Hospitals and health systems see rebounding patient volumes

Although hospitals are closer to normal when it comes to patient volume, they are still behind 2019 levels.

While telehealth use has dramatically leveled off since the height of the pandemic, health systems have significantly increased their capabilities to deliver virtual care. (Photo: Shutterstock)

Hospitals and health systems are seeing a bounce back in patient volume in 2021, though the numbers are still lower than they were pre-pandemic. A new survey from Kaufman Hall explored how health providers are adapting to the new landscape of health care delivery, as the health industry deals with changes brought on by COVID-19.

The study noted that after an initial scramble to integrate new systems such as virtual care, many systems have seen in-person volumes slowly return to something close to normal, and have less impetus for innovation.

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“After surviving the early 2021 peak of the COVID-19 pandemic, momentum has stalled on the widespread adoption of more clinically integrated digital strategies and other consumer-friendly offerings,” the report said. “Respondents to this year’s survey indicated that their organizations are taking more moderate steps for overhauling other aspects of care delivery and pricing strategy for consumers.”

Instead, the findings suggest that health care innovation may be driven in the future by changes from large, high-tech competitors that include traditional systems such as UnitedHealth Group as well as companies seen as “disruptors,” such as Apple and Amazon. New players and companies may also enter the market, making it a time where partnerships and mergers are likely to be common.

Volumes returning to near 2019 levels

The survey found that although hospitals are closer to normal when it comes to patient volume, they are still behind 2019 levels, and some areas such as emergency departments (Eds) remain significantly lower in volume. The data showed that ED volume remains 13% below 2019 numbers through the first seven months of 2021.

Expectations for a full recovery vary, the researchers said. “Respondents to this year’s survey expressed a mixed outlook on the long-term volume impact of COVID-19,” the report said. “Approximately two-thirds of respondents (68%) are somewhat or moderately concerned about a long-term volume impact from COVID-19, while 12% of respondents are very or extremely concerned about volume recovery, and 21% of respondents are not concerned at all.”

Overall, the report found, adjusted discharges in the first seven months of 2021 were 4% below volumes for the same period in 2019.

The report quoted Tom Clark, chief strategy and growth officer for Avera Health in Sioux Falls, South Dakota. “We’re seeing volumes return,” Clark said. “Surgical volumes are strong, and we’re starting to see emergency department volumes return. Clinic visits aren’t back to where they were.”

Telehealth and virtual care return to lower levels

The report noted a “boomerang” in digital health care such as telehealth services. It noted that telehealth claims increased by 2,980% nationally from September of 2019 to September of 2020. The report found that telehealth use has dramatically leveled off since the height of the pandemic, but that health systems have significantly increased their capabilities to deliver virtual care, and that they expect consumer demand for telehealth to continue at some level.

“Respondents indicated their organizations generally want to be more proactive than reactive when it comes to improving digital capabilities,” the report said. “As a result, the majority of respondents report that their organizations have already shifted how and where they deliver services, or are planning to do so.”

According to the survey, 71% of respondents said their organizations were willing to change to a moderate degree in this area or aiming to be slightly ahead of the market. And 88% of respondents said their organizations were either planning for incremental improvements or proactively changing delivery care models. Only 25% said they were making significant investments to move ahead of their competitors.

“During the pandemic, many providers realized that simply offering video visits was insufficient for replicating the in-person experience or providing adequate clinical care for many conditions,” the report said. “All told, 78% of respondents said they offer direct-to-consumer video visits, followed by online scheduling and appointment management (61%), freestanding sites of care (60%), text-a-doc or phone-based visits (58%), virtual waiting room/check-in (47%), or partnering to improve the digital experience (40%).”

With older patients becoming more familiar with virtual care, and younger patients already expecting more innovation and options, change is likely to increase, the report concluded.

“Moving forward, organizations that seek to thrive must be prepared to deliver care when, where, and how consumers want to receive it,” the report said.

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