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Ongoing COVID-19 Challenges Stagnate Hospital Visit Recovery

TransUnion Healthcare’s latest analysis reveals differing recovery trends across treatment settings and adults vs. children

Hospital visit volumes for most treatment settings slowed to a standstill during much of the summer as the COVID-19 pandemic continued to weigh on patients. Ongoing analysis from TransUnion Healthcare (NYSE: TRU) found emergency department visits were down 25% through the third week of August compared to pre-COVID-19 volumes.* This is the same level observed eight weeks prior when emergency department visit volumes were also down 25% during the week of June 21-27.

This laggard trend in emergency department visit volumes are partly a result of patients avoiding hospital emergency rooms because of COVID-19 transmission fears,1 as well as an increased use of alternative treatment settings (i.e. telehealth/virtual visits, urgent care, physician’s office, etc.).2

When looking at inpatient and outpatient treatment settings, the updated analysis of 500+ hospitals across the United States observed inpatient volumes remained 8% below pre-COVID-19 volumes during the week of August 16-22, which is the same level recorded in late June. Further, many inpatient admissions from the emergency department were also impacted and remained low in part due to the sustained decline in emergency department visits. In contrast, outpatient visit volumes have essentially returned to normal levels, down only 2% when compared to pre-COVID-19 volumes.

“As we track healthcare utilization, we’re seeing hospital visit recovery for emergency department and inpatient settings stagnating below normal levels which may reflect patients’ continued concerns with the safety of hospital settings due to COVID-19,” said David Wojczynski, President of TransUnion Healthcare. “These latest recovery trends emphasize the uncertainty that’s ahead, and our analysis can help hospital providers best respond to the ongoing operational and financial challenges of the pandemic.”

Healthcare visits by children continue to lag at the greatest rate

TransUnion Healthcare also analyzed the key differences between adult and child visit volumes between March 1-7 and August 16-22, revealing mixed trends across hospital treatment settings in August:

  • Emergency Department: Adult visit volumes continued to trend higher than child visit volumes, though the overall trend has seen minimal improvement in the last two months. Adult volumes were down 16% during the week of August 16, while child visit volumes were down 58%.
  • Inpatient: Child visit volumes have returned nearly back to pre-COVID-19 volumes, down only 2% during the week of August 16. Adult volumes were down 9% for the same time period.
  • Outpatient: Adult volumes for outpatient care were slightly lower than pre-COVID-19 volumes, down 1% – driven in part by significantly higher-than-normal visits from Gen Z patients – whereas child volumes were down 23%.

“In addition to parents’ concerns of COVID-19 transmission, a number of factors may contribute to the sustained, low levels of child visits including limited in-person education and a lack of organized extracurricular activities,” said James Bohnsack, Senior Vice President and Chief Strategy Officer at TransUnion Healthcare. “As a result of the combination of these lower levels of child visit volumes and suspended non-urgent medical procedures, revenues for many children’s hospitals have flattened amidst the pandemic.” 3

In light of these trends in child procedure volumes, children’s hospital organizations continue to struggle financially. Some relief has been provided by the Department of Health & Human Services (HHS) which allocated approximately $13 billion in CARES Act and Paycheck Protection money for pediatric and adult safety net hospitals. And recently, it announced that the Health Resources and Services Administration has distributed over $1.4 billion in Provider Relief Funds to freestanding children’s hospitals across the nation.

Patients with low-acuity diagnoses avoiding the emergency department

When analyzing patient admitting diagnoses within the emergency department setting between March 1-7 and August 16-22, TransUnion Healthcare found that volumes for higher acuity diagnoses continued to experience a faster return vs. low acuity diagnoses, though child visits remain lower than adults.

  • Less-acute diagnoses: Adult visits for less-acute diagnoses such as cough and ear pain were down 74% and 31% respectively, and child volumes were down 89% for cough and 63% for ear pain. Interestingly, child visits for fevers remained well below pre-COVID-19 volumes and have stayed around the same level in the time since COVID-19 was named a pandemic, down 81%.
  • More-acute diagnoses: Adult visits for more-acute diagnoses such as throat/chest pain were down 19% compared to pre-COVID-19 volumes and child visits were down 34% during the week of August 16.

These trends in emergency department admitting diagnoses further underscore the likelihood that patients are seeking treatment in, and are becoming more comfortable with, alternative care settings (i.e. telehealth/virtual visits, urgent care, etc.) which are often more efficient and effective options for non-emergent medical concerns such as cough, ear pain and fevers. This shift is promising for the healthcare industry, particularly when considering the consistent issue of emergency department over-utilization in the United States, as it could lead to reduced healthcare costs overall if it endures beyond COVID-19.

Relief strategies for healthcare providers

“While relief funds such as those allocated by HHS can help to offset some of the financial challenges brought on by COVID-19, the industry as a whole faces a long road to recovery,” said Bohnsack. “At the same time, hospital providers must implement the appropriate engagement and revenue recovery strategies to address these financial difficulties in the short term and to achieve pre-COVID-19 volumes in the long term."

The ongoing uncertainty around recovery and visit volumes underscores how important it is for hospital providers to think about all sources of revenue and consider holistic revenue recovery and patient engagement programs that meet patient payment needs, increase revenue, improve satisfaction and allow providers to be more nimble amidst the pandemic.

For more information on the impact of COVID-19 on the healthcare industry, as well as additional resources from TransUnion Healthcare, visit

*TransUnion Healthcare defines pre-COVID-19 volumes as the average weekly visits measured during the first 8 full weeks of the year, from the weeks of January 5-11 through February 23-29.

1 JAMA Internal Medicine - Learning From the Decrease in US Emergency Department Visits in Response to the Coronavirus Disease 2019 Pandemic

2 AHA Market Scan - The Latest Developments Driving the Transformation of Care (08.11.20)

3 Children’s Hospital Association - Children’s Hospitals’ Statement on Essential COVID-19 Relief (08.20.20)

4 TransUnion: Out-of-Pocket Costs Rising Even as Patients Transition to Lower Cost Settings of Care (06.25.2019)


About TransUnion (NYSE: TRU)

TransUnion is a global information and insights company that makes trust possible in the modern economy. We do this by providing a comprehensive picture of each person so they can be reliably and safely represented in the marketplace. As a result, businesses and consumers can transact with confidence and achieve great things. We call this Information for Good.®

TransUnion Healthcare, a wholly owned subsidiary of TransUnion, makes mutual trust possible between patients, providers, and payers by helping them navigate payment uncertainty. Our Revenue Protection® solutions leverage comprehensive data, accurate insights and industry expertise to engage patients early, ensure earned revenue gets paid and optimize payment strategies. TransUnion Healthcare helps over 1,850 hospitals and 550,000 physicians collectively recover more than $1.2 billion annually in revenue.

A leading presence in more than 30 countries across five continents, TransUnion provides solutions that help create economic opportunity, great experiences and personal empowerment for hundreds of millions of people.