Skip to main content

Hospital Margins Up, Volumes Down, Finds New Report

Analysis  |  By Alexandra Wilson Pecci  
   April 26, 2021

The report also shows that COVID-19 cases and hospitalizations continue to climb, despite increasing vaccinations.

Even as COVID-19 vaccinations continue at a steady clip across the country, hospitals face continued financial uncertainty and mixed performance, finds Kaufman Hall's National Hospital Flash Report: April 2021.

Hospitals saw year-to-date margins increase in March, while volumes continued to decline.

Many of the dramatic gains that the report measured, though, are because the March 2021 data is being compared to March 2020 data, which was at the height of the COVID-19 shutdown.


  • Operating margin increased 34.5% year-to-date, not including CARES funding. With the funding, operating margin increased 45.7% year-to-date.
  • Operating margin increased 128.4 year-over-year in March, without CARES funding, largely due to measuring March 2021 performance against the same period last year.
  • Adjusted discharges were down 7.4% year-to-date.
  • Emergency department visits fell 19.2% year-to-date.
  • Operating room minutes rose 3.1% from January to March compared to the same period in 2020.
  • Gross operating revenue (not including CARES) rose 4.4% year-to-date.
  • Both outpatient and inpatient revenue rose less than 4% year-to-date.
  • Total expense per adjusted discharge; labor expense per adjusted discharge; and non-labor expense per adjusted discharge all increased about 15% compared to the first three months of 2020.

The report also shows that COVID-19 cases and hospitalizations continue to climb.

The number of new COVID-19 cases was 50,681 on March 1 and increased 37% to 69,551 on March 31, CDC data shows.

In addition, hospital admissions of patients diagnosed with COVID-19 increased 17%, from 4,610 on March 1 to a monthly high of 5,396 on March 30.

Alexandra Wilson Pecci is an editor for HealthLeaders.

Get the latest on healthcare leadership in your inbox.