- A Kaufman Hall survey that studied hospitals in the first half of 2014 found that inpatient utilization was either flat or declining for 68% of nonprofit hospitals. At the same time, 72% of these hospitals saw an increase in utilization of outpatient services.
- Emergency room usage was also flat or declining at 60% of the respondents' hospitals. Surprisingly, more than 75% of hospitals reported that value-based reimbursement accounts for less than 10% of their total revenue.
- The survey was based on an online questionnaire of executives at nonprofit hospitals, of which 61% were in urban areas. 41% have 400 beds or more, 26% have more than 200, but fewer than 400 and the remaining 32% have fewer than 199 beds.
"These findings are a sign that macroeconomic, structural and competitive forces continue to shift the emphasis of healthcare away from expensive inpatient care," Mark Grube, managing director of Kaufman Hall, said in a statement. "In this environment, executives of acute-care organizations are challenged to determine how—and how quickly—to reposition their organizations for a healthcare system that focuses on value, health, and outpatient/web-based care."
This is not the first Kaufman study to analyze inpatient care. In May, the group released a report that found inpatient volumes down in Boston, Indianapolis and Newark, N.J. Much of the drop was attributed to fewer one-day stays and ambulatory care sensitive admissions. Hospitals are clearly going to have to figure out a way to create revenue in this new environment where inpatient stays are reduced in favor of less expensive care options. It may be particularly challenging if new payment systems, like value-based reimbursements, continue to be implemented at a slow rate.