Data shows decrease in hospital outpatient volume and revenue since COVID-19

CHICAGO (April 6, 2020) – The coronavirus pandemic has quickly brought sweeping changes with drastic impacts to hospitals across the country. Crowe, a public accounting, consulting and technology firm with offices around the world, used data gathered by its Crowe Revenue Cycle Analytics (Crowe RCA) software to more closely examine the initial impact of the pandemic on hospitals.

The Crowe RCA solution captures every patient financial transaction in more than 1,200 hospitals nationwide, as well as thousands of physicians’ offices. The data below is from the early period of the pandemic from March 11, 2020, to March 25, 2020.

Most hospitals faced exceptional declines in margin-producing surgeries – particularly elective surgeries – as labor and other physical assets were refocused to respond to the COVID-19 pandemic. However, COVID-19 patient volume has not replaced the loss of traditional medical and surgical volumes, on an inpatient or outpatient basis. This rapid shift has resulted in a more than 30% decrease in outpatient services nationally during the reporting period. According to Brian Sanderson, managing principal of healthcare services at Crowe, outpatient services provide most hospitals with higher financial margins than inpatient services and are necessary to sustain the hospitals’ missions. “In many ways, hospitals are ‘ground zero’ for the coronavirus pandemic, and its impact on clinical operations and financial performance has already brought far-reaching day-to-day challenges for health systems,” Sanderson said.

Data pulled from the Crowe RCA software during the reporting period showed the following trends:

• There was a greater than 20% decline in emergency visits and related observation cases.
• The average hospital, with more than 300 beds, saw a 29-35% drop in outpatient net revenue, particularly in elective surgeries, emergency and urgent care, observation cases and other ancillary services.
• Physician services were particularly hard hit, with dramatic – sometimes greater than 50% –decreases in patient visits for various specialties.
• Nearly all metropolitan areas studied exhibited these impacts, absent the key COVID-19 epicenters of San Francisco (where outpatient impact does not appear to be as dramatic) and New York City (where the data is too volatile to analyze).
• Although there are predictions of expected COVID-19 patient surges in various geographies over the next few weeks, the current decline in outpatient volume and net revenue nationally is projected at $12 billion-15 billion per month or the equivalent of $500 million per day. 

“Financial recovery from this loss of outpatient volume will be a long and arduous journey for most hospitals,” said Sanderson, who added that Crowe will continue to monitor the financial impact of the pandemic on health systems.

About Crowe Revenue Cycle Analytics (Crowe RCA) benchmarking data
More than 1,200 U.S. hospitals use the Crowe RCA solution to capture every patient transaction for purposes of automating hindsight, accounts receivable valuation and net revenue analyses.

About Crowe
Crowe LLP is a public accounting, consulting and technology firm with offices around the world. Crowe uses its deep industry expertise to provide audit services to public and private entities. The firm and its subsidiaries also help clients make smart decisions that lead to lasting value with its tax, advisory and consulting services. Crowe is recognized by many organizations as one of the best places to work in the U.S. As an independent member of Crowe Global, one of the largest global accounting networks in the world, Crowe serves clients worldwide. The network consists of more than 200 independent accounting and advisory services firms in more than 130 countries around the world.