARY OF OPERATING RESULTS

September 30, 2009

2

1,600

1,700

1,800

1,900

2,000

2,100

Prior Actual 1,927 1,815 1,733 1,914 1,789 1,869 1,898 1,911 1,923 2,037 1,930 1,907

Current Actual 1,915 1,732 1,868 1,744 1,725 1,973 1,970 1,895 1,960 2,055 1,931 1,981

Current Budget 1,890 1,811 1,825 1,830 1,769 1,964 1,841 1,942 1,827 1,959 1,970 1,923

Oct 08 Nov 08 Dec 08 Jan 09 Feb 09 Mar 09 Apr 09 May 09 Jun 09 Jul 09 Aug 09 Sep 09

Adult Admissions(rolling 12 months)

FY2010

YTD

5,874

5,967

5,852

3

8,000

9,000

10,000

11,000

12,000

Prior Actual 10,202 9,527 9,621 10,211 9,198 9,854 9,580 9,499 8,994 10,472 10,155 9,757

Current Actual 10,407 10,048 10,019 9,420 9,188 10,374 10,332 10,365 10,452 11,016 10,326 10,231

Current Budget 10,038 9,441 9,631 9,938 9,117 10,091 9,633 9,988 9,692 10,561 10,350 9,899

Oct 08 Nov 08 Dec 08 J an 09 Feb 09 Mar 09 Apr 09 May 09 J un 09 J ul 09 Aug 09 Sep 09

Adult Patient Days(rolling 12 months)

FY2010

YTD

30,384

31,573

30,810

4

1.70

1.80

1.90

2.00

2.10

Prior Actual 1.94 1.89 1.99 1.84 1.85 1.84 1.81 1.78 1.87 1.79 1.86 1.82

Current Actual 1.90 1.93 1.91 1.83 1.84 1.84 1.80 1.94 1.86 1.97 1.88 1.87

Current Budget 1.90 1.90 1.90 1.90 1.90 1.90 1.90 1.90 1.90 1.86 1.86 1.86


Adult Case Mix (rolling 12 months)

FY2010

YTD

1.83

1.90

1.86

5

30,000

35,000

40,000

45,000

Prior Actual 43,815 41,742 31,877 39,453 35,191 36,087 41,346 38,548 37,420 39,199 36,218 39,372

Current Actual 42,846 37,968 34,883 37,612 36,919 41,255 41,362 38,567 41,559 40,686 38,186 43,528

Current Budget 41,316 42,302 40,294 41,053 37,563 41,079 39,705 40,988 40,258 38,728 37,792 41,132

Oct 08 Nov 08 Dec 08 J an 09 Feb 09 Mar 09 Apr 09 May 09 J un 09 J ul 09 Aug 09 Sep 09

Adult Clinic Visits(rolling 12 months)

FY2010

YTD

114,789

122,400

117,652

6

180

200

220

240

260

280

Prior Actual 210 248 249 271 251 222 257 226 189 245 215 241

Current Actual 239 213 199 253 264 253 234 227 211 224 222 243

Current Budget 222 240 233 227 222 229 234 232 219 251 221 246


Pediatric Admissions (rolling 12 months)

FY2010

YTD

701

689

718

7

1,000

1,100

1,200

1,300

1,400

1,500

1,600

Prior Actual 1,302 1,330 1,294 1,461 1,369 1,357 1,263 1,249 1,126 1,179 1,270 1,287

Current Actual 1,384 1,126 1,145 1,439 1,343 1,551 1,427 1,275 1,359 1,364 1,228 1,384

Curent Budget 1,278 1,283 1,293 1,340 1,243 1,334 1,278 1,291 1,276 1,201 1,316 1,300


Pediatric Patient Days (rolling 12 months)

FY2010

YTD

3,736

3,976

3,817

8

1.10

1.20

1.30

1.40

1.50

1.60

Prior Actual 1.35 1.18 1.31 1.16 1.26 1.45 1.50 1.32 1.35 1.35 1.28 1.21

Current Actual 1.43 1.26 1.22 1.47 1.27 1.25 1.30 1.35 1.44 1.41 1.38 1.24

Current Budget 1.31 1.31 1.31 1.31 1.31 1.31 1.31 1.31 1.31 1.32 1.32 1.32


Pediatric Case Mix (rolling 12 months)

FY2010

YTD

1.28

1.35

1.32

9

6,000

7,000

8,000

9,000

10,000

Prior Actual 8,980 9,170 7,029 8,201 7,885 8,223 8,194 7,906 7,447 8,047 7,718 7,840

Current Actual 9,758 8,511 7,148 7,746 8,301 8,713 8,387 8,063 8,469 8,470 7,963 9,179

Current Budget 8,218 8,481 8,216 8,218 8,058 8,532 8,167 8,217 8,481 7,841 7,820 7,899


Pediatric Clinic Visits(rolling 12 months)

FY2010

YTD

23,605

25,612

23,560

10

Other Key Ancillary Service Activity Indicators

Month of September 2009

% VariancesActual Budget Actual Actual to 2009 to2009 2009 2008 Budget 2008

Inpatient Gross Revenues 90,508,751$ 84,614,902$ 81,172,151$ 7.0% 11.5%Outpatient Gross Revenues 75,938,948$ 72,994,989$ 65,972,763$ 4.0% 15.1%166,447,699$ 157,609,891$ 147,144,914$

Surgical Procedures: Inpatient (excludes Misc/Out of OR) 944 975 1,038 -3.2% -9.1% Outpatient 642 593 692 8.3% -7.2% AFCH 356 342 124 4.1% 187.1% Subtotal 1,942 1,910 1,854 1.7% 4.7% Misc./Out of OR 205 181 154 13.3% 33.1% Total Surgical Procedures 2,147 2,091 2,008 2.7% 6.9%

Transplants Cadaver 41 31 37 32.3% 10.8% Living 8 10 3 -20.0% 166.7% Total 49 41 40 19.5% 22.5%

Cardiology Invasive Lab Procedures Cardiovascular Lab 864 797 821 8.4% 5.2% Electrophysiology Lab 118 88 72 34.1% 63.9% Total 982 885 893 11.0% 10.0%

Emergency Room Visits 3,877 3,524 3,552 10.0% 9.1%

Radiology Procedures: MRI 2,318 2,166 2,310 7.0% 0.3% CT Scans 4,898 5,310 5,415 -7.8% -9.5% Other 18,176 17,014 17,850 6.8% 1.8% Total Radiology Procedures 25,392 24,490 25,575 3.7% -0.7%

Radiotherapy Procedures 3,038 2,610 2,301 16.4% 32.0%

11

Regional Hospital Transfers and Diversions & Cancelled Hospital Transfers Due to Lack of Beds

Sep

-07

Oct

-07

No

v-07

Dec

-07

Jan

-08

Feb

-08

Mar

-08

Ap

r-08

May

-08

Jun

-08

Jul-

08

Au

g-0

8

Sep

-08

Oct

-08

No

v-08

Dec

-08

Jan

-09

Feb

-09

Mar

-09

Ap

r-09

May

-09

Jun

-09

Jul-

09

Au

g-0

9

Sep

-09

Month & Year

Inp

ati

en

t C

as

es

MedflightDiversions

ED Diversions

Cancellations -Lack of Beds

ICUDOC Adult Peds ED MedFlight

Total: 3

1 0 2 0 0

06238

44

36

47

4769

61

62

45

49

42 50

4557

54

44

36

50

39

46

49

58 6652

417

374

336

343

386

386

413

429

465

415

339345353

306

419

379 390

368

370

405

377

456

397

416

406

Transfers from Local Hospitals(Admitted to UW Hosp Inpt Svc)*

Transfers from Regional Hospitals(Admitted to UW Hosp Inpt Svc)*

0 -

50 -

0 -

200 -

300 -

400 -

500 -

600 -

*Both exclude Transfers to UWHC Emergency Department, not admitted

Div

ers

ion

s

100 -

Inp

atie

nt

Tra

nsf

ers

23

1 3 2 2 8 4 9 10 2 0 2 7 1

46

13 19 12 1 2 1 1 1

27 3

12

Payor Mix - Inpatient Discharges12 & 3 month comparison

(period over period change)

% of Business

10/07 - 9/08

July-Sept

2008/2009

HMO/Indemnity 47% -3.3% -6.0%

Medicare 33% 6.0% 5.0%

Medicaid 9% 9.8% 10.0%

Self Pay 3% 8.6% 30.2%

13

Summary of Operating ResultsMonth of August 2009

Actual Budget Variance ActualAugust 2009 August 2009 Over/(Under) % Variance August 2008

Operating Revenue 83,844,027$ 83,003,804$ 840,223$ 1.0% 78,787,484$

Operating Expenses 76,773,779 77,537,457 (763,678) -1.0% 76,743,070

Income from Operations 7,070,248$ 5,466,347$ 1,603,901$ 29.3% 2,044,414$ (Operating Margin)

Non-Operating Income 2,580,006 977,662 1,602,344 163.9% 474,549

Net Income 9,650,254$ 6,444,009$ 3,206,245$ 49.8% 2,518,963$ (Total Margin)

14

Non Operating Income (Loss)Month of August 2009

Actual Budget Variance ActualAugust 2009 August 2009 Over/(Under) % Variance August 2008

Investment Income & Other Non-Operating Income 691,233$ 726,092$ (34,859)$ -4.8% 914,787$

Fair Value Gain (Loss) on Investments 1,209,508 - 1,209,508 100.0% (566,150)

Joint Venture Income/Losses:

Wisconsin Therapies/Chartwell 60,116 36,923 23,193 62.8% 19,753

Wisconsin Dialysis (b) 11,250 (b) (b) 20,932

UHC/Unity 474,414 100,000 374,414 374.4% 27,881

UHC/e-Care (79,283) (70,000) (9,283) -13.3% -

Madison Surgery Center 166,841 170,000 (3,159) -1.9% 87,307

Sleep Equipment of WI (a) - (a) (a) -

Madison United Healthcare Linen 29,937 3,397 26,540 781.3% (23,744)

Madison Environmental Resourcing 27,240 - 27,240 100.0% (6,217)

Total 2,580,006$ 977,662$ 1,602,344$ 163.9% 474,549$

(a) Sleep Equipment of WI has been dissolved.

(b) Wisconsin Dialysis - August 2009 results have not yet been received.

15

Summary of Operating ResultsMonth of September 2009

Actual Budget Variance ActualSeptember 2009 September 2009 Over/(Under) % Variance September 2008

Operating Revenue 81,743,335$ 79,005,496$ 2,737,839$ 3.5% 78,545,810$

Operating Expenses 77,547,119 77,020,838 526,281 0.7% 75,297,343

Income from Operations 4,196,216$ 1,984,658$ 2,211,558$ 111.4% 3,248,467$ (Operating Margin)

Non-Operating Income (7,050,888) 977,468 (8,028,356) -821.3% (4,502,802)

Net Income (2,854,672)$ 2,962,126$ (5,816,798)$ -196.4% (1,254,335)$ (Total Margin)

16

Non Operating Income (Loss)Month of September 2009

Actual Budget Variance ActualSeptember 2009 September 2009 Over/(Under) % Variance September 2008

Investment Income & Other Non-Operating Income 637,161$ 745,922$ (108,761)$ -14.6% 980,780$

Fair Value Gain (Loss) on Investments 1,397,727 - 1,397,727 100.0% (4,794,872)

Fair Value Gain (Loss) on Swap debt agreements (10,041,882) - (10,041,882) -100.0% -

Joint Venture Income/Losses:

Wisconsin Therapies/Chartwell 37,500 17,008 20,492 120.5% 25,274

Wisconsin Dialysis (19,701) 11,250 (30,951) -275.1% 1,499

UHC/Unity 911,903 100,000 811,903 811.9% (670,150)

UHC/e-Care (84,000) (70,000) (14,000) -20.0% (172,783)

Madison Surgery Center 64,133 170,000 (105,867) -62.3% 172,261

Sleep Equipment of WI - - (a) (a) -

Madison United Healthcare Linen 33,969 3,288 30,681 933.1% (42,993)

Madison Environmental Resourcing 12,302 - 12,302 100.0% (1,818)

Total (7,050,888)$ 977,468$ (8,028,356)$ -821.3% (4,502,802)$

(a) Sleep Equipment of WI has been dissolved.

17

Other Key Ancillary Service Activity Indicators Three Months Ended September 30, 2009

Actual Budget Actual Actual to FY 10 toFY '10 FY '10 FY '09 Budget FY 09

Inpatient Gross Revenues 274,323,944$ 263,940,073$ 248,124,868$ 3.9% 10.6%Outpatient Gross Revenues 226,748,749$ 221,102,362$ 202,404,324$ 2.6% 12.0%501,072,693$ 485,042,435$ 450,529,192$

Surgical Procedures: Inpatient (excludes Misc/Out of OR) 2,795 3,020 3,279 -7.5% -14.8% Outpatient 1,859 1,835 2,268 1.3% -18.0% AFCH 1,163 1,058 124 9.9% 837.9% Subtotal 5,817 5,913 5,671 -1.6% 2.6% Misc./Out of OR 655 559 561 17.2% 16.8% Total 6,472 6,472 6,232 0.0% 3.9%

Transplants Cadaver 93 102 91 -8.8% 2.2% Living 29 28 30 3.6% -3.3% Total 122 130 121 -6.2% 0.8%

Cardiology Invasive Lab Procedures Cardiovascular Lab 2,674 2,430 2,497 10.0% 7.1% Electrophysiology Lab 315 282 277 11.7% 13.7% Total 2,989 2,712 2,774 10.2% 7.8%

Emergency Room Visits 11,237 10,630 10,945 5.7% 2.7%

Radiology Procedures: MRI 7,130 6,611 7,056 7.9% 1.0% CT Scans 15,057 16,127 16,394 -6.6% -8.2% Other 53,961 51,550 52,860 4.7% 2.1% Total Radiology Procedures 76,148 74,288 76,310 2.5% -0.2%

Radiotherapy Procedures 8,926 7,883 7,562 13.2% 18.0%

% Variances

18

Summary of Operating ResultsThree Months Ended September 30, 2009

(000) Omitted


Operating Revenue $249,659 $244,945 238,020 1.9% 4.9%

Operating Expenses 233,492 233,079 228,771 0.2% 2.1%

Income from Operations $16,167 $11,866 $9,249 36.2% 74.8%(Operating Margin of 6.5%)

Non-Operating Income (1,248) 2,919 (4,686) -142.8% 73.4%

Net Income $14,919 $14,785 $4,563 0.9% 227.0%

% Variances

19

Non Operating Income (Loss) Three Months Ended September 30, 2009

(000) Omitted


Investment Income & Other Non-Operating Income 1,937$ 2,197$ 2,853$ -11.8% -32.1%

Fair Value Gain (Loss) on Investments 4,579 0 (7,330) 100.0% 162.5%

Fair Value Gain (Loss) on Swap debt agreements (10,042) 0 0 -100.0% -100.0%

UWHC portion of Joint Venture Income/Losses:

Wisconsin Therapies/Chartwell 158 78 80 102.6% 97.5%

Wisconsin Dialysis 14 34 12 -58.8% 16.7%

UHC/Unity 1,784 300 (585) 494.7% 405.0%

UHC/e-Care (188) (210) (173) 10.5% -8.7%

Madison Surgery Center 406 510 516 -20.4% -21.3%

Sleep Equipment of WI - - (2) 0.0% 100.0%

Madison United Healthcare Linen 64 10 (49) 540.0% 230.6%

Madison Environmental Resourcing 40 0 (8) 100.0% 600.0%

Total (1,248)$ 2,919$ (4,686)$ -142.8% 73.4%

% Variances

20

Performance Ratios

Favorable Direction FY 10

Budget or Target

S&P 500 "A" Rated

Moodys "A" Rated

Fitch "A" Rated

UWHCA Bond Covenant

Operating Margin 6.5% 4.8% 2.5% 2.6% 2.7%

Total Margin ** 8.0% 6.0% 4.2% 5.6% 3.9%

Days Cash on Hand * 137 138 175 180 171 90, 75 & 45

Days in Accounts Receivable 44 50 49 50 48

Debt Service Coverage Ratio ** 7.4 6.6 3.7 4.7 3.1 2.0, 1.25 & 1.0

Long Term Debt to Capitalization 32.0% 31.0% 34.2% 35.3% 40.3% 65%

Operating Cash Flow 12.2% 10.2% 9.6% 9.5% 8.8%

Cash-to-Debt 133.0% 138.9% 130.8% 133.9% 113.4%

* Days Cash on Hand calculated as a rolling 12 month average

** Excludes unrealized fair value gain/loss on investments and fair value loss on swap agreements

Industry Comparisons

21

Accounts ReceivableMonitoring Program

Net Net Days Accounts Revenue

Receivable Outstanding

September 08 109,046,050 43October 08 106,394,935 42November 08 117,633,474 46December 08 109,471,729 44January 09 108,794,653 46February 09 109,241,511 48March 09 109,827,613 45April 09 108,227,909 42May 09 101,952,966 40June 09 108,195,704 41July 09 116,266,694 43August 09 121,327,701 46September 09 117,138,592 44

22

Comparison of Charity Care & Bad Debt Expense

FY 10 FY 10 % FY 09 %Actual Budget Variance Variance Actual Variance Variance

Charity 11,183,284$ 9,700,849$ 1,482,435$ 15.3% 7,393,462$ 3,789,822$ 51.3%

% of Revenue 2.23% 2.00% 1.64%

Bad Debt 10,325,571 12,126,061 (1,800,490) -14.8% 11,010,871 ($685,300) -6.2%

% of Revenue 2.06% 2.50% 2.44%

Total 21,508,855$ 21,823,665$ (314,810)$ -1.4% 18,404,333$ 3,104,522$ 16.9%

Gross Revenue 501,072,693$ 485,042,436$ 16,030,257$ 3.3% 450,529,192$ 50,543,501$ 11.2%

Total Bad Debt & 4.3% 4.5% 4.1% Charity as % of Revenue

23

EBITDA Compared to Debt Service & Capital Expenditure

(000) Omitted

Actual Budget

Net Income $20,382 $14,785Market Value Gain/(Loss) on Unrestricted Investments 4,579 0Fair Value Gain/(Loss) on Swap Agreements (10,042) 0Depreciation 12,120 12,259Interest Expense 2,080 2,325

EBITDA 29,119$ 29,369$

and Working Capital:

Capital Expenditures (9,877) (8,225)Land purchase 3rd East parcel (2,608) 0Capital Contribution - Faculty Office Bldg Buy-out existing space (2,500) (2,500)Capital Contribution - Cardiology equipment (125) 0

Net Capital Expenditures (14,985) (10,725)

Est Annual Debt Service (4,341) (4,672)

Decrease (increase) in Working Capital (16,533) (1,353)

Total (Used) Provided ($35,859) ($16,750)

Cash Available for Temporary Investment and Future Capital Expenditures (6,740)$ 12,619$

Cash (Used) for Capital Expenditures, Debt Service

Cash Provided:

24

Summary of Changes in Net Assets

Three Months Ended September 30, 2009

Net assets at beginning of period $513,659,405

Net income 20,381,453

Change in fair value of investments 4,579,331

Change in fair value of swap agreements (10,041,882)

Capital grants, gifts and donations 129,658

Additions to permanent gift endowments 3,443

Payments to UW School of Medicine and Public Health

for capital expenditure support (2,625,000)

Increase in net assets $12,427,003

Net assets at end of period $526,086,408

25

Comparison to Local CompetitorsSeptember 30, 2009 vs. 2008

UWHC Meriter St. Mary's Total% Change in Admissions

Current Month 3.5% 1.3% (2.8)% 0.7%

3 Month Rolling Average 1.2% (1.9)% (2.5)% (0.9)%

12 Month Rolling Average 0.2% (3.3)% 2.0% (0.1)%

% Change in Average Daily Census

Current Month 5.2% (5.7)% (6.8)% (1.3)%



26

UWHC Investment & Returns

September September YTDMarket Value Investment Investment

Account Balances Allocation Return Benchmark

Operating Account and Commercial Paper

US Bank & M&I Bank 44,508,906$ 13.5% 0.25% -0.02% (A)

Intermediate Bond Fund USBank/ Baird 72,412,670$ 21.9% 3.38% 3.22% (D)

Capital Replacement Fund Account - UW Foundation 155,660,644$ 47.2% 0.24% 0.27% (B)

Endowment Fund - Equity Securities

UW Foundation $57,417,311 17.4% 6.60% 14.98% (C)

Total Unrestricted Funds 329,999,531$ 100.0%

(A) Average Financial and Non-Financial Commercial Paper, net of estimated Admin fees(B) Average 1 Month LIBOR (C) Average S & P 500 Index(D) Barclays Capital Intermediate Gov/ Credit-YTD

summary of operating results september 30, 2009. 2 adult admissions (rolling 12 months) fy2010 ytd...

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