More updates on Healthcare during the Pandemic

The business of healthcare continues to face serious headwinds as a result of the pandemic.  A few newsworthy developments: 

• A recent Kaufman Hall analysis found hospital and health system operating margins were down 96% in 2020 (through July) as compared to same period of 2019.  A meaningful amount of that decline was offset by government intervention and financial support.  But even after all stimulus and support aid from the government, hospitals and health systems found their operating margins down 26% from a year ago. They also found that more than half of all hospitals and health systems are now operating at negative margin levels. 
• It’s difficult to believe these organizations are sustainable and viable in the long term with that level of financial performance. 
• While most measures of the economy and healthcare are improving since the depth of the pandemic, many improvements are slow.  There are 1.1 million fewer healthcare jobs today than there were one year ago.  That’s a decrease in healthcare jobs of about 5%. 
• A recent American Hospital Association report hints that they expect healthcare to return to normal by July 2021.  That offers us one strong data point to look to as we build our own plans in the healthcare business. 

In other healthcare news and developments for HME and beyond: 

• Nearly half of all discharges with a home health referral do NOT result in a home health visit.  An analysis published by JAMA in September found that 46% of the time that a home health visit is directed upon discharge, no such visit occurs.  The study evaluated a window of 14 days following discharge.  While this level of non-adherence to physician directed  home health therapy is alarmingly high, it is within the range of non-compliance for prescription drug scripts.   
• I believe this finding speaks to and is caused by the enormous complexity forced upon consumer in navigating our healthcare continuum.  Some elements of this complexity include uncertainties about their out-of-pocket costs, coordinating care among differing provider organizations, barriers between people and obtaining healthcare such as in-person pick-ups, deemphasis of post-acute care by the acute care world, misunderstandings by patients exacerbated by lack of clear explanations when transitioning from one point of care to the next, to name a few.  
• It is also hard to believe that if 46% of home health referrals never result in a care episode, that we are not seeing similar leakage for home medical equipment referrals. 
• Ending on a positive note – a recent Philips Global survey of younger physicians found that this group very much wants greater collaboration between healthcare providers of all kinds, and, that this younger group sees great value in telehealth.  Encouraging sign of changing attitudes in healthcare.