Thursday, September 11, 2025

Executive Briefing Thursday September 11th, 2025

 

#HospitalOps #CMS #HealthcareWorkforce #PriceTransparency #EDBoarding #HospitalLeader #NursingExecutive #NursingLeader #EmergencyPhysician #Nursing #Hospitals  #CaseManagement

Hospital Margin / Revenue / Reimbursement

News: Hospital operating margins in the U.S. averaged 2.6% in July 2025, down from 3.4% in June, showing a decline in profitability. — https://www.beckershospitalreview.com/finance/hospital-margins-slide-to-2-6-average-profitability-declines-6-notes/?utm_source=chatgpt.com
Recommendation: Hospitals should closely monitor and manage non-labor operating expenses while pushing growth in outpatient service lines to buffer margin erosion. — https://medcitynews.com/2025/08/hospital-finance-debt-margins/?utm_source=chatgpt.com
Case Study: Kaufman Hall’s analysis of ~1,300 U.S. hospitals found margins rose to 3.7% in June from 1.9% in May, largely due to higher outpatient and volume-adjusted revenues. — https://medcitynews.com/2025/08/hospital-finance-debt-margins/?utm_source=chatgpt.com


Hospital Inpatient Throughput

News: A study showed only 28% of discharges occur outside peak hours (11 a.m.–5 p.m.); after interventions, the percentage increased to 36%, with earlier discharge orders and more discharges before 11 a.m. — https://pmc.ncbi.nlm.nih.gov/articles/PMC11838157/?utm_source=chatgpt.com
Recommendation: Develop interdisciplinary committees to redesign discharge workflows, aim to shift workload earlier in the day, and track time of order vs time of discharge. — https://pmc.ncbi.nlm.nih.gov/articles/PMC11838157/?utm_source=chatgpt.com
Case Study: The hospital that implemented Plan-Do-Study-Act cycles, rounding protocols, and incentives for early discharge saw no negative impact on patient satisfaction or length of stay while improving throughput metrics. — https://pmc.ncbi.nlm.nih.gov/articles/PMC11838157/?utm_source=chatgpt.com


Hospital Emergency Department Throughput

News: Prolonged ED LOS (> 8 hours) increased from 7.8% to 13.9% between 2017–2024; inpatient boarding > 4 hours rose from 2.6% to 6.2%. — https://pmc.ncbi.nlm.nih.gov/articles/PMC11992599/?utm_source=chatgpt.com
Recommendation: Hospitals should incorporate predictive analytics for boarding and LOS, strengthen coordination between ED and inpatient bed management, and consider process redesigns. — https://arxiv.org/abs/2505.14765?utm_source=chatgpt.com
Case Study: A deep-learning model (N-BEATSx) forecasted ED boarding counts 6 hours ahead with high accuracy, enabling proactive staffing and transfer decisions. — https://arxiv.org/abs/2505.14765?utm_source=chatgpt.com


Hospital Bed Placement Throughput

News: Nearly 30,000 hospital beds were eliminated nationwide between 2019–2022, even as patient acuity and inpatient utilization are projected to rise (5% increase in utilization, 10% increase in inpatient days over next decade). — https://www.vizientinc.com/insights/all/2025/from-every-angle-emergency-department-overcrowding?utm_source=chatgpt.com
Recommendation: Systems need to invest in bed capacity planning, explore flexible inpatient units, and reduce inpatient length of stay as part of flow improvement efforts. — https://www.vizientinc.com/insights/all/2025/from-every-angle-emergency-department-overcrowding?utm_source=chatgpt.com
Case Study: Penn Medicine’s geographic cohorting and patient flow/throughput management efforts reduced “excess days” and impressed with improvements in inter-facility bed placement and transfers. — https://www.haponline.org/Portals/1/docs/Events-and-Education/2025-Leadership-Summit/6WoodHAP5122025.pdf?ver=dZ4z_yLaJO9AVPtcYCB2DQ%3D%3D&utm_source=chatgpt.com


Hospital Patient Satisfaction / Engagement

News: In hospitals that improved discharge timing and throughput (from the above inpatient throughput case study), patient satisfaction remained stable despite significant operational changes. — https://pmc.ncbi.nlm.nih.gov/articles/PMC11838157/?utm_source=chatgpt.com
Recommendation: Engage patients early about discharge expectations and time; ensure communication about delays is transparent to support satisfaction even under stress. — https://pmc.ncbi.nlm.nih.gov/articles/PMC11838157/?utm_source=chatgpt.com
Case Study: The same hospital increased discharge orders placed before 9 a.m. from 4% to 16%, and discharges before 11 a.m. from 7% to 19%, without hurting satisfaction metrics. — https://pmc.ncbi.nlm.nih.gov/articles/PMC11838157/?utm_source=chatgpt.com


Patient Safety / Culture of Safety

News: AHA report shows hospitals absorbed $130 billion in underpayments from Medicare & Medicaid in 2023; underpayments growing ~14% annually since 2019. — https://www.aha.org/press-releases/2025-04-30-new-aha-report-hospitals-and-health-systems-squeezed-persistent-economic-challenges?utm_source=chatgpt.com
Recommendation: Hospital leadership must build financial resilience and safety culture together—underpayment impacts staffing, resources, and the ability to maintain safety standards. — https://www.aha.org/press-releases/2025-04-30-new-aha-report-hospitals-and-health-systems-squeezed-persistent-economic-challenges?utm_source=chatgpt.com
Case Study: Behavioral health services were on average -38.9% under-cost in Medicare reimbursement in 2023, suggesting patient safety and care access risks in under-financed service lines. — https://www.aha.org/guidesreports/2025-04-28-2024-costs-caring?utm_source=chatgpt.com


Quality Metrics to Share with Your Team

  1. U.S. average hospital operating margin in July 2025: 2.6%https://www.beckershospitalreview.com/finance/hospital-margins-slide-to-2-6-average-profitability-declines-6-notes/?utm_source=chatgpt.com

  2. Hospital margins improved to 3.7% in June from 1.9% in May in sample of ~1,300 hospitals — https://medcitynews.com/2025/08/hospital-finance-debt-margins/?utm_source=chatgpt.com

  3. Discharges outside peak hours increased from 28% → 36% after interventions — https://pmc.ncbi.nlm.nih.gov/articles/PMC11838157/?utm_source=chatgpt.com

  4. ED prolonged LOS (> 8 hours): 13.9% in 2024; inpatient boarding > 4 hours: 6.2%https://pmc.ncbi.nlm.nih.gov/articles/PMC11992599/?utm_source=chatgpt.com

  5. Prediction model (ED boarding count) MAE ~2.10 using deep learning model (6-hour ahead forecast) — https://arxiv.org/abs/2505.14765?utm_source=chatgpt.com

  6. Hospitals absorbed $130B+ in Medicare & Medicaid underpayments in 2023 — https://www.aha.org/press-releases/2025-04-30-new-aha-report-hospitals-and-health-systems-squeezed-persistent-economic-challenges?utm_source=chatgpt.com

  7. Behavioral health services average margin: approx –38.9% under cost in Medicare payment in 2023 — https://www.aha.org/guidesreports/2025-04-28-2024-costs-caring?utm_source=chatgpt.com


Leadership Call to Action

  1. Prioritize strengthening outpatient revenue streams and non-labor cost controls to combat shrinking operating margins.

  2. Invest in discharge planning and process changes (e.g., early morning orders, non-peak discharges) to improve inpatient throughput.

  3. Use predictive analytics for ED boarding and LOS to anticipate demand and coordinate resources proactively.

  4. Expand bed capacity planning and flexible usage (e.g. float beds, flexible inpatient units), especially in areas with expected growth in utilization.

  5. Align financial planning with safety and staffing—ensure underpaying service lines such as behavioral health are not neglected, which can undermine patient safety and access.


📍 Published at National Daily Hospital News
#HospitalOps #CMS #HealthcareWorkforce #HospitalFinance #EmergencyServices #HospitalLeader #NursingExecutive #NursingLeader #EmergencyPhysician #Nursing #Hospitals #CaseManagement #EmergencyNurse
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