New Report Analyzes 160K COVID-19 Cases, Examines Hospital Impact

An examination of patient and procedure volume at 275 U.S. hospitals has revealed key findings on the different implications of COVID-19 treatment, while detailing volume and revenue trends from the past six months.

Analytics company Strata Decision Technology used its National Patient and Procedure Volume Tracker to explore the significant financial and operational impact of the COVID-19 pandemic on the U.S. healthcare system. For the research, data scientists from Strata aggregated data from a cohort of 275 hospitals in 58 healthcare delivery systems, a subset of the over 1,000 hospitals and 220 healthcare delivery systems across the country that use the company’s StrataJazz financial planning, analytics, and performance platform.

Collectively, the hospitals in the COVID-19 cohort serve nearly 86 million Americans, account for $81 billion in annual operating expense, represent all census regions, and treated over 160,000 COVID-19 patients.

The updated National Patient and Procedure Volume Tracker reveals several key insights:

• COVID-19 inpatient volumes did not surge nationwide as expected and did not replace the dramatic decline in total admissions

• Admission rates from the ED declined across all age cohorts, suggesting providers have developed more skill in identifying who has COVID-19 and corrected treatment

• Admitted COVID-19 patients in the top seven DRGs have a length of stay 20 percent higher than non-COVID patients for the same DRG, justifying an increase in reimbursement

• While ventilator use has declined dramatically, most COVID-19 patients who are on a ventilator stay on it for over 96 hours

Overall, Strata researchers stated, “Healthcare providers have quickly learned and heroically responded to COVID-19 as demonstrated by dramatically lower ventilator and mortality rates.” They added that “Six months later, the landscape, while still very difficult, looks markedly different thanks to the infusion of $175 billion from the CARES Act and the heroic efforts of healthcare providers and systems.”

Meanwhile, the research showed, inpatient volume has not fully recovered with inpatient procedures and surgeries still down significantly. Findings in this area include:

• Volumes now approaching 2019 levels, but lost volumes have not recovered

• The “new normal” may be 90 to 95 percent of previous levels

• Inpatient procedures and surgeries continue to trail 2019 levels, down 18.6 percent cumulatively, having a negative financial impact

• Medical, not surgical service lines, have come back strongest as patients have focused on chronic, preventative, and screening care

Regarding outpatient volume, which has recovered for some, but not for all:

• Volumes fell significantly, but have now recovered, down 56 percent at the start, but down only 1.5 percent for the past 30 days

• Recovery is not evenly distributed, as some areas have come back strongly, while other care areas still lag

• Volume rebound demonstrates ongoing recovery outside the inpatient setting, including new channels such as telehealth

Emergency room visits, meanwhile, are still down by 25 percent nationally. Findings in this area include:

• ER care fell by 50 percent with people only going to the ER if essential

• Potentially serious care, that normally comes to the ER, is still being avoided or is down

• This decrease in ER visits also potentially reflects a return to the optimal role of the ER

• ER volume is still down by approximately 25 percent nationally vs. 2019

Telehealth, of course, filled a void during pandemic and was utilized for 50 percent of telehealth-eligible office visits at peak as face-to-face visits dropped by 50 percent, the analysis showed. In-person visits have since rebounded, driving telehealth down to 11 percent of eligible visits and reflecting the current hands-on nature of healthcare.

What’s more, contrary to the belief that technology is for the young, telehealth utilization was strong across age cohorts. Some visits types like behavioral health sustained telehealth volume better than others, while phone check-ins, basic follow-ups and consultations show decline, according to the report.