Vital Signs Fall 2021: Healthcare and Medical Office Report

CUMULATIVE PERCENT CHANGE IN VISITS BY SPECIALTY COMPARED TO BASELINE

Once the HHS order was lifted, procedures slowly returned and, by the end of 2020, had nearly recovered, reaching volumes just 6% below 2019 levels. PERCENT CHANGE IN VISITS FROM PRE-COVID BASELINE

Rheumatology Obstetrics/Gynecology Adult primary care Endocrinology Oncology Urology Behavioral health Surgery Orthopedics Allergy/Immunology Ophthalmology Podiatry Neurology Gastroenterology Cardiology Dermatology Physical medicine & rehab Otolaryngology Pulmonology Pediatrics

-70% -60% -50% -40% -30% -20% -10% 0% 10% 20%

2016-2019 Average 2020

1 5 9 13 17 21 25 29 33 37 41 45 49

Week Number

Source: Ateev Mehrotra et al., The Impact of COVID-19 on Outpatient Visits in 2020: Visits Remained Stable, Despite a Late Surge in Cases (Commonwealth Fund, Feb. 2021). https://doi.org/10.26099/bvhf-e411 Note: Baseline refers to the first week of March 2020. While the effects on overall outpatient visits abated significantly by the end of 2020, the cumulative effect across all specialties was a substantial decline in visits for the year. The effect was highly differentiated across specialties. Pediatric visits showed the greatest decline, while adult primary care showed only modest decline, along with other types of specialties, such as Obstetrics/ Gynecology and Rheumatology where patients may not have been able to defer care for prolonged periods of time. Healthcare spending fell at a 16.2% annual rate or by $97.6 billion in Q1 2020 and then an additional 54.1% or $383 billion in Q2 2020.

-30%-25%-20%-15%-10% -5% 0%

Source: Ateev Mehrotra et al., The Impact of COVID-19 on Outpatient Visits in 2020: Visits Remained Stable, Despite a Late Surge in Cases (Commonwealth Fund, Feb. 2021). https://doi.org/10.26099/bvhf-e411 Note: Data represent the cumulative difference in visits over weeks 10 to 52 compared to the baseline week (March 1–7). As the U.S. economy rebounded from Q3 2020 to Q2 2021, so did spending on healthcare and healthcare employment. By Q2 2021, total consumer spending had fully recovered to pre-pandemic levels, and healthcare was once again a major contributor to the recovery. As COVID-19 restrictions were lifted and patients returned to their healthcare providers, healthcare spending surged 21.5% between Q2 2020 and Q2 2021. Spending on healthcare services, which typically accounts for ~17% of total consumer spending, accounted for ~20% of the increase in U.S. consumer spending over that period. Not surprisingly, outpatient spending recovered more rapidly than spending on hospital and nursing home services.

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