Protecting Public Health and Preserving the Financial Viability of North Carolina’s Critical Health Care Facilities during Infectious Disease Outbreaks

While hospitals’ primary emphasis during the COVID-19 pandemic has been on ensuring sufficient health-related resource capacity (e.g., ICU beds, ventilators) to serve admitted patients, the impacts of the pandemic on the financial viability of hospitals has also become a critical concern. Data from the period March 2020-Janaury 2021 suggest that the halt to elective and non-emergency inpatient procedures, combined with a reduction in emergency room procedures, led to losses equal to 6.5% of revenue from inpatient procedures, or about $825 million. This study finds that societal measures to reduce the community transmission rates have a larger impact on available healthcare capacity and hospital financial losses than hospital-level decisions. This study illustrates the tradeoffs between hospital capacity, quality of care, and financial risk faced by health care facilities throughout the U.S. as a result of COVID-19, providing potential insights for many hospitals seeking to navigate these uncertain scenarios through adaptive decision-making.