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| Hospitals Knew How to Make Money. Then Coronavirus Happened. | Hospitals Knew How to Make Money. Then Coronavirus Happened. |
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| When the top-ranked Mayo Clinic stopped all nonemergency medical care in late March, it began to lose millions of dollars a day. | When the top-ranked Mayo Clinic stopped all nonemergency medical care in late March, it began to lose millions of dollars a day. |
| The clinic, a Minnesota-based hospital system accustomed to treating American presidents and foreign dignitaries, saw revenue plummet as it postponed lucrative surgeries to make way for coronavirus victims. The hospital network produced $1 billion in net operating revenue last year, but now expects to lose $900 million in 2020 even after furloughing workers, cutting doctors’ pay and halting new construction projects. | The clinic, a Minnesota-based hospital system accustomed to treating American presidents and foreign dignitaries, saw revenue plummet as it postponed lucrative surgeries to make way for coronavirus victims. The hospital network produced $1 billion in net operating revenue last year, but now expects to lose $900 million in 2020 even after furloughing workers, cutting doctors’ pay and halting new construction projects. |
| The future offers little relief, at least until the pandemic subsides and the economy recovers. The Mayo Clinic will have to rely more heavily on low-income patients enrolled in the Medicaid program, as others will be hesitant to travel across the country, or the world, for care. “It’s uncontrollable,” said Dennis Dahlen, the clinic’s chief financial officer. | The future offers little relief, at least until the pandemic subsides and the economy recovers. The Mayo Clinic will have to rely more heavily on low-income patients enrolled in the Medicaid program, as others will be hesitant to travel across the country, or the world, for care. “It’s uncontrollable,” said Dennis Dahlen, the clinic’s chief financial officer. |
| The American health care system for years has provided many hospitals with a clear playbook for turning a profit: Provide surgeries, scans and other well-reimbursed services to privately insured patients, whose plans pay higher prices than public programs like Medicare and Medicaid. | The American health care system for years has provided many hospitals with a clear playbook for turning a profit: Provide surgeries, scans and other well-reimbursed services to privately insured patients, whose plans pay higher prices than public programs like Medicare and Medicaid. |
| The Covid-19 outbreak has shown the vulnerabilities of this business model, with procedures canceled, tests postponed and millions of newly unemployed Americans expected to lose the health coverage they received at work. | The Covid-19 outbreak has shown the vulnerabilities of this business model, with procedures canceled, tests postponed and millions of newly unemployed Americans expected to lose the health coverage they received at work. |
| “Health care has always been viewed as recession-proof, but it’s not pandemic-proof,” said Dr. David Blumenthal, president of the Commonwealth Fund, a health research organization. “The level of economic impact, plus the fear of coronavirus, will have a more dramatic impact than any event we’ve seen in the health care system weather in my lifetime.” | “Health care has always been viewed as recession-proof, but it’s not pandemic-proof,” said Dr. David Blumenthal, president of the Commonwealth Fund, a health research organization. “The level of economic impact, plus the fear of coronavirus, will have a more dramatic impact than any event we’ve seen in the health care system weather in my lifetime.” |
| The disruption to hospital operations may ultimately leave Americans with less access to medical care, according to financial analysts, health economists and policy experts. Struggling hospitals may close or shut down unprofitable departments. Some may decide to merge with nearby competitors or sell to larger hospital chains. “There is a huge threat to our capability to provide basic services,” Dr. Blumenthal said. | The disruption to hospital operations may ultimately leave Americans with less access to medical care, according to financial analysts, health economists and policy experts. Struggling hospitals may close or shut down unprofitable departments. Some may decide to merge with nearby competitors or sell to larger hospital chains. “There is a huge threat to our capability to provide basic services,” Dr. Blumenthal said. |
| Hospitals are losing an estimated $50 billion a month now, according to the American Hospital Association. And 134,000 hospital employees were among the estimated 1.4 million health care workers who lost their jobs last month, data from the Bureau of Labor Statistics shows. Across the country, hospitals reported seeing between 40 and 70 percent fewer patients from late March through early May, many of them scheduled for profitable services like orthopedic surgery and radiological scans. | Hospitals are losing an estimated $50 billion a month now, according to the American Hospital Association. And 134,000 hospital employees were among the estimated 1.4 million health care workers who lost their jobs last month, data from the Bureau of Labor Statistics shows. Across the country, hospitals reported seeing between 40 and 70 percent fewer patients from late March through early May, many of them scheduled for profitable services like orthopedic surgery and radiological scans. |
| The decline affects large, elite hospital systems like the Mayo Clinic and Johns Hopkins — which estimates a loss of nearly $300 million into next year and has adopted cost reductions — as well as suburban hospitals and small rural facilities that were already financially stressed. | The decline affects large, elite hospital systems like the Mayo Clinic and Johns Hopkins — which estimates a loss of nearly $300 million into next year and has adopted cost reductions — as well as suburban hospitals and small rural facilities that were already financially stressed. |
| Lifespan Health, a five-hospital system in Rhode Island, has put off planned construction of a new spine health center. In rural Wyoming, the 12-bed Weston County Health Services hospital has only enough cash available to get through 16 days, half of what it typically kept, and executives are considering closing the emergency room. | Lifespan Health, a five-hospital system in Rhode Island, has put off planned construction of a new spine health center. In rural Wyoming, the 12-bed Weston County Health Services hospital has only enough cash available to get through 16 days, half of what it typically kept, and executives are considering closing the emergency room. |
| Hospitals that treated high numbers of coronavirus patients say they have been hit especially hard, as they had to spend heavily on protective equipment and increased staffing just as their most profitable services were halted. These patients often had long stays in intensive care units, requiring expensive equipment like ventilators and treatment from multiple specialists. | Hospitals that treated high numbers of coronavirus patients say they have been hit especially hard, as they had to spend heavily on protective equipment and increased staffing just as their most profitable services were halted. These patients often had long stays in intensive care units, requiring expensive equipment like ventilators and treatment from multiple specialists. |
| “We began ordering everything at a feverish pace,” said Kenneth Raske, president of the Greater New York Hospital Association. “The costs were sometimes 10 or 20 times normal. We were scrounging all over the world for supplies.” | “We began ordering everything at a feverish pace,” said Kenneth Raske, president of the Greater New York Hospital Association. “The costs were sometimes 10 or 20 times normal. We were scrounging all over the world for supplies.” |
| His organization estimates that, across New York City, large academic medical centers lost between $350 million and $450 million each last month. Unlike hospitals fighting smaller coronavirus outbreaks, they could not furlough workers to offset the decline. | His organization estimates that, across New York City, large academic medical centers lost between $350 million and $450 million each last month. Unlike hospitals fighting smaller coronavirus outbreaks, they could not furlough workers to offset the decline. |
| “In terms of taking care of patients, our hospitals did the right thing,” Mr. Raske said. “But the right thing has challenged their ability to continue sustaining themselves.” | “In terms of taking care of patients, our hospitals did the right thing,” Mr. Raske said. “But the right thing has challenged their ability to continue sustaining themselves.” |
| The decline in revenue is expected to be especially high among hospitals that have commanded high prices from private health plans, like the Mayo Clinic. Though coronavirus patients make up a small fraction of its patients — about 1,500 in a health system that sees more than a million annually — the global pandemic is upending its finances. | The decline in revenue is expected to be especially high among hospitals that have commanded high prices from private health plans, like the Mayo Clinic. Though coronavirus patients make up a small fraction of its patients — about 1,500 in a health system that sees more than a million annually — the global pandemic is upending its finances. |
| Last year, the clinic generated 60 percent of its $11.6 billion annual patient revenue from privately insured patients and 3 percent from those on Medicaid, according to its annual financial statement. The rest were either covered by Medicare or paid their own costs. | Last year, the clinic generated 60 percent of its $11.6 billion annual patient revenue from privately insured patients and 3 percent from those on Medicaid, according to its annual financial statement. The rest were either covered by Medicare or paid their own costs. |
| Other hospitals, including those in low-income areas or with less recognizable brands, rely more heavily on Medicaid funds. This includes many academic medical centers in large cities that see a high number of patients from their surrounding neighborhoods. | Other hospitals, including those in low-income areas or with less recognizable brands, rely more heavily on Medicaid funds. This includes many academic medical centers in large cities that see a high number of patients from their surrounding neighborhoods. |
| At the Johns Hopkins Hospital, a quarter of patient revenue comes from the public program, according to data provided by the nonprofit RAND Corporation. At NewYork-Presbyterian, it accounts for 16 percent of insurer payments. | At the Johns Hopkins Hospital, a quarter of patient revenue comes from the public program, according to data provided by the nonprofit RAND Corporation. At NewYork-Presbyterian, it accounts for 16 percent of insurer payments. |
| A nonprofit database shows that Minnesota’s private insurers pay the Mayo Clinic $566 for each obstetric ultrasound, approximately five times the Medicaid price. For an echocardiogram, the difference is tenfold. At Mayo Clinic centers in Florida and Wisconsin, according to RAND estimates, insurers pay three to four times the Medicare prices for outpatient care. Similar data for inpatient prices is not publicly available. | A nonprofit database shows that Minnesota’s private insurers pay the Mayo Clinic $566 for each obstetric ultrasound, approximately five times the Medicaid price. For an echocardiogram, the difference is tenfold. At Mayo Clinic centers in Florida and Wisconsin, according to RAND estimates, insurers pay three to four times the Medicare prices for outpatient care. Similar data for inpatient prices is not publicly available. |
| The Minnesota-based hospital system promotes its services to well-off patients, delivering quality health care alongside luxury amenities such as hotel-like suites with fluffy bathrobes, private dining rooms and access to chef-cooked meals. | The Minnesota-based hospital system promotes its services to well-off patients, delivering quality health care alongside luxury amenities such as hotel-like suites with fluffy bathrobes, private dining rooms and access to chef-cooked meals. |
| “They’ve really made a conscious effort to bolster their commercial contracts, and it’s a survival strategy,” said Lynn Blewett, a professor of health policy and management at the University of Minnesota. “To maintain the quality and the research and the excellence they’re known for, they’ve got to bring in revenue. There isn’t a lot of margin, if any, with Medicaid.” | “They’ve really made a conscious effort to bolster their commercial contracts, and it’s a survival strategy,” said Lynn Blewett, a professor of health policy and management at the University of Minnesota. “To maintain the quality and the research and the excellence they’re known for, they’ve got to bring in revenue. There isn’t a lot of margin, if any, with Medicaid.” |
| More so than most other hospitals, the 131-year-old Mayo Clinic sees a significant number of patients from afar. In a typical year, more than a million patients travel to the system’s 21 hospitals from all 50 states and 140 countries. Many are seen at its 2,000-bed Rochester, Minn., campus. International patients generally account for 1.3 percent of hospital patients but closer to 3 percent of revenue because of the complex care they receive, a spokeswoman said. | More so than most other hospitals, the 131-year-old Mayo Clinic sees a significant number of patients from afar. In a typical year, more than a million patients travel to the system’s 21 hospitals from all 50 states and 140 countries. Many are seen at its 2,000-bed Rochester, Minn., campus. International patients generally account for 1.3 percent of hospital patients but closer to 3 percent of revenue because of the complex care they receive, a spokeswoman said. |
| The clinic has used its past strong earnings to expand services abroad, opening a facility in London last fall, and now building a 741-bed for-profit institution in Abu Dhabi, in the United Arab Emirates. | The clinic has used its past strong earnings to expand services abroad, opening a facility in London last fall, and now building a 741-bed for-profit institution in Abu Dhabi, in the United Arab Emirates. |
| During the last recession of 2008, nonprofit hospitals saw their Medicaid revenue increase 17 percent, according to the credit ratings firm Moody’s, a possible preview of the changes to come in the present downturn. | During the last recession of 2008, nonprofit hospitals saw their Medicaid revenue increase 17 percent, according to the credit ratings firm Moody’s, a possible preview of the changes to come in the present downturn. |
| Minnesota expects to enroll an additional 100,000 residents in Medicaid next year. Nationally, the nonprofit Urban Institute projects between eight million and 15 million new Medicaid enrollments among those losing the private insurance they had through employers. An additional five million to 10 million Americans who lose such plans are expected to become uninsured, and four million to eight million will transition to the Affordable Care Act’s individual market plans or other sources of private insurance. | Minnesota expects to enroll an additional 100,000 residents in Medicaid next year. Nationally, the nonprofit Urban Institute projects between eight million and 15 million new Medicaid enrollments among those losing the private insurance they had through employers. An additional five million to 10 million Americans who lose such plans are expected to become uninsured, and four million to eight million will transition to the Affordable Care Act’s individual market plans or other sources of private insurance. |
| The Mayo Clinic expects to see more publicly insured patients in the second half of 2020, although it has not recorded an uptick yet. Mr. Dahlen, the chief financial officer, said, “We’ll probably see a richer mix of locals and people coming from within 100 miles.” | The Mayo Clinic expects to see more publicly insured patients in the second half of 2020, although it has not recorded an uptick yet. Mr. Dahlen, the chief financial officer, said, “We’ll probably see a richer mix of locals and people coming from within 100 miles.” |
| Like other large successful health systems, the clinic has strong cash reserves and access to credit markets. It plans to convert its shortfall by dipping into the $10.6 billion reserve of cash and investments it has built up over decades of profitability. | Like other large successful health systems, the clinic has strong cash reserves and access to credit markets. It plans to convert its shortfall by dipping into the $10.6 billion reserve of cash and investments it has built up over decades of profitability. |
| Updated June 12, 2020 | Updated June 12, 2020 |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| Independent hospitals that already teetered on the edge have less of a financial cushion and are at greater risk of shutting down services or closing altogether. | Independent hospitals that already teetered on the edge have less of a financial cushion and are at greater risk of shutting down services or closing altogether. |
| Kalispell Regional Medical Center in northwest Montana has already seen a 1 percent increase in Medicaid enrollees as patients begin to trickle back into the hospital last month. That shift from private insurance to public insurance represents a loss of $600,000 because of lower reimbursements, said Craig Boyer, the hospital’s chief financial officer. | Kalispell Regional Medical Center in northwest Montana has already seen a 1 percent increase in Medicaid enrollees as patients begin to trickle back into the hospital last month. That shift from private insurance to public insurance represents a loss of $600,000 because of lower reimbursements, said Craig Boyer, the hospital’s chief financial officer. |
| The hospital has experienced steep revenue declines after canceling most surgeries and seeing a 34 percent drop in emergency room visits. Kalispell treated a small number of coronavirus patients, including 37 who tested positive and four admitted to the hospital. | The hospital has experienced steep revenue declines after canceling most surgeries and seeing a 34 percent drop in emergency room visits. Kalispell treated a small number of coronavirus patients, including 37 who tested positive and four admitted to the hospital. |
| “If you are a patient who was scheduled for a total knee replacement, you might say, ‘My knee hurts but I’m still going to put it off while I see what happens,’” Mr. Boyer said. “We know there is a backlog, but we don’t know how many people are going to decide this isn’t the right time.” | “If you are a patient who was scheduled for a total knee replacement, you might say, ‘My knee hurts but I’m still going to put it off while I see what happens,’” Mr. Boyer said. “We know there is a backlog, but we don’t know how many people are going to decide this isn’t the right time.” |
| He also worries that a lull in summer travel will depress revenue. His hospital typically sees more patients then as visitors flock to Glacier National Park, 30 miles away. The hospital has received $10.3 million in federal stimulus plans but does not expect that to cover its losses. | He also worries that a lull in summer travel will depress revenue. His hospital typically sees more patients then as visitors flock to Glacier National Park, 30 miles away. The hospital has received $10.3 million in federal stimulus plans but does not expect that to cover its losses. |
| In neighboring Wyoming, the 90-bed Campbell County Memorial Hospital, which treated 29 coronavirus cases with no deaths, has also been hit hard. | In neighboring Wyoming, the 90-bed Campbell County Memorial Hospital, which treated 29 coronavirus cases with no deaths, has also been hit hard. |
| “The last six weeks have been disastrous for us,” said Andy Fitzgerald, the chief executive. “We’ve taken a 50 percent haircut on our revenue, and it’s the best 50 percent: elective surgery, radiology, all the outpatient care that pays for the other services we provide.” | “The last six weeks have been disastrous for us,” said Andy Fitzgerald, the chief executive. “We’ve taken a 50 percent haircut on our revenue, and it’s the best 50 percent: elective surgery, radiology, all the outpatient care that pays for the other services we provide.” |
| Local coal-mining companies, long a pillar of the economy, recently laid off hundreds of workers as global energy demands have declined. Mr. Fitzgerald expects that will mean a surge in the uninsured, who already account for 12 percent of the hospital’s patients. Wyoming is among 14 states that do not participate in the Affordable Care Act’s Medicaid expansion, which provides coverage to low-income Americans. | Local coal-mining companies, long a pillar of the economy, recently laid off hundreds of workers as global energy demands have declined. Mr. Fitzgerald expects that will mean a surge in the uninsured, who already account for 12 percent of the hospital’s patients. Wyoming is among 14 states that do not participate in the Affordable Care Act’s Medicaid expansion, which provides coverage to low-income Americans. |
| “My concern is that there is more of this in our future,” Mr. Fitzgerald said of the layoffs. “The global economy isn’t going to bounce back to full employment. The demand for what we produce here in northeastern Wyoming will probably be depressed for a while.” | “My concern is that there is more of this in our future,” Mr. Fitzgerald said of the layoffs. “The global economy isn’t going to bounce back to full employment. The demand for what we produce here in northeastern Wyoming will probably be depressed for a while.” |
| His hospital has received $10.1 million from the $72 billion in federal stimulus funds distributed so far to hospitals across the country, which he estimates will offset losses from the past two months but not the higher number of uninsured patients he expects to see in the future. | His hospital has received $10.1 million from the $72 billion in federal stimulus funds distributed so far to hospitals across the country, which he estimates will offset losses from the past two months but not the higher number of uninsured patients he expects to see in the future. |
| The Trump administration has earmarked $12 billion in relief funds for hospitals that treated 100 or more coronavirus cases, meant to offset the high costs of caring for patients whose hospital stays could last weeks. Some of that funding will go to Providence Health Systems, which owns 51 hospitals, including the Seattle-area facility that treated the first confirmed coronavirus patient in the United States. | The Trump administration has earmarked $12 billion in relief funds for hospitals that treated 100 or more coronavirus cases, meant to offset the high costs of caring for patients whose hospital stays could last weeks. Some of that funding will go to Providence Health Systems, which owns 51 hospitals, including the Seattle-area facility that treated the first confirmed coronavirus patient in the United States. |
| The hospital system has treated 1,200 coronavirus patients, and executives do not yet know whether it will break even on that care. They estimate that, even after accounting for federal stimulus dollars, Providence still lost $400 million in April. | The hospital system has treated 1,200 coronavirus patients, and executives do not yet know whether it will break even on that care. They estimate that, even after accounting for federal stimulus dollars, Providence still lost $400 million in April. |
| “We have been in this situation much longer, because of Seattle being on the forefront of the pandemic,” said Ali Santore, the hospital system’s vice president for government affairs. “We canceled elective surgeries before there was a government order. We had to see so many patients who required more supplies, isolation and nursing. Our labor costs were through the roof.” | “We have been in this situation much longer, because of Seattle being on the forefront of the pandemic,” said Ali Santore, the hospital system’s vice president for government affairs. “We canceled elective surgeries before there was a government order. We had to see so many patients who required more supplies, isolation and nursing. Our labor costs were through the roof.” |