by John R. Fischer
, Senior Reporter | May 12, 2020
Almost 55% fewer Americans sought care at hospitals in March and April due to the COVID-19 pandemic, according to a new cohort survey conducted by Strata Decision Technology.
The decline is the major driver behind an emerging clinical and financial crisis for the healthcare industry in the U.S., motivated by losses of insurance coverage, cancellation of elective procedures, resource constraints and concerns for patient and staff safety in hospitals. Strata, however, expects a resurgence in patients whose cases were deferred as states begin to reopen their economies.
"Hospitals across the country are eager to open their doors to elective procedures so they can serve their community, care for their patients, and survive economically, but how they get there is literally a hundred-billion-dollar question," said Dan Michelson, CEO of Strata Decision Technology, in a statement. "Many facilities will likely be hard-pressed to handle the surge while simultaneously maintaining capacity for COVID-19 patients. Having visibility into patient volumes across all of their service lines is key to understanding how to safely engage patients while balancing the clinical, operational and financial complexity and pressures imposed by COVID-19.”
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The hospitals in the cohort together rack up $69 billion in annual operating expenses used to care for nearly 65 million Americans. Hospitals in general account for approximately 33% or $1.3 trillion of the $4 trillion in projected national healthcare expenditures in 2020.
Health systems in the cohort lost an estimated $1.35 billion in revenue over a two week period in March and April, compared to the same time last year. This equates on a national scale to a loss of $60.1 billion per month for all hospitals.
Evaluating two million patient visits, Strata observed an average decrease of 54.5% in the number of patients across all service lines of 51 healthcare delivery systems it consulted in 40 states. Each had varying rates of COVID-19 cases in their 228 hospitals.
Decreases in patient volume across all service lines are estimated to cost $60.1 billion per month for all hospitals on a nationwide scale.
Inpatient procedures and surgeries took the largest hits to revenue, with declines seen in knee (99%) and hip (79%) replacement surgeries, along with spinal fusions (81%) and repair of fractures (38%). Coronary stents and diagnostic catheterizations also went down by 44% and 65% respectively, while diagnostic volume overall declined by 60%. Such procedures are part of the top 10 inpatient procedures that account for more than 50% of total payments made to hospitals. Cardiology meanwhile experienced a 57% decrease in patient interactions, as did breast health by 55% and cancer overall by 37%.