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COVID-19 and the Financial Health of US Hospitals

Educational Objective
To understand how COVID-19 is straining the Financial Health of US Hospitals
1 Credit CME

The rapid growth in the number of patients with coronavirus disease 2019 (COVID-19) threatened to overwhelm hospital and intensive care unit capacity.1 The pandemic also raises questions about the ability of hospitals to remain financially solvent amid unprecedented changes in care delivery and billable services. To limit the spread of disease and create additional inpatient capacity and staffing, many hospitals are closing outpatient departments and postponing or canceling elective visits and procedures. These changes, while needed to respond to the COVID-19 pandemic, potentially threaten the financial viability of hospitals, especially those with preexisting financial challenges and those heavily reliant on revenue from outpatient and elective services.

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Article Information

Corresponding Author: William L. Schpero, PhD, Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, 402 E 67th St, New York, NY 10065 (wls4001@med.cornell.edu).

Published Online: May 4, 2020. doi:10.1001/jama.2020.6269

Conflict of Interest Disclosures: Dr Khullar reported receiving grants outside this work from the American Medical Association, Physicians Foundation, and Arnold Ventures. Dr Bond reported receiving grants outside this work from Arnold Ventures, Physicians Foundation, and the American Medical Association. No other disclosures were reported.

Additional Contributions: We thank Lawrence Casalino, MD, PhD (Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College), and Sean Nicholson, PhD (Department of Policy Analysis and Management, Cornell University), for helpful comments on an earlier draft of this article. They did not receive compensation.

References
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2.
Weiss  AJ , Elixhauser  A , Andrews  RM . Characteristics of operating room procedures in US hospitals, 2011. Accessed April 4, 2020. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb170-Operating-Room-Procedures-United-States-2011.jsp
3.
Merritt Hawkins. 2019 Physician inpatient/outpatient revenue survey. Accessed April 4, 2020. https://www.merritthawkins.com/uploadedFiles/MerrittHawkins_RevenueSurvey_2019.pdf
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McHugh  M , Regenstein  M , Siegel  B .  The profitability of Medicare admissions based on source of admission.   Acad Emerg Med. 2008;15(10):900-907. doi:10.1111/j.1553-2712.2008.00238.xPubMedGoogle ScholarCrossref
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American Hospital Association. AHA Hospital Statistics. Accessed April 4, 2020. https://www.ahadata.com/aha-hospital-statistics/
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Mosley  D , DeBehnke  D . Rural hospital sustainability. Navigant. Accessed April 4, 2020. https://guidehouse.com/-/media/www/site/insights/healthcare/2019/navigant-rural-hospital-analysis-22019.pdf
7.
Coronavirus Aid, Relief, and Economic Security (CARES) Act, Pub L No. 116-136 (2020).
8.
Paycheck Protection Program and Health Care Enhancement Act, Pub L No. 116-139 (2020).
9.
Mathews  AW , Evans  M . Hospitals, doctors feel financial squeeze as coronavirus sweeps US. Wall Street Journal. Published April 1, 2020. Accessed April 4, 2020. https://www.wsj.com/articles/hospitals-doctors-feel-financial-squeeze-as-coronavirus-sweeps-u-s-11585768706
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