Pandemic reveals flaws of unemployment insurance programs

https://thehill.com/policy/finance/510368-pandemic-reveals-flaws-of-unemployment-insurance-programs

Pandemic reveals flaws of unemployment insurance programs

The lapse of enhanced jobless benefits amid a record-breaking crush of applications is exposing the flaws and shortcomings of how the U.S. provides unemployment insurance.

The economic toll of the coronavirus pandemic has torn holes in a federal safety net woven by individual systems for every state plus the District of Columbia, Puerto Rico and the Virgin Islands. More than 30.2 million Americans were on some form of unemployment insurance as of mid-July, with the Labor Department reporting a growing number of new applications in subsequent weeks.

Friday’s expiration of a $600 weekly add-on to state benefits plunged those vulnerable Americans into financial peril.

Congressional Democrats and Trump administration officials are now deadlocked over negotiations for a broader coronavirus relief package that’s expected to include some form of federal unemployment benefits.

But short-staffed unemployment offices across the U.S. grappling with outdated technology and unprecedented demand would face challenges from implementing a scaled-down or more complicated approach to the weekly payments.

Economists and labor market experts also warn that any solution that emerges from the negotiations would take weeks, if not months, to get up and running, risking a potentially catastrophic fiscal cliff for tens of millions of U.S. households.

“You ought to be able to deliver the program that’s on the books,” said Douglas Holtz-Eakin, former director of the Congressional Budget Office and a White House economist under former President George W. Bush.

“The states, collectively, seem to have not kept up the systems and we now have a big problem because of that,” he added.

The unprecedented size and speed of the pandemic-driven economic collapse has posed a brutal challenge for state unemployment agencies. After 10 years of steady economic expansion, the labor market quickly went from the lowest unemployment rate in 50 years to the highest level of joblessness since the Great Depression.

New claims for unemployment benefits were averaging roughly 200,000 nationwide a week before the pandemic — a manageable level for state agencies that had largely been neglected during the longest stretch of growth in modern U.S. history. But the coronavirus lockdowns spurred 3.3 million new claims between March 15 and March 22, a then-record that would be doubled the following week. Before the COVID-19 outbreak, the previous record was 695,000 from the first week of October 1982.

A little more than four months after the pandemic hit, state agencies are now processing roughly 2 million new claims a week for both unemployment insurance and Pandemic Unemployment Assistance (PUA), a program designed to cover those who don’t qualify for typical benefits.

“On some level, you can’t really blame states for not being prepared for that level of onslaught,” said Michele Evermore, senior policy analyst at the National Employment Law Project.

“Usually, you see the recession starting up and state agencies say ‘You know, this looks like a recession here, so let’s start to staff up.’ This came on all at once, so we’ve had these neglected, antiquated systems and then there’s all these other stressors.”

The U.S. economy has been in recession since February, according to the National Bureau of Economic Research.

Processing the massive surge of unemployment claims on shoddy technology would have been hard enough for states. Adding enhanced benefits and PUA claims to the mix strained state agencies even more.

“It took time to upgrade those systems. It took time to hire and train new staff who could deal with the volumes of the calls, and all in a pandemic, when face-to-face contact and training and being together in office were not possible,” said Julia Pollak, labor economist at job recruitment and posting company ZipRecuriter.

“So it’s easy to see in hindsight why it all fell apart.”

Enhanced unemployment benefits are among the biggest obstacles to reaching a deal on what’s likely to be the last coronavirus relief package before the election. While President Trump and Republicans are divided over how and whether to extend the federal boost, Democrats are largely united behind extending the benefits and reducing them gradually along a curve tied to the unemployment rate.

Speaker Nancy Pelosi (D-Calif.) has called for including such a mechanism, known as an automatic stabilizers, in the coronavirus package being negotiated.

Rep. Don Beyer (D-Va.), vice chair of the Joint Economic Committee, introduced a separate bill designed to tackle economic downturns beyond the coronavirus recession. His measure would establish a six-tier system for reducing the federal benefit in line with a state’s unemployment rate.

The approach was endorsed by former Federal Reserve Chairman Ben Bernanke, who oversaw the central bank’s response to the Great Recession, and his successor, Janet Yellen.

“Every time you get close to a cliff and there’s a political battle and political price to be paid, probably by both sides, rather than just saying ‘This is what’s needed,’ let’s kick it in,” Beyer said in an interview.

“We talked to economists all across the country and virtually everyone we talked to said this makes the most sense.”

But Republican lawmakers and right-leaning economists have pushed back on efforts to codify mandatory spending and make decisions now about what will be needed to mitigate future crises.

“It’s hard for me to understand why it’s appropriate now to anticipate the economic conditions in the future and tie the hands of future elected representatives of Congress,” Holtz-Eakin said.

“It forked out $2.3 trillion in [the CARES Act] across the board in ways that got to small businesses, to households, to the employed, the unemployed. If you’re going to have one in 100-year events, that’s how you deal with them,” he added.

Republicans have instead proposed replacing the flat $600 weekly boost with a percentage of the worker’s pre-pandemic earnings in addition to what is prescribed by each state. While the wage-replacement is more tailored, Evermore warned that making the necessary calculations for each claimant could overwhelm an already teetering system.

“If you told states that they had to do a percentage replacement — oh, my gosh, that’s a recipe for crashing everything,” she said.

“It’s just not how the system is set up to work.”

 

 

 

 

The Mask Slackers of 1918

As the influenza pandemic swept across the United States in 1918 and 1919, masks took a role in political and cultural wars.

The masks were called muzzles, germ shields and dirt traps. They gave people a “pig-like snout.” Some people snipped holes in their masks to smoke cigars. Others fastened them to dogs in mockery. Bandits used them to rob banks.

More than a century ago, as the 1918 influenza pandemic raged in the United States, masks of gauze and cheesecloth became the facial front lines in the battle against the virus. But as they have now, the masks also stoked political division. Then, as now, medical authorities urged the wearing of masks to help slow the spread of disease. And then, as now, some people resisted.

In 1918 and 1919, as bars, saloons, restaurants, theaters and schools were closed, masks became a scapegoat, a symbol of government overreach, inspiring protests, petitions and defiant bare-face gatherings. All the while, thousands of Americans were dying in a deadly pandemic.

The first infections were identified in March, at an Army base in Kansas, where 100 soldiers were infected. Within a week, the number of flu cases grew fivefold, and soon the disease was taking hold across the country, prompting some cities to impose quarantines and mask orders to contain it.

By the fall of 1918, seven cities — San Francisco, Seattle, Oakland, Sacramento, Denver, Indianapolis and Pasadena, Calif. — had put in effect mandatory face mask laws, said Dr. Howard Markel, a historian of epidemics and the author of “Quarantine!

Organized resistance to mask wearing was not common, Dr. Markel said, but it was present. “There were flare-ups, there were scuffles and there were occasional groups, like the Anti-Mask League,” he said, “but that is the exception rather than the rule.”

At the forefront of the safety measures was San Francisco, where a man returning from a trip to Chicago apparently carried the virus home, according to archives about the pandemic at the University of Michigan.

By the end of October, there were more than 60,000 cases statewide, with 7,000 of them in San Francisco. It soon became known as the “masked city.”

“The Mask Ordinance,” signed by Mayor James Rolph on Oct. 22, made San Francisco the first American city to require face coverings, which had to be four layers thick.

Resisters complained about appearance, comfort and freedom, even after the flu killed an estimated 195,000 Americans in October alone.

Alma Whitaker, writing in The Los Angeles Times on Oct. 22, 1918, reviewed masks’ impact on society and celebrity, saying famous people shunned them because it was “so horrid” to go unrecognized.

“The big restaurants are the funniest sights, with all the waiters and diners masked, the latter just raising their screen to pop in a mouthful of food,” she wrote.

When Ms. Whitaker herself declined to wear one, she was “forcibly taken” to the Red Cross as a “slacker,” and ordered to make one and put it on.

The San Francisco Chronicle said the simplest type of mask was of folded gauze affixed with elastic or tape. The police went for gauze masks, which resembled an unflattering “nine ordinary slabs of ravioli arranged in a square.”

There was room for creativity. Some of the coverings were “fearsome looking machines” that lent a “pig-like aspect” to the wearer’s face.

The penalty for violators was $5 to $10, or 10 days’ imprisonment.

On Nov. 9, 1,000 people were arrested, The San Francisco Chronicle reported. City prisons swelled to standing room only; police shifts and court sessions were added to help manage.

“Where is your mask?” Judge Mathew Brady asked offenders at the Hall of Justice, where sessions dragged into night. Some gave fake names, said they just wanted to light a cigar or that they hated following laws.

Jail terms of 8 hours to 10 days were given out. Those who could not pay $5 were jailed for 48 hours.

On Oct. 28, a blacksmith named James Wisser stood on Powell and Market streets in front of a drugstore, urging a crowd to dispose of their masks, which he described as “bunk.”

A health inspector, Henry D. Miller, led him to the drugstore to buy a mask.

At the door, Mr. Wisser struck Mr. Miller with a sack of silver dollars and knocked him to the ground, The San Francisco Chronicle reported. While being “pummeled,” Mr. Miller, 62, fired four times with a revolver. Passers-by “scurried for cover,” The Associated Press said.

Mr. Wisser was injured, as were two bystanders. He was charged with disturbing the peace, resisting an officer and assault. The inspector was charged with assault with a deadly weapon.

That was the headline for a report published in The Los Angeles Times when city officials met in November to decide whether to require residents to wear “germ scarers” or “flu-scarers.”

Public feedback was invited. Some supported masks so theaters, churches and schools could operate. Opponents said masks were “mere dirt and dust traps and do more harm than good.”

“I have seen some persons wearing their masks for a while hanging about their necks, and then apply them to their faces, forgetting that they might have picked up germs while dangling about their clothes,” Dr. E.W. Fleming said in a Los Angeles Times report.

An ear, nose and throat specialist, Dr. John J. Kyle, said: “I saw a woman in a restaurant today with a mask on. She was in ordinary street clothes, and every now and then she raised her hand to her face and fussed with the mask.”

Suffragists fighting for the right to vote made a gesture that rejected covering their mouths at a time when their voices were crucial.

At the annual convention of the Illinois Equal Suffrage Association, in October 1918, they set chairs four feet apart, closed doors to the public and limited attendance to 100 delegates, the Chicago Daily Tribune reported.

But the women “showed their scorn” for masks, it said. It’s unclear why.

Allison K. Lange, an associate history professor at Wentworth Institute of Technology, said one reason could have been that they wanted to keep a highly visible profile.

“Suffragists wanted to make sure their leaders were familiar political figures,” Dr. Lange said.

San Francisco’s mask ordinance expired after four weeks at noon on Nov. 21. The city celebrated, and church bells tolled.

A “delinquent” bent on blowing his nose tore his mask off so quickly that it “nearly ruptured his ear,” The San Francisco Chronicle reported. He and others stomped on their masks in the street. As a police officer watched, it dawned on him that “his vigil over the masks was done.”

Waiters, barkeeps and others bared their faces. Drinks were on the house. Ice cream shops handed out treats. The sidewalks were strewn with gauze, the “relics of a torturous month,” The Chronicle said.

The spread had been halted. But a second wave was on the horizon.

By December, the San Francisco Board of Supervisors was again proposing a mask requirement, meeting with testy opposition.

Around the end of the year, a bomb was defused outside the office of San Francisco’s chief health officer, Dr. William C. Hassler. “Things were violent and aggressive, but it was because people were losing money,” said Brian Dolan, a medical historian at the University of California, San Francisco. “It wasn’t about a constitutional issue; it was a money issue.”

By the end of 1918, the death toll from influenza had reached at least 244,681, mostly in the last four months, according to government statistics.

In January, Pasadena’s city commission passed a mask ordinance. The police grudgingly enforced it, cracking down on cigar smokers and passengers in cars. Sixty people were arrested on the first day, The Los Angeles Times reported on Jan. 22, in an article titled “Pasadena Snorts Under Masks.”

“It is the most unpopular law ever placed on the Pasadena records,” W.S. McIntyre, the chief of police, told the paper. “We are cursed from all sides.”

Some mocked the rule by stretching gauze across car vents or dog snouts. Cigar vendors said they lost customers, though enterprising aficionados cut a hole in the cloth. (They were still arrested.) Barbers lost shaving business. Merchants complained traffic dropped as more people stayed home.

Petitions were circulated at cigar stands. Arrests rose, even of the powerful. Ernest May, the president of Security National Bank of Pasadena, and five “prominent” guests were rounded up at the Maryland Hotel one Sunday.

They had masks on, but not covering their faces.

As the contagion moved into its second year, so did the skepticism.

On Dec. 17, 1918, the San Francisco Board of Supervisors reinstituted the mask ordinance after deaths started to climb, a trend that spilled over into the new year with 1,800 flu cases and 101 deaths reported there in the first five days of January.

That board’s decision led to the creation of the Anti-Mask League, a sign that resistance to masks was resurfacing as cities tried to reimpose orders to wear them when infections returned.

The league was led by a woman, E.J. Harrington, a lawyer, social activist and political opponent of the mayor. About a half-dozen other women filled its top ranks. Eight men also joined, some of them representing unions, along with two members of the board of supervisors who had voted against masks.

“The masks turned into a political symbol,” Dr. Dolan said.

On Jan. 25, the league held its first organizational meeting, open to the public at the Dreamland Rink, where they united behind demands for the repeal of the mask ordinance and for the resignations of the mayor and health officials.

Their objections included lack of scientific evidence that masks worked and the idea that forcing people to wear the coverings was unconstitutional.

On Jan. 27, the league protested at a Board of Supervisors meeting, but the mayor held his ground. There were hisses and cries of “freedom and liberty,” Dr. Dolan wrote in his paper on the epidemic.

Repeal came a few days later on Feb. 1, when Mayor Rolph cited a downturn in infections.

But a third wave of flu rolled in late that year. The final death toll reached an estimated 675,000 nationwide, or 30 for every 1,000 people in San Francisco, making it one of the worst-hit cities in America.

Dr. Dolan said the story of the Anti-Mask League, which has drawn renewed interest now in 2020, demonstrates the disconnect between individual choice and universal compliance.

That sentiment echoes through the century from the voice of a San Francisco railway worker named Frank Cocciniglia.

Arrested on Kearny Street in January, Mr. Cocciniglia told the judge that he “was not disposed to do anything not in harmony with his feelings,” according to a Los Angeles Times report.

He was sentenced to five days in jail.

“That suits me,” Mr. Cocciniglia said as he left the stand. “I won’t have to wear a mask there.”

 

 

 

 

US weekly jobless claims hit 1.4 million, post second straight weekly increase

https://www.businessinsider.com/us-jobless-claims-unemployment-insurance-labor-market-filings-recession-coronavirus-2020-7

  • US jobless claims for the week that ended Saturday totaled 1.43 million, the Labor Department said Thursday. That came in slightly below the consensus economist estimate of 1.45 million.
  • It marked a second consecutive weekly increase after the prior week’s report ended a 15-week streak of declines. This week’s report brought total filings over a 19-week period to more than 54 million.
  • Continuing claims, the aggregate total of people receiving unemployment benefits, totaled 17 million for the week that ended July 18.

More than a million Americans filed for unemployment benefits last week, reflecting the continued high level of pandemic-induced layoffs as the US rolls back its economic-reopening efforts.

New US weekly jobless claims totaled 1.43 million in the week that ended Saturday, the Labor Department reported Thursday. That was slightly below the consensus economist estimate of 1.45 million compiled by Bloomberg. It also was a minor increase over the prior week’s 1.3 million filings, a reading that marked the first gain in 15 weeks.

In just a few months, the more than 54 million unemployment claims filed during the coronavirus pandemic have far surpassed the 37 million during the 18-month Great Recession. The latest figure is more than double the 665,000 filed during the Great Recession’s worst week.

“A combination of uncertainty from rising virus cases to the withdrawal of financial support is concerning for an already fragile recovery,” said Daniel Zhao, senior economist at Glassdoor. “The economy is still in deep risk of falling sideways – where conditions improve so sluggishly that the effects of the crisis become increasingly permanent.”

Continuing claims, which represent the aggregate total of people receiving unemployment benefits, came in at 17 million for the week that ended July 18, a decline from the prior period’s revised number.

Stubbornly high weekly claims for unemployment insurance add to growing concerns that the economic recovery from the pandemic-induced recession is stagnating as coronavirus cases increase. A number of states have had to pause or roll back their reopening plans to deal with COVID-19 spikes, harming the economic recovery.

Going forward, industry watchers will be waiting to see what the July jobs report shows. The report, due August 7, reflects a reference period that includes last week, when initial jobless claims ticked up for the first time in 15 weeks. That could foreshadow a negative headline jobs number in July, although the nonfarm payroll report has become increasingly difficult to predict.

Last week, the additional $600 unemployment benefit from the CARES Act expired, meaning that soon millions of Americans will see a significant decrease in weekly income. The GOP this week introduced its proposal, the HEALS Act, that would cut the weekly benefit to $200 until states could implement a program that’d replace 70% of wages for most filers.

In the week ending July 25, there were 829,697 initial claims from 50 states reporting for Pandemic Unemployment Assistance, the program that extended benefits to gig workers and independent contracts. The total applications for all state programs for the week ending July 11 was 30.2 million. 

 

 

 

 

July ends on an uncertain note in the pandemic battle

https://mailchi.mp/0fa09872586c/the-weekly-gist-july-31-2020?e=d1e747d2d8

Fighting a losing battle - post - Imgur

After a week that brought the most disastrous economic data in modern history, the death of a former Presidential candidate from COVID, and signs of an alarming surge in virus cases in the Midwest, Congress left Washington for the weekend without reaching a deal on a new recovery bill. That left millions of unemployed Americans without supplemental benefit payments, business owners wondering whether more financial assistance would be forthcoming, and hospitals facing the requirement to begin repaying billions of dollars of advance payments from Medicare.

Also remaining on the table was funding to bolster coronavirus testing, with the top health official in charge of the testing effort testifying on Friday that the system is not currently able to deliver COVID test results to patients in a timely manner. While the surge in cases appears to be shifting to the Midwest, there were early indications of positive news across the Sun Belt, as the daily new case count in Florida, Louisiana, Texas, Arizona and California continued to decline, while daily death counts (a lagging indicator) continued to hit new records.

Nationally, the daily case count appears to have reached a new plateau of around 65,000, with daily deaths rising to a 7-day average above 1,150, matching a level last seen in May.

Meanwhile, new clinical findings continued to refine our understanding of how the virus attacks its victims. Reporting in JAMA Cardiology, researchers used cardiac MRI to examine heart function among 100 coronavirus patients, 67 of whom recovered at home without hospitalization, finding that 78 percent demonstrated cardiac involvement and 60 percent had evidence of active heart muscle inflammation—concerning signs pointing to possible long-term complications, even in patients with relatively mild courses of COVID infection.

And yesterday in JAMA, investigators reported that while young children are typically less affected by COVID-19 than adults, children under 5 may harbor 100 times as much active virus in their nose and throat as infected adults. While the study does not confirm that kids spread the virus to adults, it is sure to raise concerns about reopening schools, which has generally been considered relatively safer for younger children.

US coronavirus update: 4.8M cases; 151K deaths; 52.9M tests conducted.

 

 

 

Fewer than 10% of primary care practices have stabilized operations amid COVID-19 pandemic

https://www.fiercehealthcare.com/practices/fewer-than-10-primary-care-practices-have-stabilized-operations-amid-covid-19-pandemic?mkt_tok=eyJpIjoiWTJGaE1qTTRaalpsT1dGayIsInQiOiJTNWFxb3VcL3J3ZmE4ZWV0bFwvOGJCYUc0Ukd3TWp4WlM1SzBzT01aeVJIUGlsSWkwNTlVajJxekJqUUsrcWoxZ0IwTUNqVlhTWVJLQmZkSk1XNGtKVEdCOWg3NmRWeFdldFpsSmlONnFvTTFGQ2l1bzQ4S3ZqNWpoaUx2d1pHaSs1In0%3D

Fewer than 10% of primary care practices have stabilized ...

Four months into the COVID-19 pandemic, fewer than 10% of U.S. primary care practices have been able to stabilize operations.

Nearly 9 in 10 primary care practices continue to face significant difficulties with COVID-19, including obtaining medical supplies, meeting the increasing health needs of their patients, and finding sufficient resources to remain operational, according to a recent survey of close to 600 primary care clinicians in 46 states.

Only 13% of primary care clinicians say they are adapting to a “new normal” in the protracted pandemic, the survey found.

More than four months into the pandemic and at a time when 39 states are experiencing an increase of COVID-19 cases, fewer than 4 in 10 clinicians feel confident and safe with their access to personal protective equipment, according to the survey from the Larry A. Green Center in partnership with the Primary Care Collaborative, which was conducted July 10 to July 13.

Among the primary care clinicians surveyed, 11% report that staff in their practice have quit in the last four weeks over safety concerns.

A primary care provider in Ohio said this: “The ‘I can do 4-6 weeks of this’ transition to ‘this feels like a new/permanent normal’ is crushing and demoralizing. Ways to build morale when everyone is at a computer workstation away from other staff (and patients) feels impossible.”

“In the first few months of the pandemic, the country pulled together to stop the spread of the virus, and it seemed like we were making progress. Primary care clinicians and practices were working hard, against tremendous challenges,” said Rebecca Etz, Ph.D., co-director of The Larry A. Green Center in a statement.

“But now the country is backsliding, and it’s clear that primary care doesn’t have enough strength to deal with the rising number of cases. If primary care were a COVID-19 patient, it would be flat on its back,” Etz said.

The survey conducted by the Larry A. Green Center is part of an ongoing series looking at the attitudes of primary care clinicians and patients during the COVID-19 pandemic and the abilities of practices to meet patients’ needs.

Close to 40% of primary care providers report they are maxed out with mental exhaustion and 18% say they spend each week wondering if their practice or job will still be there next week.

In addition to feeling stressed, clinicians and their practices are also experiencing upheaval. The survey found that 22% of clinicians report skipped or deferred salaries, and 78% report preventive and chronic care is being deferred or delayed by patients.

Primary care clinicians report that 42% of in-person volume is down but overall contact with patients is high, while 39% report not being able to bill for the majority of work delivered, the survey found.

“Given the rapidly rising infection rates and persistent lack of PPE, more than a third of primary care clinicians are reporting feeling unsafe at the office, and 20% are cutting back on face-to-face visits while doing more remote outreach,” said Ann Greiner, president and CEO of the Primary Care Collaborative in a statement.

Greiner said this is a clear signal that payers must advance or retain parity for telehealth and telephonic calls.

“It also is a clarion call to move to a new payment system that doesn’t rely on face-to-face visits and that is prospective so practices can better manage patient care,” she said.

Providers say they need more support from private insurers, particularly when it comes to reimbursing for telehealth and telephone visits. 

According to the survey, a primary care doctor in Illinois said, “Recently told we would not be able to conduct telephone visits due to lack of reimbursement. I work in a low-income Medicare population which has low health literacy and no technology literacy. We were 80% telephone and 20% Zoom and in-office. This further exemplifies the extreme health care disparities in the U.S.”

 

 

 

Did a third of the economy really vanish in just three months?

https://www.washingtonpost.com/business/2020/07/30/did-third-economy-really-vanish-just-three-months/?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR11oZa1zNZ4rPe-mKLgDKQDwgqCYa_r9DXpQtycSqu0ojgHKGVN8H8ljOs

 

The second quarter GDP report confused many, but any way you slice it, the economy saw its worst quarter in at least 145 years.

The Commerce Department opened today’s announcement of second-quarter economic growth with an eyeball-blistering observation: “Real gross domestic product (GDP) decreased at an annual rate of 32.9 percent in the second quarter of 2020.”

That 32.9 percent represents the loss of a third of the economy. Let that sink in. Now let it wriggle back out again — it is not exactly true. Why? The Commerce Department reports quarterly GDP at an annual rate to allow easy comparisons to other time periods. Remove the annualization, and we see the economy contracted a still-abysmal 9.5 percent.

In other words, 32.9 percent is how much the economy would shrink if the business closures and spending cuts of the second quarter increased at a compounding 9.5 percent for an entire year, after adjusting for seasonality.

Think of what an apocalypse that would be. Annualization assumes the businesses closed this quarter would remain closed and that just as many more would close in the third quarter. And we’d expand the closures again in the fourth quarter and again in the first quarter of next year.

In other words, take the devastation you saw in the past three months and multiply it by four. That is essentially what annualizing does, though compounding means the actual math is a bit more complicated.

The Commerce Department’s affection for annualization does not stop at percentage change. It also reports quarterly GDP totals at an annualized rate — when Commerce says GDP was at $17.2 trillion in the past quarter, it means GDP would be at $17.2 trillion if this quarter’s $4.3 trillion in output continued for a full year.

With that in mind, here is U.S. GDP, adjusted for inflation and reported as quarterly totals, as suggested by reader Nick Estes.

That chart does not crash by a third, obviously. A 32.9 percent drop would mean a loss of about $1.6 trillion from last quarter. In fact, the economy shrank $0.45 trillion in the second quarter, on the heels of a $0.06 trillion (1.3 percent) decrease in the first quarter of 2020.

To see a third of the economy truly vanish, look at the Great Depression. From 1929 to 1933, GDP contracted about 36 percent, according to data collected by economists Nathan Balke and Robert Gordon. That is the actual contraction — no annualization in sight.

Commerce Department data, which start in 1947, show the previous worst quarter on record was a 2.6 percent drop in 1958. That contraction just happened to coincide with the “Asian flu” pandemic, which claimed about a million lives worldwide.

With Balke and Gordon’s expanded data, we can also establish that a drop of 9.5 percent makes this quarter the worst since at least 1875. The next worst were in 1893, when a legendary panic and run on the banks resulted in a long, painful depression, and 1937, when the Great Depression took a turn for the worse. Then, we saw drops of 8.4 percent and 7.2 percent, respectively.

 

 

3 Months Of Hell: U.S. Economy Drops 32.9% In Worst GDP Report Ever

https://www.npr.org/sections/coronavirus-live-updates/2020/07/30/896714437/3-months-of-hell-u-s-economys-worst-quarter-ever?utm_campaign=storyshare&utm_source=facebook.com&utm_medium=social&fbclid=IwAR1L_YW1uYovd5bpjtU6xV7HI_DgGsYPgmdEs3fz0RbOn8XukrKhafRsljE

Economy Shrank At 32.9% Rate In 2nd Quarter

Percent change from the preceding period, seasonally adjusted annual rate

3 Months Of Hell: U.S. Economy Drops 32.9% In Worst GDP Report ...

The coronavirus pandemic triggered the sharpest economic contraction in modern American history, the Commerce Department reported Thursday.

Gross domestic product — the broadest measure of economic activity — shrank at an annual rate of 32.9% in the second quarter as restaurants and retailers closed their doors in a desperate effort to slow the spread of the virus, which has killed more than 150,000 people in the U.S.

The economic shock in April, May and June was more than three times as sharp as the previous record — 10% in 1958 — and nearly four times the worst quarter during the Great Recession.

“Horrific,” said Nariman Behravesh, chief economist at IHS Markit. “We’ve never seen anything quite like it.”

Another 1.43 million people filed for state unemployment last week, an increase of 12,000, the Labor Department reported Thursday. It was the second week in a row of increased unemployment filings and shows that the economic picture continues to remain grim.

GDP swings are typically reported at an annual rate — as if they were to continue for a full year — which can be misleading in a volatile period like this. The overall economy in the second quarter was 9.5% smaller than during the same period a year ago.

After a sharp drop in March and April, economic activity began to rebound in May and June, although that recovery remains halting and could be jeopardized by a new surge of infections.

“As soon as the virus started to take off again in key states like Texas, California, Arizona, Florida, it’s fading very rapidly,” Behravesh said.

Restaurant owner Cameron Mitchell likens the pandemic to a hurricane. What appeared to be a business rebound in June turned out to be merely the eye of the storm, and he’s now being buffeted by gale-force winds again.

“Our associates are more scared to work today and guests are more afraid to go out, so sales have dropped,” Mitchell said.

Business at his restaurants in Florida had nearly recovered to pre-pandemic levels in June but has since fallen sharply.

Other industries have enjoyed a more durable recovery, though few are back to where they were in February.

Dentists’ offices are ordinarily one of the more stable parts of the economy, but they closed for all but emergency services during much of the spring. Dental hygienist Alexis Bailey was out of work for 10 weeks before her office in Lansing, Mich., reopened at the end of May.

At first, she was reluctant to go back to work while the virus was still circulating.

“I was terrified,” Bailey said. “I was not happy to be back. But I have a job to do and I like to do it and I want to help people. We talk about how essential we are, so that’s what we’ve had to do.”

Within an hour of returning to work, Bailey said, she began to feel comfortable, particularly with the additional protective gear and other safety precautions her office has adopted.

“I tell my patients all the time I wouldn’t be here if I didn’t feel safe,” she said.

Nationwide, dental offices added more than a quarter-million jobs in May and another 190,000 in June. And there has been no shortage of patients.

She thought no one would want to come. “But we’re booked,” Bailey said. “People miss getting their teeth cleaned. They want to catch up. Every time they come in, they say, ‘This has been nice to get out of the house and feel safe and talk to somebody.’ ”

Factory production has also begun to rebound, along with construction. But airlines and amusement parks are still struggling.

“It’s very much a sort of two-tiered economy right now,” Behravesh said.

The unemployment rate approached 15% in April, and in June it was still higher — at 11.1% — than during any previous postwar recession.

While the drop in GDP was largely driven by a decline in consumer spending, the economic fallout was cushioned somewhat by an unprecedented level of federal relief.

Wages and salaries fell sharply in April, but that was more than offset by the $1,200 relief payments that the government sent to most adults and by supplemental unemployment benefits of $600 per week.

Those government payments helped prevent an even steeper drop in consumer spending — the lifeblood of the U.S. economy — and allowed struggling families to buy groceries and pay rent.

Federal Reserve Chair Jerome Powell said Wednesday that the money “has been well spent. It has kept people in their homes. It has kept businesses in business. So that’s all a good thing.”

Those extra unemployment benefits are expiring this week, though. With coronavirus infections still threatening the recovery, additional federal support is likely to be necessary.

“Until we get the virus under control, we’re going to need more help,” Behravesh said. “Our view is that we’re not going to get to the pre-pandemic levels of economic activity until some time in 2022.”

Restaurant owner Mitchell says his business lost $700,000 in June alone. He predicts a wave of restaurant bankruptcies unless the federal government provides more relief.

“No one is looking for a handout here,” he said. “We’re looking to survive.”

He’s watching news of vaccine trials closely in hopes that eventually diners will feel comfortable eating out again in large numbers.

“I don’t think it’s the next couple of weeks,” he said. “But I tell our team, ‘Every day that goes by, it’s one day closer to the end of this thing.’ ”

 

 

 

6 months in: Following the flow of CARES hospital funding

https://www.healthcaredive.com/news/6-months-cares-hospital-funding-covid/581506/

Congress has allocated $175 billion to help providers respond to the COVID-19 crisis, but HHS has been hit with multiple complaints about distribution as that money goes out the door.

The COVID-19 pandemic created massive upheaval for the nation’s healthcare system still evident six months after the U.S. declared it a national public health crisis.

The virus continues to surge, reaching new heights with more than 4 million confirmed cases and more than 143,000 deaths. No other country has experienced more deaths or cases than the U.S., data with Johns Hopkins Coronavirus Research Center show.

Parts of the country are facing the prospect of another lockdown as cases overwhelm healthcare facilities.

Forced into quickly responding to the pandemic, health systems have taken substantial financial hits. While the impact has been far from even, one estimate from the American Hospital Association estimates the nation’s health systems’ financial losses in the first four months of the outbreak reached nearly $203 billion.

To help staunch the free fall, Congress earmarked $175 billion in two pieces of legislation in an attempt to keep providers afloat as the virus wreaked havoc on the economy. The majority of that was from the Coronavirus Aid, Relief, and Economic Security Act passed in late March.

Yet, about 65% of the money has yet to go out to providers, with just $61 billion delivered and attested to by providers by mid-July, a senior HHS official told Healthcare Dive.

Still, with no end in sight for the pandemic, at least on U.S. shores, providers are ramping up lobbying in an effort to secure more funding as case counts soar. AHA is asking for another $100 billion in the next round of congressional relief now under discussion.

Many healthcare providers stopped profitable elective procedures as stay-at-home orders blanketed parts of the country to contain the spread of the disease. This also allowed providers to conserve much needed resources such as personal protective equipment that proved hard to procure amid the crisis.

But revenue quickly plummeted as providers delayed care in preparing for a surge of COVID-19 patients.

“The funding hospitals and health systems have received to date, while helpful, is just a small fraction of what we estimate they will lose this year,” Lisa Kidder Hrobsky, group vice president of federal relations for AHA, told Healthcare Dive in a statement.

Where did the money go?

So far, HHS has outlined a spending plan for $125 billion of the $175 billion in provider relief funds.

The program has been met with an array of criticism, including whether the distribution of funds went to those most in need and whether the fine print has deterred providers from taking a piece of the massive financial package.

https://www.datawrapper.de/_/7PvZ4/

In response to those critiques, HHS has sent out additional federal funding in more targeted waves since April.

The first tranche of money — $30 billion in April — was designed to get out the door quickly, as providers were struggling. From there, HHS has attempted to pinpoint the money to certain providers and geographic areas to appease the needs of various providers.

To even out distribution, HHS began sending targeted funding, such as to hospitals overrun with COVID-19 patients, mainly in New York and other hard hit areas. The agency also funneled money to rural providers and skilled-nursing facilities, among others.

After HHS was met with the argument that wealthier hospitals, or those that had larger shares of privately-insured patients, received more funding, it allocated money for those taking care of the neediest.

At the same time, as the agency doles out the rest of the $175 billion, it has promised to reimburse providers for uninsured COVID-19 patients. That has raised questions about whether HHS will have enough for uninsured care and additional tranches.  

However, a senior HHS official said it has only paid out $340 million to providers for uninsured COVID-19 patients, less than what they had expected. So low, that HHS has been trying to encourage providers to apply for such funding.

Timeline of HHS funding

  • AprilHHS​ released $30 billion from the first tranche of money based on a provider’s 2018 Medicare fee-for-service revenue. By the end of April, an additional $20 billion from general distribution was released, for a total of $50 billion.
  • MayMore than $26 billion was sent to rural, skilled-nursing facilities and those hit hard by the virus.
  • JuneHHS released an additional $25 billion earmarked for safety-net providers and those that cater to large populations of Medicaid patients.
  • JulyHHS​ said it would release another $4 billion for safety-net providers and certain specialty rural providers missed in earlier rounds, along with another $10 billion for those in hot spots.

Fears eased over fine print

Some providers declined or returned funding they had received, worried about the fine print or the terms and conditions, like how to appropriately spend the money.

However, HHS has relaxed some of those conditions, easing the fears of some.

For a lot of providers, it was a sigh of relief, causing many to say, “‘Great, we can feel comfortable participating in this program’,” Tim Fry, an attorney with McGuireWoods, told Healthcare Dive.

In particular, HHS recently said that if at the end of this pandemic, providers didn’t use all of the funding for lost revenue or healthcare related expenses, there will be a process to return the money. Initially, providers expressed concern that it was an all-or-nothing program.

Plus, HHS provided clarity on how the money can be used, stipulating that the funds go to healthcare-related expenses or lost revenue attributable to the coronavirus. HHS has provided more guidance and examples of appropriate uses, a relief to many, Fry said.

Earlier, health systems were overwhelmed by the administrative burden and fearful over how to appropriately spend the money without running afoul of new rules.

“We are not infinitely flexible around those requirements, but when we hear from providers of issues that they’re having — and we think we can be reasonably [accommodating], we try to be,” a senior HHS official said.

 

 

 

 

6 months in: What will the new normal look like for hospitals?

https://www.healthcaredive.com/news/6-months-in-new-normal-hospitals-covid/581524/

Experts say a sustained state of emergency is likely until there is a cure or vaccine for COVID-19.

The first U.S. hospital to knowingly treat a COVID-19 patient was Providence Regional Medical Center in Everett, Washington, on Jan. 20. Since then, every aspect of healthcare has been upended, and it’s becoming increasingly clear all parts of society will have to adapt to a new baseline for the foreseeable future.

For hospitals and doctors’ offices, that means building on a major shift to telemedicine, new workflows to allow for more infection control and revamping the supply chain for pharmaceuticals, personal protective equipment and other supplies. That’s on top of ongoing challenges of burned out workers and staff shortages further exacerbated by the pandemic.

Looking out even further, the industry will have to figure out how to treat potential chronic conditions in COVID-19 survivors and, until an effective vaccine is developed, how to manage new outbreaks of the disease.

Experts say U.S. hospitals are generally in a much better position for dealing with COVID-19 now than they were in March, and providers are learning more every week about the best treatments and care practices.

June survey of healthcare executives conducted by consultancy firm Advis found that 65% of respondents said the industry is prepared for a fall or winter surge, about the inverse of what an earlier survey with that question showed.

“We’ve evolved. We’re in a much better state now than we were in the beginning of the pandemic,” Michael Calderwood, associate chief quality officer at Dartmouth-Hitchcock Medical Center, told Healthcare Dive. “There’s been a lot of learning.”

But the number of positively identified cases has now topped 4 million, and little political will exists to reinstitute widespread shutdowns even in areas where surges have filled ICUs to capacity. No treatment or vaccine for the disease exists or appears imminent. Testing and contract tracing efforts are too few and remain scattered and uncoordinated.

Whether there is a clear nationwide second wave or smaller surges in various parts of the country at different times, hospitals will need to remain in an effective state of emergency that requires constant vigilance until there is a cure or vaccine.

“Until we’re armed with that, we’re always going to have to be working like this. I don’t see any other way,” Diane Alonso, director of Intermountain Healthcare’s abdominal transplant program, told Healthcare Dive.

The fall will bring additional challenges. Flu season usually begins to ramp up in October, and if the strains in wide circulation this year are severe, that will further stress the health system. While some schools have announced they will be virtual-only for the rest of 2020, others are committed to in-person classes. That could mean increased community spread, especially in college towns. Colder weather that forces people indoors — where the novel coronavirus is far more likely to spread — will also be a complicating factor.

So far, hospitals have been reluctant to once again halt elective procedures, though some have had to, arguing that the care is still necessary and can be done safely when the proper protections are in place. But that doesn’t mean volume will rebound to pre-pandemic levels.

“While we think demand will come back, we’ve seen some flattening on demand in certain aspects that may be the new indicator of the new norm in terms of how people seek care,” Dion Sheidy, a partner and healthcare advisory leader at advisory firm KPMG, told Healthcare Dive.

Accelerating trends to provide care outside hospitals

When the number of COVID-19 cases first surged in the U.S. and stay-at-home orders were implemented nationwide, telehealth became a necessary way for urgent care to continue.

Virtual visits skyrocketed in March and April as CMS and private payers relaxed regulations and expanded coverage. Some of that will be rolled back, but much may persist as patients and providers grow more used to using telehealth and platforms become smoother.

Virtual care can’t replace in-person care, of course, and some patients and doctors will prefer face-to-face visits. The middle- to long-term result is likely to be that telehealth thrives for some specialties like psychiatry, but drops substantially from the highest levels during shutdowns throughout the country.

Other care settings outside of the hospital may see upticks as well, including at-home and retail-based primary and urgent care.

Renee Dua, the CMO of home healthcare and telemedicine startup Heal, said the company has seen virtual visits increase eight fold since the pandemic began in the U.S. and a 33% increase in home visits as people seek to continue care while reducing their risk of exposure to the coronavirus.

“The idea that you do not use an office building to get care — that’s why we started Heal — we bet on the fact that the best doctors come to you,” Dua told Healthcare Dive.

And care does need to continue, particularly vital services like vaccinations and pediatric checkups.

“You cannot ignore preventive screenings and primary care because you can get sick with cancer or with infectious diseases that are treatable and preventable,” Dua said.

Movements toward non-traditional settings existed before anyone had heard of COVID-19, but the realities of the pandemic have shifted resources and spurred investment that will have lasting effects, Ross Nelson, healthcare strategy leader at KPMG, told Healthcare Dive.

“What we’re going to see is there going to be an acceleration of the underlying trends toward home and away from the hospital,” he said.

Some of this was already underway. Multiple large health systems have established programs to provide hospital-level care at home and major employers have inked contracts to have primary care delivered to employees at on-site clinics.

PPE, staff shortages lingering

A key problem for hospitals in the first COVID-19 hotspots, such as Washington state and New York City, was a lack of necessary personal protective equipment, including N95 masks, gowns, face shields and gloves.

Also running low were supplies like ventilators and some drugs necessary for putting people on those machines.

While advances have certainly been made, the country did not have enough time to build up those supply stores before new surges in the South and West. The result has been renewed worries that not enough PPE is available to keep healthcare workers safe.

Chaun Powell, group vice president of strategic supplier engagement at group purchasing organization Premier, said “conservation practices continue to be the key to this” as COVID-19 surges roll through the country. The longer those dire situations continue, the more stress is put on the supply chain before it has a chance to recover.

Premier’s most recent hospital survey found that more than half of respondents said N95s were heavily backordered. Almost half reported the same for isolation gowns and shoe covers.

Calderwood said there has been improvement, however. “We have a much longer days-on-hand PPE supply at this point and the other thing is, we’ve begun to manufacture some of our own PPE,” he said. “That’s something a number of hospitals have done in working with local companies.”

But the ability to manufacture new PPE in the U.S. also depends on the availability of raw materials, which are limited. That means significant advancements in domestic production are likely several months away, Powell said.

Health systems have stepped up the ability to coordinate and attempt to get equipment where it’s needed most, especially for big-ticket items like ventilators. Providers are more hesitant, however, to let go of PPE without the virus being better contained.

The backstop supposed to help hospitals during a crisis is the national stockpile, which the federal government is attempting to resupply. It doesn’t appear to be enough, though, at least not yet, Calderwood said.

“One thing that concerns me is we did have a national stockpile of PPE, and I get the sense that we’ve kind of burned through that supply,” he said. “And now we’re relying on private industry to meet the need.”

Another problem hospitals face as the pandemic drags on is maintaining adequate staffing levels. Doctors, nurses and other front-line employees are in incredibly stressful work environments. The great potential for burnout will exacerbate existing shortages, just as medical schools are still trying to figure out how to continue with training and education.

“Those areas are concerning to our hospitals because our hospitals depend on a whole myriad of medical staff,” Advis CEO Lyndean Brick said. “Whether it’s physicians, nurses, technicians, housekeepers — that whole staff complement is what’s at the core of healthcare. You can have all the technology in the world but if you don’t have somebody to run it that whole system falls apart.”

On top of that is the increase in labor strife as working conditions have deteriorated in some cases. Nurses have reported fearing for their safety among PPE shortages and alleged lapses in protocol. Brick said she expects strike threats and other actions to continue.

Changing workflows

When COVID-19 cases started ramping up for the first time in the U.S., hospitals throughout the country, acting on CMS advice, shut down elective procedures to prepare their facilities for a potential influx of critical patients with the disease. In some areas, hospitals did have to activate surge plans at that time. Others have done so more recently as the result of increases in the South and West.

But few have resorted to once again halting electives. Brick told Healthcare Dive she doesn’t expect that to change, mostly because hospitals have by and large figured out how to properly continue that care.

She trusts any that can’t do so safely, won’t try.

For the majority of our providers, except in the occasional state where they’re having a real problem right now, I think that we’re going to see elective surgeries still continue,” Brick said. “Because most of our hospitals have capacity right now. They’re able to do this successfully and securely, and it’s really detrimental to patients to not get the care that they need.”

Hospitals rely on elective procedures to drive their revenue, an added motivation to find ways to keep them running even when COVID-19 is detected at greater levels in the community.

Intermountain, based in Salt Lake City, recently performed its 100th organ transplant of the year, ahead of last year’s pace despite the disruption of the COVID-19 crisis.

Alonso, the program director for abdominal transplants, said that while transplants are considered essential services, staff did pause some procedures when electives were halted and have re-evaluated workflow to be as safe as possible to patients, who are at higher risk after surgery because they are immunocompromised.

The hospital developed a triage system to help evaluate what services are necessary based on what level of COVID-19 spread is present in the community and how many beds and staffers are available to treat them.

The system’s main hospital has certain floors and employees designated for COVID-19 treatment. Staff have been reallocated for certain needs like testing and there are plans available if doctors and surgeons need to be deployed to the ICU.

As many outpatient visits as possible are being changed to virtual, but in the building, patients are screened for symptoms and required to wear masks and follow distancing protocols.

At the transplant center, doctors were at one point divided into teams in case someone got sick and coworkers had to self-isolate.

“We went through a dry run where, at the beginning, we shut down incredibly hard to see how we could do it operationally,” Alonso said. Intermountain hasn’t had to do that again, but is ready if such measures become necessary, she said.

Brick and others said that despite the genuinely frightening circumstance brought by the pandemic, hospitals’ responses have been admirable and providers have been quick to adapt. Slow or nonexistent leadership at the federal level, especially in sourcing and obtaining PPE, has been the bigger roadblock.

“Across the board, the whole healthcare industry has responded beautifully to this,” Brick said. “Where our country has fallen down is we don’t have a master plan to deal with this. Our federal leadership is reactionary, and we are not coordinating a master plan to deal with this in the long term. That’s where my concerns are at. My concerns are not at our local hospitals. They have their acts together.”

 

 

 

 

Canceled elective procedures putting pressure on nation’s hospitals

https://www.healthcarefinancenews.com/news/canceled-elective-procedures-putting-pressure-nations-hospitals

U.S. Hospitals Brace for 'Tremendous Strain' from New Virus - JEMS

Even upticks in COVID-19 patients haven’t made up for the revenue losses, since reimbursement for those services is comparatively slim.

Elective procedures are in a strange place at the moment. When the COVID-19 pandemic started to ramp up in the U.S., many of the nation’s hospitals decided to temporarily cancel elective surgeries and procedures, instead dedicating the majority of their resources to treating coronavirus patients. Some hospitals have resumed these surgeries; others resumed them and re-cancelled them; and still others are wondering when they can resume them at all.

In a recent HIMSS20 digital presentation, Reenita Das, a senior vice president and partner at Frost and Sullivan, said that during the pandemic, plastic surgery activity declined by 100%, ENT surgeries declined by 79%, cardiovascular surgeries declined by 53% and neurosurgery surgeries declined by 57%.

It’s hard to overstate the financial impact this is likely to have on hospitals’ bottom lines. Just this week, American Hospital Association President and CEO Rick Pollack, pulling from Kaufman Hall data, said the cancellation of elective surgeries is among the factors contributing to a likely industry-wide loss of $120 billion from July to December alone. When including data from earlier in the pandemic, the losses are expected to be in the vicinity of $323 billion, and half of the nation’s hospitals are expected to be in the red by the end of the year.

Doug Wolfe, cofounder and managing partner of Miami-based law firm Wolfe Pincavage, said this has amounted to a “double-whammy” for hospitals, because on top of elective procedures being cancelled, the money healthcare facilities received from the federal Coronavirus Aid, Relief, and Economic Security Act was an advance on future Medicare payments – which is coming due. While hospitals perform fewer procedures, they will now have to start paying that money back.

All hospitals are hurting, but some are in a more precarious position than others.

“Some hospital systems have had more cash on hand and more liquidity to withstand some of the financial pressure some systems are facing,” said Wolfe. “Traditionally, the smaller hospital systems in the healthcare climate we face today have faced a lot more financial pressure. They’re not able to control costs the same way as a big system. The smaller hospitals and systems were hurting to begin with.”

LOWER REVENUE, HIGHER COSTS

Some hospitals, especially ones in hot spots, are seeing a surge in COVID-19 patients. While this has kept frontline healthcare workers scrambling to care for scores of sick Americans, COVID-19 treatments are not reimbursed at the same level as surgeries. Hospital capacity is being stretched with less lucrative services.

“Some hospitals may be filling up right now, but they’re filling up with lower-reimbursing volume,” said Wolfe. “Inpatient stuff is lower reimbursement. It’s really the perfect storm for hospitals.”

John Haupert, CEO of Grady Health in Atlanta, Georgia, said this week that COVID-19 has had about a $115 million negative impact on Grady’s bottom line. Some $70 million of that is related to the reduction in the number of elective surgeries performed, as well as dips in emergency department and ambulatory visits. 

During one week in March, Grady saw a 50% reduction in surgeries and a 38% reduction in ER visits. The system is almost back to even in terms of elective and essential surgeries, but due to a COVID-19 surge currently taking place in Georgia, it has had to suspend those services once again. ER visits have only come back about halfway from that initial 38% dip, and the system is currently operating at 105% occupancy.

“Part of what we’re seeing there is reluctance from patients to come to hospitals or seek services,” said Haupert. “Many have significantly exacerbated chronic disease conditions.”

Patient hesitation has been an ongoing problem, as has the associated cost of treating coronavirus patients, said Wolfe.

“When they were ramping up to resume the elective stuff, there was a problem getting patients comfortable,” he said. “And the other thing was that the cost of treating patients in this environment has gone up. They’ve put up plexiglass everywhere, they have more wiping-down procedures, and all of these things add cost and time. They need to add more time between procedures so they can clean everything … so they’re able to do less, and it costs more to do less. Even when elective procedures do resume, it’s not going back to the way it was.”

Most hospitals have adjusted their costs to mitigate some of the financial hit. Even some larger systems, such as 92-hospital nonprofit Trinity Health in Michigan, have taken to measures such as laying off and furloughing workers and scaling back working hours for some of its staff. At the top of the month, Trinity announced another round of layoffs and furloughs – in addition to the 2,500 furloughs it announced in April – citing a projected $2 billion in revenue losses in fiscal year 2021, which began on June 1.

Hospitals are at the mercy of the market at the moment, and Wolfe anticipates there could be an uptick in mergers and consolidation as organizations look to partner with less cash-strapped entities. 

“Whether reorganization will work remains to be seen, but there will definitely be a fallout from this,” he said.