Large reductions in Medicaid would likely have significant implications for hospitals, given that hospital care accounted for about one third of Medicaid spending in 2023. Options under consideration for reducing Medicaid spending include targeting state directed payments to hospitals or restricting states’ ability to fund Medicaid through provider taxes. Because provider taxes disproportionately fund supplemental payments to hospitals, restricting them as a revenue source is likely to result in lower funding for hospitals broadly, including for rural hospitals. Also being considered among other options is reducing the federal share of funding for Medicaid expansion, which has helped improve hospital finances.
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- Capital expenditures, commonly known as CapEx, are funds used by a company to acquire, upgrade, and maintain physical assets such as property, buildings, an industrial plant, technology, or equipment.
- While there has been interest among some policymakers in sustaining rural hospitals, doing so may be difficult in certain scenarios—such as in areas with shrinking populations—and could involve tradeoffs.
- Analyses of hospital margins relied primarily on RAND Hospital Data and focused on non-federal general short-term hospitals, excluding those in U.S territories.
The vast majority (96%) of births in rural areas occurred in a hospital in 2023 according to KFF analysis of CDC data. Managing shipping costs for import operations can feel like a constant challenge. High shipping prices, which often fluctuate due to global trends, don’t just eat into your profits—they can also make it harder to compete, especially if you’re trying to grow your business in a tough market. Plus, you get 24/4 agent support that takes care of your shipment so you can focus on growing your business.
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However, if you have questions about what’s deductible, it’s typically a good idea to consult with a tax expert. One type is a fixed expense, which don’t change with the change in production. (Examples include rent or a mortgage.) Another type is a variable expense, which changes with the change in production. (Examples include utilities and the cost of goods sold.) Expenses can also be categorized as operating and non-operating expenses. The former is directly related to operating the company, while the latter is indirectly related. Non-operating expenses are kept separate from operating expenses from an accounting perspective so it’s clear how much a company earns from its core activities.
Yes, a salary is considered an expense and is reported as such on a company’s income statement. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities. Depending on the type of shipment, different factors can make up the total landed cost. Meet the Engine Marketing Team, where creativity is combined with strategy to craft engaging and informative content. Our team is dedicated to curating stories and articles that provide valuable insights into the world of travel, accommodation, and hospitality. Business dinners, client meetups, and even small gifts for stakeholders are part of doing business on the road.
- Non-operating expenses are kept separate from operating expenses from an accounting perspective so it’s clear how much a company earns from its core activities.
- Decreases in Medicaid spending could accelerate the closure of obstetrics service lines in rural hospitals, in addition to affecting the availability of services at rural hospitals more generally.
- According to the American Hospital Association, Medicare Advantage reimburses rural hospitals at lower rates than traditional Medicare on average.
- If management provides employees with a company credit card, they’ll generally set strict guidelines and limits on what it can be used to pay for.
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The hospital industry has been lobbying Congress against proposed cuts, arguing that reductions in Medicaid spending would threaten access to care at hospitals. The financial health of rural hospitals has been an ongoing concern for some policymakers. More recently, these concerns have been amplified in the context of the concurrent budget resolution that passed the House and Senate in April 2025, with instructions for the House to reduce federal Medicaid spending by up to $880 billion or more over the next decade. Strains on hospital finances could have implications for both access to care as well as local economies, including in rural areas. Hospitals are the sixth largest employer nationally when comparing industry subsectors. As policymakers consider reductions in Medicaid and Medicare spending, some are considering options to support rural and safety-net hospitals.
The likelihood of having negative margins tended to decrease with lower occupancy rates and fewer beds, except that hospitals with 25 or fewer beds were less likely to have negative margins than average. That may reflect the fact that this group mostly includes critical access hospitals, which receive additional government support. Rural hospitals may face financial and operational challenges for a number of reasons. For example, rural hospitals tend to have low patient volumes, stemming from low and declining populations in rural areas and rural patients bypassing local hospitals for treatment at urban facilities.
Large, high occupancy, system-affiliated, and non-government rural hospitals were more likely than other rural hospitals to have positive margins. While 56% of rural hospitals overall had positive margins, the share was larger among hospitals with at least 200 beds (73%), with occupancy rates of at least 75% (70%), and that were affiliated with a broader system (63%). For-profit and nonprofit rural hospitals also more frequently had positive margins (62% and 61% respectively) than rural hospitals overall. Rural hospital closures often raise concerns about access to care and the local economy. When a rural hospital closes, patients may have to travel further to obtain services, which could lead some to forgo care altogether. Closures may be especially problematic for people who have difficulty traveling long distances and for people with time-sensitive conditions, such as heart attacks and childbirth.
Variable expenses often comprise a significant portion of the monthly budget and require more flexibility and planning. A strong budgeting strategy may help you stay in control of your finances, avoid overspending, and prepare for unexpected costs. However, to keep pricing strategies accurate, businesses need to update their landed cost calculation regularly. By taking into consideration changing exchange rates and market dynamics, landed costs will better reflect the real-time financial situation. Travel and accommodations are the most significant business expenses, and clear spending and reimbursement limits should be established for their costs.
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Whether or to what extent rural hospitals experience revenue declines as Medicare Advantage covers a larger share of Medicare patients is unclear. Half (50%) of rural hospitals in states that had not adopted the ACA Medicaid expansion as of the beginning of 2023 had negative margins in that year, compared to four tenths (41%) of rural hospitals in expansion states. Differences were larger among hospitals in the most rural areas (i.e. in rural areas not adjacent to metropolitan areas). In those regions, about six tenths (59%) of hospitals in non-expansion states had negative margins compared to less than half (45%) of rural hospitals in expansion states.
The Census Bureau classifies urban areas as census blocks (which are smaller geographic areas than counties) with at least 2,000 housing units or where more than 5,000 people reside. Landed cost calculation is the sum of the purchase price, transportation, duties, taxes, and other fees (expected or not). At Ship4wd, our comprehensive freight forwarder platform offers you the chance to look through hundreds of options and choose the one that fits your needs and budget. Your define expense shipping partner charges are usually negotiable, but, as industry experts admit, a really good forwarder is worth it over a cut-rate shipper. The said information is neither owned by BFL nor it is to the exclusive knowledge of BFL.
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Other platforms, including Workstem and InfoTech requires an upfront payment plus relatively complex setup procedures. FORHP is an office within the Health Resources and Services Agency (HRSA) that distributes grants, technical assistance, and other support to rural areas, including rural hospitals. FORHP defines “rural” as all nonmetropolitan counties, as well as well as some portions of metropolitan counties based on population density, terrain ruggedness, and commuting patterns. About half of sole community hospitals (49%), Medicare-dependent hospitals (52%), and low-volume hospitals (52%) had negative margins in 2023. As discussed below, there have been proposals to increase Medicare reimbursement for these facilities. A smaller share of critical access hospitals (40%) and rural referral centers (37%) reported negative margins in 2023 than hospitals in other designated categories, such as sole community hospitals.
Examples of expenses include rent, utilities, wages, maintenance, depreciation, insurance, and the cost of goods sold. According to the IRS, to be deductible, a business expense “must be both ordinary and necessary.” Ordinary means the expense is common or accepted in that industry, while necessary means the expense is crucial to earning income. Business owners are not allowed to claim their personal, non-business expenses as business deductions. Businesses are allowed to write off tax-deductible expenses on their income tax returns to lower their taxable income and thus their tax liability. However, the Internal Revenue Service (IRS) has strict rules on which expenses businesses are allowed to claim as a deduction.
Operating margins were approximated as (revenues minus expenses) divided by revenues after removing reported investment income and charitable contributions from revenues. The Methods section of a prior KFF analysis of operating margins includes additional details, such as the limitations of available financial data. Data for certain characteristics were missing for 1% or less of the sample with margins data. While 44% of rural hospitals overall had negative margins, about half of rural hospitals that had beds (52%) and were not affiliated with a broader health system (51%) had negative margins.
Capital expenditures, commonly known as CapEx, are funds used by a company to acquire, upgrade, and maintain physical assets such as property, buildings, an industrial plant, technology, or equipment.