{"id":4213,"date":"2020-05-05T20:43:16","date_gmt":"2020-05-05T20:43:16","guid":{"rendered":"http:\/\/803.557.mywebsitetransfer.com\/?p=4213"},"modified":"2020-05-05T20:43:30","modified_gmt":"2020-05-05T20:43:30","slug":"the-united-states-of-healthcaresm-part-10","status":"publish","type":"post","link":"https:\/\/pwer.com\/?p=4213","title":{"rendered":"The United States of Healthcare(SM) (Part 10)"},"content":{"rendered":"\n<p><strong>A Post COVID-19 United States &#8211; Hospitals and Providers<\/strong><\/p>\n\n\n\n<p>In our last blog, we commented on the challenges hospitals, both large and small, public and private, are facing as a result of the COVID-19 crisis. &nbsp;The news on hospitals has been getting worse by the day. &nbsp;While we see that changing, it most likely will not be this year.<\/p>\n\n\n\n<p>Last week, we heard that the U.S. GDP had contracted 4.8% as of the end of April. &nbsp;That is a huge drop in GDP in a period of just two months, even for a \u201cnormal recession,\u201d if there is such a thing. &nbsp;What was missed in the headlines, however, is economists have estimated that 47% of that drop was related to healthcare services.<\/p>\n\n\n\n<p>We have been making the case with positive growth in numbers that healthcare is the single largest industry in the U.S. currently at about 18% of GDP. &nbsp;However, even we are stunned by the impact on the nation\u2019s economy that was due, in part, to the 47% drop in healthcare revenues. &nbsp;In 30 years, we have never seen healthcare really contract. &nbsp;I have even testified in depositions that healthcare is recession proof. &nbsp;That was accurate until now, and we are 100% certain we will return to previous trend lines, if not supersede them in the next few years. &nbsp;No one could have conceived that nearly all of healthcare (excluding COVID-19 and life and death emergencies) would be literally stopped in its tracks.<\/p>\n\n\n\n<p>Hospitals account for about 33% of all healthcare expenditures and physician services are about another 20%.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"717\" height=\"391\" src=\"http:\/\/803.557.mywebsitetransfer.com\/wp-content\/uploads\/2020\/05\/1.23.png\" alt=\"\" class=\"wp-image-4214\" srcset=\"https:\/\/pwer.com\/wp-content\/uploads\/2020\/05\/1.23.png 717w, https:\/\/pwer.com\/wp-content\/uploads\/2020\/05\/1.23-300x164.png 300w\" sizes=\"auto, (max-width: 717px) 100vw, 717px\" \/><\/figure>\n\n\n\n<p>If you close most hospitals to elective care, you are taking a huge part of $3.4 trillion offline, or about $1 trillion and placing it on hold. &nbsp;Yes, we likely had hundreds of billions spent in the treatment of COVID-19 however, 80% or so was in big city hotspots on the east and west coasts with exceptions like Detroit and Chicago who have similar dense population areas.<\/p>\n\n\n\n<p>Recently, CROWE reported<a href=\"#_ftn1\">[1]<\/a> that <strong><u>\u201cU.S. hospitals are losing $1.4 billion daily revenue, due to patient volume decline.\u201d<\/u><\/strong> &nbsp;The article noted that with the exemption of New York City and San Francisco, \u201c\u2026health systems across the United States experienced an average decline in patient volume of 56% between March 1, 2020 and April 15. 2020.\u201d<\/p>\n\n\n\n<p>Hospitals were not prepared for the huge surge in COVID-19 non-critical patients. &nbsp;Some hospitals had very limited hospital experience except for the approximately 5,000 acute-care hospitals in the United States, which is a very large percentage of the total number of hospitals. We expect the rebound in healthcare will be back to near normal rather quickly; though as of the date of this blog, it has only just started. &nbsp;As of last week, inpatient admissions were down 30%, emergency department visits were down 40% [a topic for another day and will contribute to increasing the no-COVID-19 mortality rates] and outpatient ancillary is down 62%. &nbsp;Our home state of Florida, with one of the oldest populations in the United States, has seen a drop of 47% in hospital admissions.<\/p>\n\n\n\n<p>We expect to see most hospitals re-open for non-emergency care and in-patient procedures are impossible to predict today or what the volumes will be. &nbsp;How will hospitals prioritize procedures? &nbsp;Will they open longer or have two shifts at the outpatient care? &nbsp;How will they staff, and will all employees return at the same time?<\/p>\n\n\n\n<p>For some hospitals, the impact is even more severe and that is because over the last decade hospitals have been acquiring medical practices at a historic rate.&nbsp; From 2012 to 2018, hospital acquisitions of medical providers increased by 128% and today approximately 170,000 doctors are employed by hospitals.&nbsp; In some regions, that percentage has grown to 300%.&nbsp;&nbsp; Many believe that consolidation of medical practices by hospitals is increasing overall healthcare cost.&nbsp; For a point of reference see U.S. healthcare cost increases from 1960 to 2018.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"624\" height=\"663\" src=\"http:\/\/803.557.mywebsitetransfer.com\/wp-content\/uploads\/2020\/05\/1.45.png\" alt=\"\" class=\"wp-image-4215\" srcset=\"https:\/\/pwer.com\/wp-content\/uploads\/2020\/05\/1.45.png 624w, https:\/\/pwer.com\/wp-content\/uploads\/2020\/05\/1.45-282x300.png 282w\" sizes=\"auto, (max-width: 624px) 100vw, 624px\" \/><\/figure>\n\n\n\n<p>Source: Peterson-KFF<\/p>\n\n\n\n<p>In our next blog, we will continue to talk about the overwhelming challenges and opportunities facing physicians in a post COVID-19 world.<\/p>\n\n\n\n<p>-Noel J. Guillama, President<\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p><a href=\"#_ftnref1\">[1]<\/a> <a href=\"https:\/\/www.crowe.com\/insights\/asset\/h\/hospital-volumes-hit-unprecedented-lows\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.crowe.com\/insights\/asset\/h\/hospital-volumes-hit-unprecedented-lows<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A Post COVID-19 United States &#8211; Hospitals and Providers In our last blog, we commented on the challenges hospitals, both large and small, public and private, are facing as a result of the COVID-19 crisis. &nbsp;The news on hospitals has been getting worse by the day. &nbsp;While we see that changing, it most likely will not be this year. Last week, we heard that the U.S. GDP had contracted 4.8% as of the end of April. &nbsp;That is a huge drop in GDP in a period of just two months, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4216,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4213","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/pwer.com\/wp-content\/uploads\/2020\/05\/AdobeStock_333032562-scaled.jpeg","_links":{"self":[{"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/posts\/4213","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4213"}],"version-history":[{"count":1,"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/posts\/4213\/revisions"}],"predecessor-version":[{"id":4217,"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/posts\/4213\/revisions\/4217"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/media\/4216"}],"wp:attachment":[{"href":"https:\/\/pwer.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4213"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4213"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4213"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}