COVID Impact: Lost Patient Volumes ‘Have Not Recovered’

September 23, 2020

Inpatient volumes are approaching 2019 levels but the lost volumes have not fully recovered from the effects of the coronavirus disease 2019 (COVID-19) pandemic, according to a Strata Decision Technology study released Wednesday morning.

Inpatient procedures and surgeries did not surge “as expected” and are down nearly 19% compared to 2019 levels, according to Strata, causing a “negative financial impact” on provider organizations. 

The study also suggests that ‘the new normal’ may be 90% to 95% of previous patient volumes.

In addition to the declines in inpatient volumes, emergency department admission rates are still down 25% nationally, according to the study. Meanwhile, outpatient volumes declined by 56% at the start of the pandemic but have only decreased 1.5% over the past 30 days.

According to Strata, the traditional fee-for-service system is a “systemic risk” and the study’s findings indicate that provider organizations should embrace the transition towards a value-based care model.

“This report should compel health systems to accelerate their move to value-based models of care, fast track digital health efforts, and evaluate how to reduce their cost of care delivery,” Steve Lefar, executive director of StrataSphere for Strata, said in a statement. “It is more important than ever to understand cost and revenue drivers today and in the future. The time is now for leaders to quickly evaluate and start making changes.”

The Strata study also states that telehealth utilization was “strong across all age cohorts,” with peak volumes of 50% of all patient encounters in April before reaching a steady rate of 11% this month.

While phone check-ins, basic follow ups, and consultations remain above pre-COVID levels, those telehealth volumes have declined since the start of the pandemic, while behavioral health visits have maintained its highs.

In light of the “volume shocks,” Strata recommends that provider organizations recast plans and reexamine “true revenue and cost levers as determined by contracts, actual prices (not just charges) and actual supplies and time and labor costs.”

The report also analyzes the impact of the $2.2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act on hospital and health system finances, calling the stimulus package a “lifeline that avoided catastrophe.”

According to Strata, the decision by federal lawmakers to raise the Medicare reimbursement rate by 20% for COVID-19 related DRGs was “justified,” since admitted COVID-19 patients in the top seven DRGs have a length of stay “20% higher than
non-COVID patients for the same DRGs.”

In March, a Strata report warned that despite the reimbursement hike, many hospitals would not have sufficient cash flows to survive for the next two to three months.