Much of the increase in Medicaid patients at LGMC can be attributed to newly insured Medicaid recipients, who lacking access to primary care services, utilized hospital services at LGMC.
Staffing costs at LGSW, which LGHS purchased from HCA In 2015, losses at LGHS' physician group, and a shift in payor mix at LGMC has pressured margins.
Among the initiatives, LGMC plans to shift elective orthopedic services to LGSW and open a small skilled nursing unit.
A second pressure on LGHS's performance was a rise in Medicaid at LGMC. Louisiana expanded Medicaid in 2016 and the number of uninsured individuals that converted to Medicaid exceeded the stat's projections.
Many of the Medicaid patients utilizing LGMC were using the emergency room because they didn't have a primary care physician.
Fitch expects LGHS' operations will improve as services ramp up at LGSW and LGMC free up capacity with the shift of some services to LGSW.
GROWING HEALTHCARE SYSTEM: With the acquisition of LGSW, LGMC's inpatient market share increased to over 50% in its primary service area of Lafayette and it is now more than twice its nearest competitor.
30, 2017, LGMC had $193.0 million in unrestricted cash and investments, which equated to 101.7 days cash on hand (DCOH) and 70.5% cash to debt, both of which trail Fitch's respective 'A' medians of 218 days and 150.6%.
Fitch expects LGMC's debt burden to moderate as capital needs remain manageable over the next two to three year and the debt amortizes.}
Over the last two years, LGMC has produced a breakeven operating margin after a five year period of above median performance.
It removed a competitor from the market and provided need capacity for LGMC. LGMC management reports that the flagship hospital is often at full capacity and runs on diversion for the middle part of most weeks.
The other pressure on LGMC's performance was a rise in Medicaid at its flagship hospital.