- Hospitals are treating an influx of sicker patients who deferred care earlier in the pandemic at the same time as rising COVID-19 admissions, the American Hospital Association warned this week. The higher patient acuity is increasing the burden on staff and creating "unsustainable" financial challenges, the hospital lobby said in a report.
- The issue requires federal support and resources, the group said. The AHA urged Congress to halt cuts in Medicare payments to providers and to make permanent enhanced insurance subsidies that have improved patient access to care.
- The AHA said it is also asking Congress to hold commercial health insurers accountable for improper business practices. In May, the association urged the Justice Department to investigate Medicare Advantage organizations that it said are routinely denying patients access to services, citing a report from the HHS Office of the Inspector General.
Americans have been slow to return to the doctor for routine screenings and other non-emergency care after facility shutdowns delayed visits for many at the start of the pandemic, raising concerns of an eventual upturn in sicker patients needing more intensive treatment.
Health systems have pointed to rising acuity levels over the past year, indicating that they are admitting patients with more severe conditions who require longer hospital stays and more staff to care for them. This has helped drive up demand and expenses for labor and contributed to falling income at a number of hospital chains.
Earlier this month, Fitch downgraded Community Health Systems' ratings outlook to negative from stable after escalating labor costs contributed to deteriorating operating conditions at the for-profit system in the first half of the year.
The AHA, in its new report, is focusing attention on rising acuity as it sounds an alarm about the deepening financial woes facing hospitals. Patient acuity, as measured by the average length of hospital stay, was up nearly 10% at the end of 2021, compared to before the pandemic, the association said.
And evidence suggests worsening patient outcomes could be accumulating. The AHA cited a survey in which 37% of primary care physicians said their patients with chronic conditions were in noticeably worse health from the pandemic. A study published in the journal Cancer found screenings decreased by 80.6% for colorectal cancer, 69% for cervical cancer and 55.3% for breast cancer over a three-month period in 2021.
Other data tracked a higher case mix for patients receiving mastectomies, appendectomies and hysterectomies and longer hospital stays for patients with rheumatoid arthritis, neuroblastoma and adrenal cancer.
The AHA said a Kaufman Hall analysis found hospital labor costs were up 12% in June from a year ago. Hospitals also are contending with higher cost drugs, the need for more supplies and equipment, rapidly rising general inflation and reimbursement shortfalls. “These mounting costs are threatening the financial stability of hospitals around the country," the organization said.