Jul. 9—WINDBER, Pa. — Hospitals are changing — with their business models becoming increasingly built on outpatient, same-day discharges, health leaders say.
The shift over the past decade away from inpatient, overnight stays is forecasted to become "seismic" by 2030, according to the American Hospital Association.
Chan Soon-Shiong Medical Center at Windber President Tom Kurtz said technological advancements and payer preferences have set the change in motion. Already, more than 80% of Chan Soon-Shiong's revenue is outpatient-driven, Kurtz said.
"A lot of things contribute to the shift: immunity-based procedures, pharmaceutical changes, medical-device advancement," he said. "And when you couple that with patient convenience and accessibility, you can see how this came about."
Citing a forecast from the market analytics firm Sg2, the American Hospital Association predicts hospital outpatient departments will grow by about 20% in the 10-year period from 2020 to 2030.
Ambulatory or outpatient surgery centers are set to grow by 25%. Virtual visits are forecasted to rise from near zero to 29% of all hospitals' evaluation and management. Hospital inpatient discharge volumes, however, are projected to be flat or drop by 1% by 2030.
'Strangled' capacity
Throughout the COVID-19 pandemic, the lack of available hospital beds across the country appeared to signal a lack of planning, Kurtz said.
But he said the pandemic disrupted a strategically executed decrease in hospital beds that's been occurring for the past 10 years alongside increased outpatient services.
"You can say, 'Why weren't we prepared?' — but it's because the hospital business is so far ahead toward the outpatient business," he said.
However, Kurtz is concerned by hospital bed reductions caused by hospital closures.
According to the U.S. Government Accountability Office, more than 100 rural hospitals that provided essential health care to their communities closed from January 2013 to February 2020.
As a result of closures, people had to travel farther to get the same health care services — an average of about 20 miles farther for common services such as inpatient care. People had to travel even farther, about 40 miles on average, for less common services such as alcohol or drug treatment.
The loss of rural hospitals is a continuing trend, Kurtz said.
"We haven't seen the full effects COVID has had on small hospitals' finances," he said. "Bed capacity will get strangled even more."