Pausing elective operations cost hospitals $22B in 2020

Hospitals lost out on roughly $22.3 billion over just a three-month period in 2020 after pausing elective surgeries during the COVID-19 pandemic, according to a study published in Annals of Surgery. The findings come as many healthcare workers and seniors are getting vaccinated in the U.S., bringing new hopes that a return to normal is in the not-too-distant future.

Putting a halt on elective surgeries was one of the first recommendations from former Surgeon General Jerome Adams and the Centers for Medicare and Medicaid Services in March as COVID-19 spread across the U.S. Most hospitals saw an immediate drop in patient volumes and lucrative procedures as patients avoided in-office care and rescheduled or canceled elective surgeries. Some reports found revenue drops of 30% to 40% as a result.

However, some health systems, including Tenet Healthcare and Advocate Aurora Health, were able to keep their regular services running, at least partially.

Still, the financial impact for the year was severe, as elective surgeries are “a substantial driver of hospital revenue,” wrote first author of the study, Sourav K. Bose, MD, MSc, MBA, of the Leonard Davis Institute of Health Economics at the University of Pennsylvania.

The researchers forecasted revenues and demand from March to May 2020 from the Nationwide Inpatient Sample. They found national revenue loss from ceasing major elective surgeries was $22.3 billion. 

Some hospitals have fully resumed elective surgeries that were postponed early on in the pandemic. Others have resumed only to pause and restart again as local COVID-19 cases alternatingly spike and recede. 

Pausing elective surgeries was meant to help hospitals conserve their resources and staff for emergency COVID-19 patients and also reduce the spread of the virus through decreased person-to-person contact.

All types of hospitals saw volume and revenue loss from elective surgeries. Hospitals that are still constrained by COVID-19 pressures should consider expanding their capacity, according to Bose et al. Conversely, hospitals that aren’t seeing a big patient volume return could mitigate their financial losses by marketing their services. Unfortunately, rural and urban community hospitals may be at increased financial risk in this time, which could deepen disparities that already exist. 

The decision to pause elective surgeries has proven painful for more than half of patients, according to a separate study also published in Annals of Surgery. For this project researchers looked into patients’ perspectives on returning to elective surgery after COVID-19. One patient stated that “the increasing pain has given me some dark days during lockdown.” However, when operations were paused, most patients understood why and were willing to accept the decision, the study authors reported. Even though “a large proportion” were happy at the recommencement of surgeries, the majority were still concerned about contracting COVID-19 while in the hospital. Just 5.9% of patients felt it was unsafe.

Amy Baxter

Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."

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