Inpatient Admissions Up 0.6% in May

As part of the sixth wave of the US Hospital Executives Business Survey, UBS Evidence Lab conducted an online survey of 41 C-level Executives of short-term acute care hospitals across the US. To qualify for the survey, respondents had to be C-level Executive, President/Vice-President, Director or Controller of a private short-term acute care hospital. The US Healthcare Facilities & Managed Care Research Team at UBS leverage the UBS monthly hospital survey which comprised of respondents representing 201 hospitals across 26 US states, we detail our findings below:

  • The survey suggests that unadjusted May inpatient volumes were up 0.6% Y/Y (versus up 2.0% in April and 0.7% in March).
  • Last year, the survey found that May 2023 inpatient volumes were up 2.1% Y/Y. May Commercial admits was flat Y/Y, after increasing 0.9% in April and increasing 0.3% in March.
  • Managed Medicare (MA) volumes were up 0.7% Y/Y after increasing 1.7% in April and up 1.0% March. We estimate the calendar was a 1.4% headwind in May Y/Y (despite the same number of week days and weekend days) due to higher inpatient admission volumes on Monday compared to later in the week.

Key Takeaways: Capital Spending, Divestiture of Service Lines & DPP

This month, we asked respondents a series of questions on hospital CAPEX, JV/outsourcing opportunities, and the current Debt Payment Programme (DPP) payment backdrop in their states.

  1. We first asked respondents how they expect capital spending in their health system to trend over the next 12 months vs the prior year. One-third of respondents expect higher capital spending in the year ahead, while one-half expect spending to be relatively flat year to year.
  2. Then we asked participants whether they are increasing spending in areas such as Imaging, Robotics, Technology and Surgical Capacity. The majority of respondents see increases in year-to-year spending of technology, while Robotics category sees the least % of respondents looking to increase spend.
  3. We next asked participants what services their health system is likely to evaluate for JV/divestiture over the next 12 months. Around half of respondents consider inpatient behavioral as an area to JV/divest. Around a quarter of respondents consider the same for inpatient rehab and clinical lab services. Other business lines respondents mentioned include gastrointestinal, home health, radiology and cardiovascular.
  4. We finally asked respondents whether their states are considering or already has a DPP program. According to the respondents, Ohio, Washington, Wyoming, and Alabama are considering DPPs and North Dakota and Tennessee are considering increasing their DPP payments. We note that outside of Alabama and the widely known pending Tennessee DPP increase, the public hospitals do not have material exposure to the states mentioned.

Other Volume Metrics and Payer Mix

  • Outpatient volumes grew 1.6% Y/Y after increasing 2.7% in April;
  • Outpatient surgeries were up 0.8% Y/Y after a 2.1% increase Y/Y in April.
  • Inpatient surgeries were up 0.5% Y/Y after up 0.3% in April; and ER visits were up 2.4% after a 2.1% increase in April.
  • Medicaid admits decreased 0.1% (up 0.9% in April).
  • Self-pay admits were flat in May (up 0.6% in April), and Medicare admits were up 0.5% in May (up 1.6% in April).
  • Finally, births were down 1.4% Y/Y in May (up 0.9% Y/Y in April).

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