Hospital revenues, delayed elective surgeries top trends to watch over next year: survey

Drops in hospital revenue—largely due to cancellations of elective surgeries in the months after the start of the COVID-19 pandemic—are expected to have the greatest impact across the industry over the next year, according to a new survey of healthcare leaders.

In Definitive Healthcare's 2020 Healthcare Trends Survey, released today, the data firm polled more than 2,300 leaders across healthcare including health IT and providers about the trends that would have the greatest impact over the next 12 months.

More than 36% said the loss of revenue in hospitals was the single biggest trend to watch in the industry in the year ahead.

Nearly a quarter of those polled said the implications of delayed care including surgeries would be the most crucial area of change because of the potential ripple effects across the industry if patients' deferred preventive and critical care resulted in serious health implications, they said.

"The concern, of course, is that as we get into the rest of the year, there is going to be a pent-up demand for those surgeries," Todd Bellemare, Definitive Healthcare's vice president of professional services, told Fierce Healthcare. "There will be a bit of a bounce back when people start going back to the hospital to schedule these surgeries."

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One in 10 respondents indicated their concern about rising unemployment rates and the resulting loss of commercial health insurance coverage by many Americans and the impact it would have on these broader revenue trends at health systems. Meanwhile, about 5% of respondents saw a mounting elective surgery backlog as an important trend in the year ahead.

"As we get into the next year, hopefully with increased therapies coming out and a vaccine in wintertime 2021, that hopefully will spur people to feel more comfortable to schedule that knee replacement that’s been bugging them," Bellemare said. "Of course, that is tied back to the economy with people getting back onto the insurance rolls."


About 23% of those polled said increased use of telehealth technologies would be one of the most important drivers of change in the year ahead. Definitive Healthcare data show telehealth adoption increased by 4,545%, with the greatest amount of growth in the Northeast.

"It has exploded. People did want to go to the doctor’s office, and they did change some of the regulations going into March to allow providers to provide these services," Bellemare said. 

How much of this telehealth adoption has staying power? 

More than half of survey respondents (54.9%) said they believe routine care for patients with chronic conditions could benefit from reducing the number of in-person visits and could stick around. Meanwhile, nearly 15% of respondents said they believe cold, flu and infectious disease screenings over telehealth platforms will continue as providers and patients seek to prevent infection spread.

Another 15% of respondents indicated mental and behavioral telehealth visits are likely here to stay. 

"Psychology and psychiatry are two of the specialties that have increased the most in the months since March and remained high," Bellemare said. "It’s almost like people said: 'This really works for this type of therapy, so let’s just keep going with it.'"

Meanwhile, other areas of care using telehealth have seen declines since their highs in utilization this spring such as primary care providers and cardiologists. "Those telehealth claims shot up, but have drastically reduced as people got more comfortable with going back into their physician's office," he said. 

While providers have been conducting virtual visits for post-hospital discharge follow-up, fewer than 8% of respondents said they saw that telehealth trend continuing. Only 3.5% indicated they saw post-surgical care using telehealth as an area that's here to stay, as those follow-ups often require more careful inspection.