DES MOINES — The Iowa Hospital Association projects a significant financial setback this year for hospitals because of the COVID-19 pandemic.

In a study conducted by CliftonLarsonAllen, updated its May reports by projecting a loss of $433 million in 2020. The report also showed that half of Iowa hospitals were operating at a financial loss at the end of October.

The estimated total cost of COVID-19 to Iowa hospitals had March-December is $1.25 billion, but provider relief funds offset some of the loss, leading to the $433 million loss.

The report also highlighted key hospital trends in the state:

• 11% decline in outpatient visits

• 17% decline in inpatient discharges

• 22% decline in ambulatory surgeries

• 24% decline in inpatient surgeries

• 26% increase in expenses per discharge

• 29% decline in operating margin

• 8.3% increase in the average length of stay for acute care patients

"The report underscores the immense financial strain Iowa hospitals and health systems are facing because of COVID-19," said Iowa Hospital Association President and CEO Kirk Norris. "We also must remember that many Iowa hospitals were experiencing severe financial issues before COVID-19. A new rural emergency hospital model is needed for hospitals to survive beyond the pandemic."

Compounding the dire financial picture is the uncertainty surrounding the amount of provider-relief funds that must be returned.

"As challenging as this year has been, 2021 may prove to be devastating for many Iowa hospitals if a significant amount of relief funding must be repaid," Norris said. "Action by Congress and Iowa's legislature is needed urgently to support the immediate and long-term viability of Iowa's hospitals and health systems."

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