HELENA - St. Vincent Healthcare of Billings had the highest profit of any hospital in Montana in 2007, clocking in at $38.6 million, a 13.5 percent margin on its income - while providing about $5 million in charity care.
Its neighboring competitor, Billings Clinic, had a more modest return of 5.9 percent, or about $22.7 million - while providing $14 million in charity care.
So, can any conclusions be drawn from these numbers about the character of each hospital?
Perhaps, say top officials at each hospital - although any inferences should consider other factors not immediately evident in the raw numbers, they say.
The author of the state report showing these numbers also said that while they shed light on the finances and mission of the state's largest hospitals, they don't tell the whole story.
"It's certainly the case that no two communities, no two hospitals are alike," said Larry White, research assistant professor at the University of Montana's School of Public and Community Health Sciences. "They have different arrays of services."
White's report, released this week by the Montana attorney general's office, looked at how 11 nonprofit hospitals in Montana are meeting their obligation to provide "community benefits" in exchange for their exemption from property and income taxes.
It showed that all 11 hospitals are providing benefits equal to or greater than the dollar value of tax exemptions, although some more than others.
St. Vincent, with its high profit margin, had a proportionately low community-benefit level, in part because it made so much money.
Jim Paquette, chief executive officer for St. Vincent, said the hospital has been socking away cash the past few years in preparation for a major building project. For that reason, its nonoperating income, such as investment income, has been inflating its overall profit margin, he said. The hospital's 2007 profit on operating income was a more modest 6 percent, compared to a Montana average of 4.4 percent.
Paquette also said St. Vincent still provided $17 million in community benefits, and that its uncompensated care, which includes charity care and bad debt, is in line with most other hospitals when weighed against its operating expenses.
"We're more than adequately able to demonstrate our reinvestment in the community," he said.
Billings Clinic has a different organizational model than St. Vincent, with more than 200 physicians on staff, long-term care and a hospital, all under one business umbrella.
President and Chief Executive Officer Nicholas Wolter said Billings Clinic has had a strong commitment to providing charity care and other community benefits.
While the report reflects that commitment, Wolter said he's not sure Billings Clinic "can do it as aggressively as we have been," as the economy slows down.
"Our overall operating margins are not quite where we'd like them to be," he said. Billings Clinic had a 2.9 percent return on its operating income in 2007.
Wolter said it's likely that Billings Clinic's charity care dollars are higher than St. Vincent in part because Billings Clinic has so many physicians on staff, but that he'd have to know more about both hospitals' numbers to know the degree of that factor. St. Vincent has 93 physicians on staff.
White, the report's author, said listing a hospital's community benefits is not always an exact science.
For example, St. Peter's Hospital in Helena listed nearly $9 million in "subsidized health services," more than at hospitals two or three times its size.
Peggy Stebbins, spokeswoman for St. Peter's, said the hospital listed the cost of services it provides at a loss, and that different hospitals may account differently for this category of services. A new Internal Revenue Service form this year may help standardize the accounting for community benefits.
Stebbins said that hospitals similar to St. Peter's in size reported about the same level of charity care - sometimes more, sometimes less.
"The bottom line is that St. Peter's is very proud of the charity care and other benefits it provides the community," she said.