June 30, 2021

Down in Louisiana, where the bayous slowly snake their way past moss-laden cypress and where 300-year-old live oaks stand witness to a colorful and mystical past, the state’s residents are readying themselves for another hurricane season. It seems to be an annual rite of endurance for this intrepid population. In the early 90s, Mary Chapin Carpenter captured this gulf-coast reality in her hit song, Down at the Twist and Shout:

They got a alligator stew and a crawfish pie
A gulf storm blowin’ into town tonight
Livin on the delta’s quite a show
They got hurricane parties every time it blows
Hurricanes happen; and there’s one thing you come to understand after enduring years of these cyclonic weather assaults: after the front-end eye-wall hits and passes on by, there are several minutes of calm winds and clearer skies. There is the illusion that all is well, but the back end of the storm is on its way.

The Current Calm

Right now, the American hospital industry seems to be recovering nicely from a devastating year of elective surgery cancelations, overworked staff, major shifts in care parameters, and a dip in case-related revenue. According to a study conducted by healthcare consulting firm Kaufman Hall, hospitals across the country have made gains in several financial categories in the first five months of 2021. Case volumes are nearing pre-pandemic levels, and the median operating margin for hospitals in May was 2.6 percent (3.5 percent if you include federal relief funds). Compared to the first five months of 2020, hospital operating margins rose 95.2 percent, year to date. These increases appear to be primarily due to an increase in case volume.

Here are some other notable findings of the study as summarized by Becker’s CFO Report:

The study revealed that gross operating revenue increased 18.6 percent from January to May of this year when compared to the same period last year. It also grew 5.9 percent in the first five months of 2021 when compared to 2019 levels.

Outpatient revenue saw the biggest revenue boost, jumping 25.1 percent, year to date, above last year’s levels.

Inpatient revenue was up 13.1 percent, year to date, versus January to May of 2020.

Adjusted discharges were also up 9.1 percent, year to date, while adjusted patient days rose 14.3 percent year to date.

Operating room minutes jumped 28.3 percent, year to date, when compared to 2020.

Emergency department visits were down 0.2 percent compared to January to May of 2020.

Total expense per adjusted discharge was down 1.7 percent when compared to the same period last year.
All these encouraging trends and positive numbers are undoubtedly the reason why the Wall Street Journal is reporting that securities associated with major for-profit hospitals have done very well against the broader market so far in 2021. For example, so far this year, Dallas-based Tenet Healthcare’s shares are up about 70 percent; Tennessee-based Community Health Systems’ shares have more than doubled; and Nashville-based HCA Healthcare’s shares have also jumped, according to a June 24 report.

A Coming Storm?

While some analysts believe that the above figures may represent a longer-term trend, hospital executives should take stock of the variables that are always swirling around in the background. What about the so-called Delta variant? Will this mean an eventual return to lockdowns and elective surgeries being canceled? Parts of Canada and all of Great Britain are currently under some form of COVID-related restrictions. To what extent can American hospitals be certain of the disease and patient landscape in the coming months?

One of the factors that should come into play for your future planning is the extent to which adverse events connected with the COVID jab will funnel patients into your facility. Many hospital administrators, C-suite executives and clinical department heads may not be aware of the numbers coming out of the Centers for Disease Control and Prevention (CDC), which indicate significant numbers of serious adverse reactions to the injection. The CDC’s Vaccine Adverse Event Reporting System (VAERS) now lists over 6,000 deaths and over 31,000 serious injuries due to the mRNA and other COVID-related injections. You’ll recall that a 2011 study commissioned by the U.S. Department of Health and Human Services (HHS) indicated that less than one percent of adverse events are actually reported within the voluntary VAERS system.

While many wrangle over the precise reporting frequency associated with VAERS, it remains true that clinicians are the primary reporters. However, it’s possible that many doctors and nurse practitioners, etc. are not even aware that this reporting system exists. (I met one such clinician last month.) That said, one of the adverse events that is being reported involves heart inflammation among young adults and teens. There have been enough of these reports that the CDC held a mid-June meeting to discuss the issue. In addition, the U.S. Food and Drug Administration (FDA) has announced it will be adding a myocarditis warning label with the vaccine insert.

Finally, it remains to be seen what, if any, delayed onset of symptoms these injections will produce within the millions of Americans who have already received them. Many medical experts who have studied the mRNA technology and what these injections are designed to do within the body have expressed concerns that serious health issues will arise in some individuals weeks, months or even years after the injection. This could potentially mean large numbers of significant adverse events never being reported within VAERS due to the temporal delay between injection and symptom onset.

In conclusion, whether its 10 times the above-referenced 31,000 figure or 100 times, hospitals should expect to see more patients in the days ahead for the purpose of treating these serious side effects. This may be the back-end eye-wall preparing to hit. Perhaps that’s positive news for patient volumes; not so positive news for the patients.

We at MiraMed Global Services want to keep you informed and prepared for all eventualities. We also want to assist you in your business needs. To view our array of services, please visit www.miramedgs.com. You can contact us at info@miramedgs.com.