Hospitals are seeing a mix of short-term challenges and long-term growth trends, according to Kaufman Hall's "National Hospital Flash Report."
The report includes data from 1,300 hospitals gathered in November 2024. Overall, operating margins and EBITDA margins are down month-over-month and year-over-year, but year-to-date figures demonstrate significant recovery. Revenue per calendar day, gross operating room revenue, and inpatient and outpatient revenues reflect steady year-over-year growth and robust year-to-date increases despite monthly declines.
Regionally, the West experienced the steepest declines in operating margin month-over-month but leads in year-to-date revenue growth. The Midwest shows steady year-over-year improvements in operating margins and consistent year-to-date growth. The South was the strongest performer, with year-to-date operating margin growth of +19% and double-digit revenue gains. The Northeast/Mid-Atlantic and Great Plains regions face significant operational challenges, with steep month-over-month margin declines and lackluster year-to-date margin performance.
Despite these challenges, most regions show positive long-term revenue trends, emphasizing the need to address short-term margin pressures while capitalizing on revenue growth opportunities.
Hospital leaders are focusing on balancing short-term challenges with long-term opportunities. The data highlights concerning month-over-month declines in operating and EBITDA margins across all regions, indicating immediate pressures such as rising costs, seasonal fluctuations, and operational inefficiencies.
On a positive note, year-to-date and year-over-year revenue growth across most metrics suggests that hospitals are effectively driving patient volume or improving service reimbursement, especially in outpatient and operating room services. The South and Midwest demonstrated strong year-to-date margin and revenue performance.
However, hospitals in struggling regions like the Northeast/Mid-Atlantic and Great Plains may require targeted intervention. Leaders may evaluate cost structures, staffing levels, and service line profitability to identify areas of improvement. For the West, while revenue growth is strong, the significant margin declines suggest escalating expenses or inefficiencies that need attention.
Here is the data from the report:
Overall
Operating margin
1. Month over month: -14%
2. Year over year: -2%
3. Year to date vs. 2023: 15%
Operating EBITDA margin
4. Month over month: -10%
5. Year over year: -2%
6. Year to date vs. 2023: 8%
Operating revenue per calendar day
7. Month over month: -4%
8. Year over year: 5%
9. Year to date vs. 2023: 9%
Gross operating room revenue per calendar day
10. Month over month: -6%
11. Year over year: 4%
12. Year to date vs. 2023: 9%
Inpatient revenue per calendar day
13. Month over month: -3%
14. Year over year: 3%
15. Year to date vs. 2023: 7%
Outpatient revenue per calendar day
16. Month over month: -7%
17. Year over year: 5%
18. Year to date vs. 2023: 9%
West
Operating margin
19. Month over month: -22%
20. Year over year: -8%
21. Year to date vs. 2023: 20%
Operating EBITDA margin
22. Month over month: -16%
23. Year over year: -11%
24. Year to date vs. 2023: 15%
Revenue per calendar day
25. Month over month: -4%
26. Year over year: 7%
27. Year to date vs. 2023: 10%
Gross operating room revenue per calendar day
28. Month over month: -4%
29. Year over year: 5%
30. Year to date vs. 2023: 7%
Inpatient revenue per calendar day
31. Month over month: -1%
32. Year over year: 5%
33. Year to date vs. 2023: 7%
Outpatient revenue per calendar day
34. Month over month: -6%
35. Year over year: 6%
36. Year to date vs. 2023: 11%
Midwest
Operating margin
37. Month over month: -6%
38. Year over year: 7%
39. Year to date vs. 2023: 13%
Operating EBITDA margin
40. Month over month: -4%
41. Year over year: 3%
42. Year to date vs. 2023: 8%
Revenue per calendar day
43. Month over month: -1%
44. Year over year: 4%
45. Year to date vs. 2023: 6%
Gross operating room revenue per calendar day
46. Month over month: -6%
47. Year over year: 3%
48. Year to date vs. 2023: 7%
Inpatient revenue per calendar day
49. Month over month: -2%
50. Year over year: 3%
51. Year to date vs. 2023: 7%
Outpatient revenue per calendar day
52. Month over month: -7%
53. Year over year: 3%
54. Year to date vs. 2023: 7%
South
Operating margin
55. Month over month: -9%
56. Year over year: 0%
57. Year to date vs. 2023: 19%
Operating EBITDA margin
58. Month over month: -8%
59. Year over year: 2%
60. Year to date vs. 2023: 8%
Revenue per calendar day
61. Month over month: -3%
62. Year over year: 4%
63. Year to date vs. 2023: 11%
Gross operating room revenue per calendar day
64. Month over month: -6%
65. Year over year: 5%
66. Year to date vs. 2023: 9%
Inpatient revenue per calendar day
67. Month over month: -2%
68. Year over year: 4%
69. Year to date vs. 2023: 9%
Outpatient revenue per calendar day
70. Month over month: -7%
71. Year over year: 6%
72. Year to date vs. 2023: 8%
Northeast / Mid-Atlantic
Operating margin
73. Month over month: -6%
74. Year over year: -15%
75. Year to date vs. 2023: 12%
Operating EBITDA margin
76. Month over month: -3%
77. Year over year: -9%
78. Year to date vs. 2023: -1%
Revenue per calendar day
79. Month over month: -3%
80. Year over year: 5%
81. Year to date vs. 2023: 8%
Gross operating room revenue per calendar day
82. Month over month: -5%
83. Year over year: 5%
84. Year to date vs. 2023: 9%
Inpatient revenue per calendar day
85. Month over month: -3%
86. Year over year: 4%
87. Year to date vs. 2023: 8%
Outpatient revenue per calendar day
88. Month over month: -7%
89. Year over year: 6%
90. Year to date vs. 2023: 9%
Great Plains
Operating margin
91. Month over month: -28%
92. Year over year: -1%
93. Year to date vs. 2023:0%
Operating EBITDA margin
94. Month over month: -20%
95. Year over year: -4%
96. Year to date vs. 2023: -1%
Revenue per calendar day
97. Month over month: -6%
98. Year over year: 5%
99. Year to date vs. 2023: 7%
Gross operating room revenue per calendar day
101. Month over month: -8%
102. Year over year: 3%
103. Year to date vs. 2023: 9%
Inpatient revenue per calendar day
104. Month over month: -5%
105. Year over year: 4%
106. Year to date vs. 2023: 10%
Outpatient revenue per calendar day
107. Month over month: -8%
108. Year over year: 4%
109. Year to date vs. 2023: 10%