Inpatient volumes are expected to decline but outpatient volume will increase correspondingly, according to Healthcare Financial Management Association's (HFMA) Healthcare Financial Pulse survey. Some financial executives surveyed anticipate that volume will grow in selected inpatient areas, including cardiac, surgical and intensive care unit/critical care unit (ICU/CCU) services.

Also, two-thirds of survey respondents anticipate a modest increase in net patient revenue over the previous year. Specifically, 14 percent expect a more than 5 percent increase in net patient revenue, compared with 13 percent who anticipate a more than 5 percent decline

However, uninsured and underinsured patients will present significant challenges as hospitals are called upon to provide greater amounts of charity care and community benefits. Specifically, 81 percent indicate negative effect from underinsured and self-pay patients, 77 percent indicate negative effect from uninsured patients and 63 percent indicate negative effect from Medicare/Medicaid payment.

Of the 263 responses received from financial executives in hospitals and health systems in March, HFMA said that:

• Most respondents project that outpatient volume growth will be modest;
• More than half of respondents project a growth in inpatient volume in the area of cardiac services; and
• Some hospitals project inpatient volume growth in surgical and ICU/CCU services.

The outlook for operating room volume is mixed among types of surgery: Respondents anticipate a slight majority of respondents anticipate growth in cardiac surgery volume and a decline or little change in general surgery and OB/GYN volume.

Of the respondents who project growth across outpatient services, they anticipate about half of the growth in outpatient radiology, laboratory, surgery and home health services.

Hospital have begun adopting strategies to cope with changing volumes, including adjusting staffing in response to volume changes (76 percent); increasing accountability for financial performance of service lines (73 percent); improving relations with referring physicians (58 percent); and renegotiating supply chain contracts (58 percent).

Read the full survey results.