U.S. hospitals lost more than $20 billion from suspending elective surgeries over three months at the beginning of the COVID-19 pandemic's onset in this country, according to an article published recently in the Annals of Surgery.
The finding comes as hospitals see hope from ongoing vaccine distribution but also fear new more contagious strains of the novel coronavirus. ICUs in many areas remained under pressure and hospitals are also facing staff shortages and burnout.
In a White House press briefing Wednesday, Centers for Disease Control and Prevention Director Rochelle Walensky said federal health officials are watching the variants closely.
"We have always expected that variants would emerge and we have been looking for them," she said. "The variants that we have identified more recently seem to spread more easily — they're more transmissible — which can lead to an increased number of cases and increased stress on our already taxed healthcare system."
More about the financial troubles hospitals have experienced will become clear in the coming weeks as health systems report fourth-quarter and full-year earnings, but research suggests 2021 will be another difficult year.
The Annals of Surgery article found that the revenue loss from halted electives was consistent across all hospital types, but existing trends for urban non-teaching facilities and those in rural areas put them at increased financial risk.
To recover volumes, hospitals should consider hiring more staff, scheduling procedures on nights and weekends and directing marketing efforts toward assuaging patient fears about returning to get care, they wrote.
The research adds to growing evidence that larger health systems with access to capital and other resources are likely better able to weather the financial strain that came from pandemic-related disruptions.
National for-profit chain operators have largely been able to weather the pandemic and large nonprofit systems have been able to maintain hundreds of days of cash on hand, even as the need to expand ICU capacity and limit community spread have forced them to curtail nonemergency care at times.
Still, hospitals across the board continued to struggle. Median operating margins for 2020 were down 1.2 percentage points compared to 2019 levels, according to a Kaufman Hall report published this week.
Expenses per adjusted discharge were up 14% while patient volumes remained depressed. "The next few months are expected to be rough, as the nation's hospitals and health systems cope with rising COVID-19 infections as people congregate indoors over the colder winter months, and as the new, more contagious variant of the virus spreads nationwide," according to the report.
Hospitals were helped greatly by federal relief bills allocating $175 billion toward healthcare providers. Additional legislation proposed by the Biden administration includes more funding that could help hospitals.
Separately, a Transunion brief released Wednesday suggested hospital patient volumes won't return to pre-pandemic levels at any point this year. It showed that in the back half of 2020, emergency room visits were down 22% year over year and inpatient visits dropped 7%.
Outpatient visits however, were up 5%, continuing a trend from the past few years as care settings have migrated.
The level of rebound for emergency and inpatient volumes will depend on the vaccine rollout, which has so far stumbled, and the nation's ability to contain the virus, according to the report.