The COVID-19 pandemic brought about a drastic downturn in hospital finances at a time when hospitals were called to play a frontline role in the fight against the pandemic. According to projections from the American Hospital Association, hospitals will lose $323 billion in 2020 due to COVID-19, with $202 billion of this loss taking place in the first four months of the national health emergency in the US (March through June). This financial downturn was driven by an unprecedented and abrupt reduction in the utilization of hospital services. As the fight against the coronavirus continues, much remains uncertain. Hospitals’ ability to navigate these uncertain times will depend, in part, on their success in anticipating and responding to future changes in the demand for hospital services.
Below we present a conceptual framework for understanding changes in inpatient hospital services as a result of the pandemic. Our framework suggests the following:
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Berna Demiralp is a Principal Research Associate at KNG Health Consulting and Director of the Evaluation and Health Economics practice. She is an applied micro-economist with expertise in health, labor and demographic economics. She specializes in designing and implementing impact evaluations with particular emphasis in quasi-experimental designs. Dr. Demiralp evaluates Medicare programs and alternative payment models; analyzes cost, utilization, and patient outcomes associated with acute and post-acute care; and assesses cost-effectiveness of treatment alternatives. She evaluated the direct and spillover effects of Medicare’s Hospital Readmissions Reduction Program on hospital readmissions using an interrupted time series design. She served as project director on KNG Health’s evaluation of the effects of participation in Accountable Care Organizations on care quality and Medicare payments for high-cost populations, using propensity score matching and difference-in-difference estimation. She conducted a comparative effectiveness study of long-term care hospitals in caring for critically ill patients, using an instrumental variable approach. She is currently leading the KNG Health team’s task in monitoring the performance of the State Innovation Model (SIM) initiative, including Maryland’s new All-Payer model, applying trend analysis and statistical process control to identify changes in cost and utilization in acute and post-acute care settings. Prior to joining KNG Health, Dr. Demiralp held positions in consulting and academia. As Senior Research Associate at Optimal Solutions Group and later at Summit Consulting, Dr. Demiralp served as Project Director and Lead Analyst for projects funded by the Centers for Medicare and Medicaid Services (CMS), the Department of Labor, and the Small Business Administration. She has extensive experience in designing and implementing mixed-method, rapid-cycle evaluations, including the evaluations of SBA’s Regional Clusters Initiative and CMS’ Graduate Nurse Education Demonstration. Dr. Demiralp also worked as an Assistant Professor in the Department of Economics at Old Dominion University and as an Associate Economist at RTI International. Dr. Demiralp has published in peer-reviewed journals including Medical Care, Health Services Research, European Economic Review, Journal of Macroeconomics, Eastern Economic Review and Journal of Economics and Finance. She received her PhD in economics from Johns Hopkins University and her BA from Davidson College. |
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Aishwarya Agarwal is a Research Associate in the Evaluation and Health Economics Practice at KNG Health. Ms. Agarwal has experience in conducting quantitative analyses and statistical modelling in the domains of healthcare policy and development studies, and has a particular interest in micro-econometric methods and applications in health economics. Prior to joining KNG Health, Ms. Agarwal worked as a Research Assistant at the Poverty, Health and Nutrition Division at International Food Policy & Research Institute where she was involved in assessing the geospatial impact of health policies in India, focusing on slum and rural households. Ms. Agarwal received a Master of Arts in Economics from the University of Texas at Austin and a Bachelor of Arts in Economics from Delhi University. |