CLEVELAND, Ohio — Hospitals everywhere have been financially hit hard by the COVID-19 pandemic.

“COVID, it clearly has an impact on the revenue side of the equation for all hospitals,” said Thomas Campanella, healthcare executive-in-residence at Baldwin Wallace University.

Campanella said this is largely because of the halt of elective surgeries, which is where most hospitals gain the most profit, among other things.

“It’s a combination of fewer elective surgeries and most hospitals; they gain the most profit off of surgeries and especially elective surgeries, their profit margins greater there. And that's what they actually use to subsidize other parts of the operations where they're losing money. And so from a pure revenue standpoint, revenue is down because of it and it's gradually coming back, but it's still not even close to where it used to be,” said Campanella. “And then on the other end of the equation from a cost side of it, it has been quite challenging because you've either had to hire new people that have particular backgrounds and specialties that allow you to better manage COVID within your organization. In many cases, you're paying premiums or overtime to existing staff. And then there's technology and other areas where you may not have had before, but you really need to have now.”

John Palmer, director of public affairs at the Ohio Hospital Association breaks down the impact.

“Overall, $3.6 billion impact to the hospital industry in the state. And in Cares Act funding, we received about $2.2 billion. So again, there's about roughly about one and a half billion dollars that is still out there that that hospitals are dealing with from a hardship,” said Palmer.

Palmer said out of 240 hospitals in Ohio, 55 are independent. Campanella explained the financial burden is especially challenging for independent hospitals and hospitals in rural areas that were already facing challenges prior to COVID.

“Because they don't have the profit embedded within their organization as maybe some of the other big integrated systems have, they don't have the balance sheet, if you want to say of assets that would allow them to weather a storm like this,” said Campanella.

And other healthcare service providers are also affected. Dentist, Dr. Greg Devor, has an office in the Cleveland suburb of Lakewood. He said at the peak of the shutdown, he furloughed all of his employees, including his wife and daughter, and five months later is still recovering from the loss of revenue.

“To have to lay everybody off and put everybody on unemployment for an open-ended amount of time was very, very tough. I mean, we lost seven weeks, about two months’ worth of production that we'll never get back,” said Dr. DeVor.

“Our average month pre-Corona versus now, and we're only about 5 percent below what we were beforehand, but being shut for two months, cash flow took we went from a hundred miles an hour to zero very, very quickly, and it takes a while for insurances to kick back in, once you start submitting claims again," he added.

When it comes to hospitals, Campanella and Palmer said some of these hospitals could look to merge or collaborate with other hospitals or organizations.

Going forward — as some people may not feel comfortable going into hospitals, let alone being admitted, hospitals have to innovate and find new ways to see patients — which these health experts predict will lead to losses in revenue as hospitals will provide less inpatient care, and more outpatient.

“Last year we did 35, close to 36 million procedures in Ohio, and the bulk of that was outpatient care. And so we're seeing a lot of shifts happening to outpatient settings versus inpatient settings,” said Palmer.

Palmer said OHA will continue to work with policymakers at the federal and state level to get independent hospitals support and urges people to not avoid hospitals if they’re in need of care.

“We're encouraging all Ohioans that not to delay care, that if they haven't talked to their doctor or haven't followed up since the spring to encourage them to do that, because hospitals are taking a lot of precautions to make sure their facilities are clean and safe and following those protocols,” said Palmer.