An uptick in operating expenses contributed to a 12% decrease in first-half excess revenue for Novant Health Inc.
Novant reported $505.6 million in excess revenue, compared with $575.4 million a year ago.
Excess revenue in a not-for-profit organization, such as Novant, is equivalent to profit in a for-profit business, while a deficit is equivalent to a loss.
The Winston-Salem not-for-profit healthcare system continues to benefit in revenue from its major hospital expansion into South Carolina with Hilton Head Hospital, Coastal Carolina Hospital and East Cooper Medical Center.
Core operating income dropped 40.8% to $169.1 million.
Core operating revenue was up 9.4% to $6.24 billion. The breakdown was $5.17 billion in net patient-service revenues and $1.06 billion in "other revenue."
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Novant said the increase in patient-services revenue came mostly from payments related to the state's Healthcare Access and Stabilization Program, known as HASP.
HASP payments serve as the lucrative carrot to encourage the state's healthcare systems and hospitals to support Medicaid expansion and the medical debt relief initiative. Every N.C. hospital joined the initiative by August 2024.
The system also continues to mention increases in patient volumes and pharmacy sales.
Expenses were $6.07 billion, an increase of 17%, mostly due to HASP-related expenses, higher medical supplies costs and other expenses related to increased patient volume.
Salaries and employee benefits rose 11.3% to $3.07 billion, primarily from increases in employee pay and merit increases.
Supplies and equipment expenses climbed 12.7% to just under $2.7 billion.
Meanwhile, investment income was $338.2 million, up from $292.2 million a year ago.
Not-for-profit hospitals, such as Novant, Atrium Health Wake Forest Baptist and Cone Health, depend on investment income to boost their bottom lines and help pay for capital improvements.
Investment income volatility in the stock market has been expected amid uncertainty over the Trump administration's tariff strategies.
Novant has more than 40,000 employees, including 8,145 in Forsyth County, making it one of the Triad's largest employers. It has a major presence in Charlotte and Wilmington and a budding central and coastal S.C. market.
Novant operates 19 hospitals, including Forsyth, Clemmons, Kernersville and Thomasville medical centers and Medical Park Hospital in Winston-Salem.
Triad expansion plans
During the second quarter, Novant reported that Community Hospital of Stokes and about 200 employees had officially joined the system.
Novant has signed a 30-year lease with the Stokes County Board of Commissioners to operate the Danbury hospital, with an option to renew for an additional 15 years.
Also during the first half, Novant received approval from the Surry County Board of Commissioners to take over Mount Airy's Northern Hospital. That transaction is projected to close by Sept. 30.
Novant has pledged to provide $135 million in capital and operating expenses over 10 years.
The Triad's three not-for-profit healthcare systems have applied for state regulatory approval to add hospital beds in Forsyth County, all acknowledging that their priority is to better serve an aging population.
Regulators with the N.C. Division of Health Service Regulation determined in the 2026 State Medical Facilities Plan that Forsyth needs an additional 103 acute-care hospital beds by 2030.
Those 103 beds are also designed to serve Yadkin County residents. The county has not had a hospital since the for-profit owner of Yadkin Valley Community Hospital abruptly closed the facility on May 22, 2015, amid a financial dispute with the county commissioners.
Novant projected a $4.3 million capital investment for the Forsyth bed extension and a $35.5 million capital investment for the Kernersville bed expansion.
Cone Health has applied to open a $320-million, 56-bed, 198,593-square-foot hospital on an undeveloped 59-acre site near the Northern Beltway west of Interstate 74 and U.S 311.
Baptist filed to add 103 beds to its main campus, with a projected $101.1 million capital investment.
Other hospital expansion plans
In August, Novant was approved to build a $336.4 million, 32-bed hospital in Concord.
Also in August, Novant was approved to open a $323 million, 24-bed hospital in Lincoln County.
In April, Novant gained approval from N.C. health regulators to open a community hospital in Monroe, one of the state's largest suburban communities.
Novant plans to spend $346.1 million on a 32-bed hospital. Wesley Chapel Medical Center is projected to open in 2030.
Also in April, state health regulators approved Novant's opening of a 34-bed Asheville Medical Center. The $322.7 million hospital is slated to open in 2030.
