Hospitals are facing unprecedented drops in revenue due to coronavirus & readying for a shifting insurance landscape. Some are dipping into investments to fund shortfalls, while others are reliant on federal relief to keep operating

The biggest challenge facing hospitals right now isn't the lost revenue in recent months (which is, by all means, a significant challenge on its own).

The biggest challenge is a shift in the insurance landscape, that is already underway. A thread (1/9):

— Sarah Kliff (@sarahkliff) May 15, 2020

Bonus tweet: We've asked hospitals to run themselves as businesses.

We don't do that with our fire departments, or our electric grids.

A lot of what is playing out right now in health care is a direct consequence of that policy decision. (10/9)

— Sarah Kliff (@sarahkliff) May 15, 2020

Even as we discipline the excessive prices in American health care, we must address Medicaid’s low reimbursement rates, late payments+other poor practices that make it an undesirable payer. Everyone understands that this is a huge problem. Bipartisan failure w/huge consequences https://t.co/lESvmmzY0D

— Harold Pollack (@haroldpollack) May 15, 2020

Worth noting that:

– So far, most for-profit hospital execs sound pretty sanguine about payer mix shifts

– In the last recession, as Medicaid jumped as a % of hospital revenue (as mentioned below), revenue growth continued apace, and hospital operating margins barely dipped https://t.co/BqoZz2iik2

— Dan O'Neill (@dp_oneill) May 15, 2020

It's depressing to see how much hospital finances depend on lucrative elective surgeries and procedures. Joint replacements, for instance, are huge profit centers. Hospitals make a lot less treating #COVID19 patients, even the ones in ICUs, than on elective surgery. https://t.co/SaDkkMyzHX

— David Gorski, MD, PhD (@gorskon) May 15, 2020