Hospital volumes under pressure as labor crisis persists, Kaufman Hall says

This audio is auto-generated. Please let us know if you have feedback.

Dive Brief:

  • The healthcare workforce crisis is pressuring hospital patient volumes, with two-thirds of executives in a new Kaufman Hall survey reporting that staffing shortages required their facilities to operate below full capacity over the past year, directly affecting revenue.
  • Volume growth year over year in key service lines has changed little since 2021 among the 86 organizations surveyed, leading several executives to question whether volumes will ever return to pre-pandemic levels. A decline in cardiology volumes stood out, and only oncology saw a significant rise from last year, with 40% of respondents indicating volumes were at or above pre-pandemic levels, the report released Tuesday said.   
  • The pandemic may have hastened the migration of care to outpatient, virtual and home settings, while at the same time, new technologies and treatments are reducing demand for some surgical interventions, Kaufman Hall said. If volumes continue to decline, hospitals will need both performance improvement efforts and larger structural transformations, the advisory firm said.

Dive Insight: 

Staffing shortages, especially in nursing, have been cited as the culprit responsible for sharply higher expenses and operating losses at numerous health systems throughout 2022. “There simply are not enough candidates available to fill empty positions, with particularly acute problems in nursing,” the Kaufman Hall report said.

Across the country, nurses have taken to the picket line to demand better working conditions and pay. Physicians, too, are struggling with burnout, and recent surveys point to frustrations worsening this year.

The deteriorating financial performance at hospitals has prompted ratings agencies, the American Hospital Association and other experts to warn that current conditions at hospitals are not sustainable. Reduced procedure volumes are in turn dimming prospects for medical device makers as surgeons report performing fewer valve replacements and other procedures. 

In its latest report, Kaufman Hall called stabilizing use of contract labor a hopeful sign even as wage pressures and staffing shortages persist. The survey found 19% of respondents saw wage increases of more than 10% for support services and two-thirds saw increases of more than 10% for clinical staff over the past year. About one-third reported wage increases for clinical staff reached 15% or more.

Volumes in hospitals’ emergency, radiology and pediatric departments were mostly unchanged from last year’s levels, while orthopedics, cardiology and neurosurgery declined from a year ago, the report said. The drop in cardiology was viewed as significant, with only 26% of respondents reporting a full return of volumes, down from 44% in 2021.

Many hospital leaders noted an increase in inpatient length of stay, attributing the rise to staffing shortages at post-acute care facilities that are causing backups in discharging patients from inpatient care.