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September’s Index

This month’s index, inspired by the Harpers index, touches on charity care, gross margins, stock valuation metrics for three healthcare firms, sample UK health costs, algorithms, machine learning, and big data (just kidding on the last 3).

The cost of charity and other uncompensated care as a percentage of total revenue at HCA hospitals in 2018: 7%.

In 2010: 6%.

Income as a multiple of federal poverty limits required to access charity care at HCA hospitals prior to 2018: 2x.

In 2018: 4x (with sliding scales of patient responsibility after 2x).

Gross margin for Pharmacy Benefit Manager Express Scripts in 2017, 2010: 8.8%, 6.6%.

Price-to-revenue of LVGO: 27x

2018 annual revenue growth: 121%.

Free cash flow (2018): -$34M; FCF margin: -50%.

Price-to-revenue of HCAT: 10x

2018 annual revenue growth: 54%.

Trailing twelve month (ttm) Free cash flow (FCF): -$37M; FCF margin: -32%.

Price-to-revenue HQY: 4x

2018 annual revenue growth: 25%.

Free cash flow (ttm): $113M; FCF margin: 35%.

The Google Trends for direct primary care by state:

Median monthly cost per person for direct primary care: $70-80.

Mean cost of preferred brand drugs in the US: $265 (2018 CMS continuance tables).

Generic: $37.

Number of states that don’t allow doctors to directly dispense drugs: 3.

The top drug therapy classes by per member per month costs: inflammation (commercially insured), oncology (Medicare), HIV (Medicaid).

Percent of economists who forecast a recession by the end of 2021: 70.

Percent who forecast a recession in 2008: almost none.

Assets that currently have negative yields to maturity: $17T.

Cost for a standard visit with a GP at a private clinic in Leeds, England: £50.

Basic labs for UTI: £200

Wait at walk-in center: 2 hrs.

Cost of walk-in center visit (with EU passport): £0.

Rx cost: £9.

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