The number of elective procedures conducted at local hospitals has bounced back, nearly two months after they were reintroduced.

These routine procedures were postponed nationwide at the start of the coronavirus pandemic, as hospitals worked to squirrel away personal protective equipment, make room for COVID-19 patients and limit the number of people inside the hospital.

Due to the resulting revenue loss, coupled with the costs of additional safety equipment and fewer in-person visits, hospitals across the state and beyond have been financially hemorrhaging. New Hampshire hospitals collectively lost $575 million in revenue between March and July, according to a report in the Concord Monitor.

By early May, the state lifted its restrictions on elective procedures, and Cheshire Medical Center in Keene and Monadnock Community Hospital in Peterborough began to slowly bring back those that were time-sensitive, starting with ones that had been canceled in the months prior.

Then, in July, as the number of active COVID-19 cases in New Hampshire continued to subside, both hospitals began offering all elective procedures again to patients.

At Cheshire Medical, an affiliate of the Dartmouth-Hitchcock Health system, procedures are back to the levels they were before the pandemic hit and have been through July and August, according to spokeswoman Heather Atwell.

Atwell declined to give specific numbers on how many of these procedures the hospital conducts.

“Recovering to these business levels indicates a strong level of patient confidence in our safety measures at Cheshire,” she said in an email.

Monadnock Community Hospital, meanwhile, is reporting 80 percent of its pre-pandemic volume, spokeswoman Laura Gingras said.

At both hospitals, patients who come in for elective procedures are screened at the door for COVID-19 symptoms and are required to don a face mask while inside.

Reintroducing these procedures has been critical in helping shore up the revenue gap that started over the spring.

From March 16 to the end of April, Cheshire Medical was losing $2 million weekly, Atwell said. Prior to the pandemic, the hospital had a $2.6 million, or 1.6 percent, positive year-to-date operating margin.

Though this revenue loss has made an impact, Atwell said being part of a larger hospital system gave Cheshire Medical more financial security than others.

Monadnock Community Hospital lost $1.7 million in March, and projected at the time that it would lose between $3 and $4 million monthly — a total of $24 million by the end of September, according to an April news release.

Gingras said she was unable to provide an updated figure Wednesday.

The Peterborough hospital’s financial losses led to staff cuts. In May, 100 employees were placed on 90-day furloughs, and by the end of July, 21 of those employees’ positions were eliminated. The other furloughed employees returned to the hospital Aug. 10, Gingras said.

Cheshire Medical has received more than $40 million in grants and loans from federal relief programs meant to help sustain the health care system through the COVID-19 pandemic, and Monadnock Community Hospital more than $16.5 million, according to COVID Stimulus Watch, an online tracker run by Good Jobs First, a Washington, D.C.-based nonprofit organization.

Beyond their importance to hospitals’ finances, Atwell said elective procedures — as well as other in-person health needs, like annual physicals — can be imperative for a patient’s health.

Elective procedures are also not always optional; they just can be scheduled in advance and address issues that aren’t life-threatening. Examples of this are cataract surgery, carpal tunnel surgery, joint replacement, a hysterectomy and sinus surgery.

The Keene hospital has also seen a 40 percent decrease in emergency department visits since March because of patients worrying they’ll contract COVID-19, Atwell said, even if they legitimately need to seek care.

“In our messaging we’ve emphasized how critical it is to not postpone care for health needs, or ignore medical symptoms that need medical attention,” she said. “Early detection and treatment means better health outcomes.”

 

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