RESUMO
The COVID-19 pandemic caused major disruptions to the operation and financing of US acute care hospitals. Previous research has documented early effects of the COVID pandemic on hospital financial performance. This paper updates the literature with current data on utilization and financial performance for a large sample of California hospitals covering the period 2017 through the end of 2022 and the first quarter of 2023. The data show that, while hospital overall utilization has largely returned to pre-COVID levels, patient mix has changed and financial performance still lags. Hospital net income margins remain below pre-COVID levels which could trigger price increases to commercially insured patients to offset continuing post-COVID financial shortfalls.
COVID-19 created substantial disruptions and stresses to our health care system, including hospitals, and as such, it is critical to understand how hospital financial performance continues to be affected by these challenges. This study analyzes current data (through quarter [Q] 1 of 2023) to assess evolving financial trends affecting hospitals. The data show that hospitals weathered the initial impact in 2020 and 2021 but encountered challenging financial conditions in 2022 as net income from both operating and nonoperating sources fell dramatically in the face of a sustained increase in operating costs and decreasing revenue from nonoperating sources. Pressures on net income from operations persisted through Q1 of 2023, although nonoperating income has rebounded. Importantly, the data show that trends vary substantially across hospitals and that there is a large subset of hospitals that remain under severe financial pressure and may require assistance from policymakers to sustain operations until their financial positions are stabilized.
