By Alanna Moriarty, Content Marketing Manager, Definitive Healthcare
While many hospitals across the U.S. begin to recover from the worst of COVID-19 cases, healthcare industry leaders are raising questions about the long-term impacts of the pandemic on care delivery and patient outcomes. One key question is whether physicians will see increases in patient complication rates as a result of postponing care—both for patients delaying treatment for existing conditions and patients who put off seeking an initial diagnosis.
An increase in complication and mortality rates is not only problematic for patients, it also negatively impacts hospital revenue by making care facilities vulnerable to financial penalties from the Centers for Medicare and Medicaid Services (CMS). Providing treatment for advanced-stage illnesses is often more expensive than preventative and early stage interventions, further stretching the already limited budgets of hospitals in Texas and across the U.S.
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As of April 2020, Texas ranked 8th for greatest volume of total COVID-19 cases in the United States, with the state’s physicians reporting more than 10,300 diagnoses across all facility types. COVID-19 diagnoses are concentrated in the inpatient hospital setting, with 6,240 reported cases resulting in total charges of $26,293,060.
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The ten Texas hospitals reporting the greatest volumes of COVID-19 diagnoses are highlighted in the figure 1 table (below). Four of these hospitals appear on the list of Texas hospitals reporting the highest net patient revenues: Houston Methodist, Memorial Hermann Southwest, Houston Methodist Sugar Land, and Houston Methodist Willowbrook. This overlap is likely attributed to larger hospitals seeing greater patient volumes and therefore treating a higher percentage of patients with COVID-19.
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However, it does not appear that net patient revenue necessarily correlates with number of patient discharges or the number of staffed beds at a hospital. Memorial Hermann Southwest Hospital—which ranks 5th by net patient revenue—reported the greatest volume of patient discharges at 80,012 but has fewer staffed beds than the four preceding hospitals. Similarly, Memorial Hermann Texas Medical Center ranked 4th for highest net patient revenue but has the greatest number of staffed beds and second-greatest patient discharge volume.
For the fourth consecutive year, the top Houston-area hospitals reported inpatient services as the primary driver of patient revenues. According to the table of top Houston-area hospitals by net patient revenue, 56 percent reported higher revenues from inpatient than outpatient services—down from 60 percent the previous year.
Higher inpatient revenue for hospitals is contrary to the national trend of growing outpatient services, though fewer Houston-area hospitals reported this than last year. The expansion of outpatient care can be partially attributed to broader care services becoming available at clinics and outpatient surgery centers.
Patients seeking outpatient care outside the hospital setting could hurt the bottom lines of many hospitals and health systems by diverting spending away from the primary revenue source of more than half of Houston-area hospitals. This may be further exasperated by patients seeking alternate outpatient care options for fear of catching or spreading the COVID-19 virus.
Coordinated healthcare delivery is vital when treating complex patient conditions and will likely be the subject of renewed emphasis after the COVID-19 pandemic, with many patients displaying symptoms of long-term respiratory damage that will require extensive treatment. By preemptively coordinating care delivery for all patients, healthcare leaders guard against unnecessary or duplicate testing and providing patients with a clear network of healthcare professionals from whom to seek care.
Of the 25 Houston-area hospitals reporting the highest net patient revenues, 20 are part of the same network as other hospitals on the list. Six are part of the Houston Methodist Health System, six are part of the Memorial Hermann Health System, six are part of the HCA Gulf Coast Division Health System, and two are part of CHI St. Luke’s Health. Hospitals that are part of a wider healthcare network have greater access to in-network specialists and other physicians than standalone hospitals and may be able to deliver more coordinated care to patients.