October 2018
Volume
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National Volume Observations
September was a challenging month for hospitals, with strong underperformance in volume indicators. These declines were a primary contributor to the poor financial performance highlighted in the previous section. Inpatient discharges declined 5.9 percent and 4.1 percent materially month over month and year over year respectively. Inpatient discharges lagged behind budgets by 6.8 percent, indicating that these declines were not anticipated. Outpatient gains partially offset inpatient volume declines, while ED visits mirrored inpatient underperformance.
Hospitals underperformed compared to budgets in June, August, and September. Year-over-year discharges have been volatile the last four months, performing above for the prior year two months and below prior year the other two months. Lengths of stay increased in September, further supporting the idea that providers are seeing fewer but sicker patients. Over the past quarter, inpatient volumes generally have fallen short of expectations and decreased year over year. This reflects the long-term trend of declining utilization and the ongoing impact of value-based care initiatives, making it imperative that hospital leaders build appropriate assumptions into their strategic and financial plans.
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