New data indicating the overall number of hospital visits rose 2.6 percent in 2013 doesn't tell much of a single story given the crosscurrents running below the surface.
Because the industry for now is still entrenched in a fee-for-service reimbursement environment, the 15 million uptick in visits, producing a total of 603 million, isn't bad news. The thinking is that consumers of health care are returning for procedures that were previously put off for economic reasons. That makes sense.
But the report containing the numbers, from the IMS Institute for Healthcare Informatics and called "Medicine Use and Shifting Costs of Healthcare," indicates that broader, more significant trends are taking place as anticipated.
For one, outpatient care is where the bulk of the absolute growth took place, and that was largely for patients with commercial insurance. Such privately insured visits rose by 18 million in 2013 to 281 million, a 6.8 percent increase from 2012's total of 263 million visits. Everything else was close to flat, or negative. Outpatient Medicare-covered visits fell by 5 million to 62 million, a 7.5 percent drop from 67 million in 2012.
Granted, a 2-million increase in scheduled inpatient visits — given the higher acuity of that care — represents a higher per unit revenue source that probably was welcomed by cash-strapped hospitals. When scheduled inpatient visits rise at that amount to 22 million from 20 million, as the IMS report indicates, hospital executives will take notice.
But at the same time, the number of unscheduled inpatient admissions through the emergency department fell by the same number, 2 million. So inpatient admissions were essentially flat in 2013.
Meanwhile, hospitals in 2013 also experienced limited growth in ED visits. After rising to 169 million in 2012 from 145 million in 2009 — that's an increase of 16.6 percent over three years — those kind of admissions rose by just 1 million in 2013 to 170 million, which is a less than 1 percent increase.
This kind of scenario could offer more incentive to hospital executives to keep their sights set on the industry transition away from fee-for-service reimbursed care. Of course, the trick will be managing operations well enough to keep the hospital afloat during the transition.