title: Analysis of cash flow in academic medical centers in the United States.
abstract: OBJECTIVE
  To examine cash flow margins in academic medical centers (AMCs; i.e., teaching hospitals) in an effort both to determine any significant differences in a set of operational and financial factors known to influence cash flow for high- and low-cash-flow AMCs and to discuss how these findings affect AMC operations.
  
  
  METHODS
  The authors sampled the Medicare cost report data of 103 AMCs for fiscal years 2005, 2006, and 2007, and then they applied the t test to test for significant mean differences between the two cash flow groups across operational and financial variables (e.g., case mix, operating margin).
  
  
  RESULTS
  Compared with low-cash-flow AMCs, high-cash-flow AMCs were larger-bed-size facilities, treated cases of greater complexity, generated higher net patient revenue per adjusted discharge, served a significantly lower percentage of Medicaid patients, had significantly higher average operating profit margins and cash flow margin ratios, possessed a higher number of days of cash on hand, and collected their receivables more quickly.
  
  
  CONCLUSIONS
  Study findings imply that high-cash-flow AMCs were earning higher cash flow returns than low-cash-flow AMCs, which may be because high-cash-flow AMCs generate higher patient revenues while serving fewer lower-paying Medicaid patients.
authors.affiliation: Department of Health Administration, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, 23298-0203, USA. mccue@vcu.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McCue
authors.forename: Jon M
authors.initials: JM
authors.lastname: Thompson
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D000067:Accounts Payable and Receivable; D004469:Economics, Hospital; D017598:Efficiency, Organizational / Q000191:economics*; D005102:Health Expenditures; D006801:Humans; D006278:Medicare; D010350:Patient Credit and Collection / Q000191:economics; D014481:United States