The Effect of the COVID-19 Pandemic on the Economics of U.S. Emergency Care

ABSTRACT Objective We describe how the COVID-19 pandemic affected the economics of emergency department (ED) care. Methods We conducted an observational study of 136 EDs January 2019-September 2020, using 2020-to-2019 three-week moving ratios for ED visits, complexity, revenue, and staffing expenses. We tabulated 2020-to-2019 staffing ratios and calculated hour and full-time-equivalent (FTE) changes. Results Following the COVID-19 pandemic’s onset, geriatric (65+), adult (18-64), and pediatric ( Conclusion The COVID-19 pandemic adversely impacted the economics of ED care, with large drops in overall and, in particular, low-acuity ED visits necessitating reductions in clinical hours and ED clinician compensation. Staffing cutbacks could not match reduced revenue at small EDs with minimum emergency physician coverage requirements.