Some hospitals have reported returning to pre-COVID-19 volumes for certain services, but the pandemic continues to affect outpatient and surgical volumes, largely due to workforce capacity constraints.

1. CONFIDENTIAL AND PROPRIETARY
Any use of this material without specific permission of McKinsey & Company
is strictly prohibited
COVID-19 hospital
insights survey
February 2022
Document intended to provide insight rather than
specific client advice

2. McKinsey & Company 2
Overview of this document
Solving the COVID-19 humanitarian challenge is the top priority. Much remains to be done globally to prepare,
respond, and recover—from protecting at-risk populations to supporting affected patients, families, and communities.
To address this crisis, countries including the United States will need to respond in an evidence-informed manner,
leveraging public health infrastructure and proactive leadership.
This document is meant to help with a specific goal: provide timely insights on hospital systems’ reported
volumes and plans to address potential capacity challenges in response to COVID-19. These insights draw upon
findings from McKinsey’s Hospital Insights Survey from February 14–18, 2022. Results represent leaders’ stated
perspectives and are not meant to indicate or predict actual future volumes.
We have also developed a broader perspective on implications for businesses across sectors, which can be
found here: https://www.mckinsey.com/business-functions/risk/our-insights/covid-19-implications-for-business. This
supplemental material discusses implications of the ongoing coronavirus response for the wider economy, businesses,
and employment. It also explores how organizations can respond to challenges in order to protect their people and
navigate through an uncertain situation.
For all formal guidance, you can find up-to-date information at the COVID-19 website of the Centers for Disease
Control and Prevention (CDC), with a section specific to healthcare professionals:
https://www.cdc.gov/coronavirus/2019-ncov/index.html.
Current as of February 18, 2022

3. McKinsey & Company 3
Survey methodology
Between February 14 and 18, 2022, McKinsey surveyed strategic and operational leaders from 101
large private-sector hospitals in the United States to see how COVID-19 had affected hospital
volumes and to understand expectations and implications for the upcoming year(s). A similar survey
was also conducted in October 2021, with 100 large private-sector hospitals, and in July 2021, May
2021, February 2021, and July 2020, with about 30 large health-system respondents.
All of the respondents to our 2022 survey represent hospitals with more than 200 beds. These 101
hospitals include facilities from all regions of the United States (Midwest, Northeast, South, and West),
and collectively represent about 10 percent of all hospital beds in the country. They also represent
hospitals of different scales, including national and regional systems and independent hospitals.
All survey questions were based on the experiences of an individual facility, rather than the system
overall. Responses were aggregated and weighted equally for analyses.
Current as of February 18, 2022

4. McKinsey & Company 4
Demographics of 101 US hospitals surveyed
Midwest: 25 respondents
South: 33 respondents
West: 16
respondents
Northeast: 27
respondents
37%
31%
500-1,000
200-500
More than 1,000
33%
Number of hospital beds, % of respondents1 Region of hospital, # of respondents2
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022)
Note: Figures may not sum to 100%, because of rounding.
1. Q2: Number of hospital beds across your hospital?
2. Q3: In which state is your hospital located?
3. Q4: What type of health system are you a part of?
Current as of February 18, 2022
Health system type, % of respondents3
National
17%
20%
63%
Regional
Independent

5. McKinsey & Company 5
Operating-room volumes are still more than 5% below 2019
levels; respondents expect return to baseline by Q2 2022
Operating room (OR) procedures for 2021/2022 compared with 2019 baseline,
% of respondents1
Current as of February 18, 2022
Projected OR procedures for 2022+,
% change from 20192
3%
Q2 2022
4%
5%
2%
Q3
2022
Q2
2022
Q4
2022
2023
44 43
32 29
23
17 18 16 20 18 19
29 29 24
29 29
33
32
36
31 29 31
29 33 30
32 33
31
16 19
23
22 28
31 31 28 26 26 29
16 18
22
8 6 8
12 9
14 16 17 17 18 17 16 15 17
6 8 7 9 9 6 6 8 6 7
Jan
Feb Jul
4 5
Jan
4
Mar Apr Aug
5
Sep
May Jun Oct Nov Dec Feb
MTD3
No change
>10% decrease 0-10% decrease >10% increase
0-10% increase
-13% -13% -10% -7% -7% -3% -4% -3% -4% -5% -5% -6% -8% -6%
Average
change
from 2019
baseline
2021 2022
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022); “Survey: US hospital patient volumes move back towards 2019 levels,” McKinsey, November 2021
1. Q13: When comparing 2019 to 2021, what percentage change in operating room surgeries did your hospital have in 2021 compared to the same month in 2019 (eg, 10% decrease in admissions in April 2021 compared to April 2019)?
2. Q14: When comparing 2019 to 2021 and beyond, what percentage change in operating room surgeries do you expect for each time period compared to 2019 (eg, 10% increase in admissions in Sept. 2021 compared to Sept. 2019)?
3. Month to date
The previous survey, in Oct 2021, showed a
faster projected return to 2019 baseline
levels for operating-room procedures

6. McKinsey & Company 6
Reported procedural volumes are below 2019
baseline levels in all regions
Northeast: Operating-room (OR) procedures for 2021+
compared with 2019 baseline, % change from 20191
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022)
Current as of February 18, 2022
–12
–15
–13
–10 –9
–4 –4 –4 –4 –4 –4
–7
–10 –9
–5
–20
5
–15
–10
10
0
Midwest: OR procedures for 2021+ compared with 2019
baseline, % change from 20191
South: OR procedures for 2021+ compared with 2019
baseline, % change from 20191
West: OR procedures for 2021+ compared with 2019
baseline, % change from 20191
Reported actuals
–12 –11
–7
–4 –4
–2 –2
–5
–8
–4 –3
–5
–7
–5
5
0
–20
–15
–10
–5
10
–20
0
–5
–15
–10
10
5
–5
–15
Oct
Jan Feb
–13
Mar
–9
Apr May Jun Jul Aug
–5
Sep Nov Dec Jan Feb
MTD2
–11
–9
–5
–3 –2
–8 –8 –7
–4 –5
10
–20
0
–10
–15
5
Mar
–3
–9
Jan Feb
–1
–15
Apr May Sep
Jul
Jun Aug
–15
Oct Nov Dec Jan Feb
MTD2
–7 –6 –5
–3
1
–6
–4 –4
–6
1. Q13: What percentage change in operating room surgeries did your hospital have in 2021 compared to the same month in 2019 (eg, 10% decrease in admissions in April 2021 compared to April 2019)?
2. Month to date.
2021 2021

7. McKinsey & Company 7
Outpatient visits remain below 2019 baseline levels, but
levels are anticipated to rise above 2019 by Q2 2022
Outpatient visits for 2021/2022 compared with 2019 baseline, % of respondents1
Current as of February 18, 2022
Projected outpatient visits for 2022+,
% change from 20192
4%
7%
6%
7%
Q2 2022
36 36
30 27 23
17 13 15
21 22 18 23 20
14
32 33
32
31
29
28 32 29
24 24 28
27 34
27
11 11
19
17
21
27 24 25 23 19 18
19 15
29
16 15 9
13 17 18 21 21 23 26 27 20 21 22
6 6 11 13 11 11 11 11 10 10 10 12 11 9
Jan
Oct
Jun
Apr
Feb
Jan Jul
Mar May Aug Sep Nov Dec Feb
MTD3
>10% decrease 0-10% decrease No change 0-10% increase >10% increase
-10% -8% -5% +1% -3% -2% -2% -2% -3% -3% -2% -3% -4% -1%
Average
change
from 2019
baseline
2021 2022
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022); “Survey: US hospital patient volumes move back towards 2019 levels,” McKinsey, November 2021
1. Q11: When comparing 2019 to 2021, what percentage change in outpatient visits did your hospital have in 2021 compared to the same month in 2019 (eg, 10% decrease in admissions in April 2021 compared to April 2019)?
2. Q12: When comparing 2019 to 2021 and beyond, what percentage change in outpatient visits do you expect for each time period compared to 2019 (eg, 10% increase in admissions in Sept. 2021 compared to Sept. 2019)?
3. Month to date.
Reported outpatient visit volume trails 2019
baseline, while prior survey estimates
from Oct 2021 expected a faster return to
2019 levels
Q3
2022
Q2
2022
Q4
2022
2023

8. McKinsey & Company 8
Reported outpatient visits remain at or below 2019
baseline levels in all regions
Northeast: Outpatient visits for 2021+ compared with 2019
baseline, % change from 20191
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14–18, 2022)
Current as of February 18, 2022
–5
–15
–10
0
5
10
–1
–4
–10
–11
0
–6
1
–4 –3 –2 –2 –2
1
–4
Midwest: Outpatient visits for 2021+ compared with 2019
baseline, % change from 20191
South: Outpatient visits for 2021+ compared with 2019
baseline, % change from 20191
West: Outpatient visits for 2021+ compared with 2019
baseline, % change from 20191
Reported actuals
–15
–5
–10
0
10
5
–5 –4
–10
–4
–5
1
–3 –2 –2 –3 –4
–2
–4 –5
10
5
–5
–15
–10
0
0
Jan Nov
Feb Mar Apr May Jun Jul
–7
Aug Sep Oct
–2
–2
Dec Jan Feb
MTD2
–2
–7
–3 –3
–1
0
–4 –4 –3 –4
5
–10
–5
10
0
–15
Feb
Jan Sep
Mar Apr May Jun Jul Aug Oct Nov Jan
–1
Feb
MTD2
–12 –12
–9
0
4
–3
–6
–1
–1 –2 –1
0 0
Dec
1. Q11: What percentage change in outpatient visits did your hospital have in 2021 compared to the same month in 2019 (eg, 10% decrease in admissions in April 2021 compared to April 2019)?
2. Month to date.
2021 2021

9. McKinsey & Company 9
In January 2022, providers saw greatest decreases in plastic
surgery and ophthalmology outpatient volume compared to 2019
OB-GYN3
Orthopedic
surgery
Plastic
surgery
Neuro-
surgery
0
Gastro-
enterology
Ophthal-
mology
ENT2 Family
medicine
Derma-
tology
Pediatrics
Urology
–1
Cardio-
vascular
surgery
Neurology
General
internal
medicine
Oncology
General
surgery
Cardiology Psychiatry
–12
–5
–5
–7
–4
–1
–6
–4
–2
–5
0 0
1
0
6
–4
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14–18, 2022)
1. Q15: For January 2022, what was the percentage change in outpatient volume for each of the following specialties compared to 2019 (eg, 10% decrease in orthopedic surgery volume in June 2021 vs June 2019)?
2. Ear, nose, and throat (otolaryngology).
3. Obstetrics and gynecology.
Current as of February 18, 2022
Percentage change in outpatient visits in January 2022 vs 2019, % by specialty1

10. McKinsey & Company 10
Northeast and West reported consistent declines in volume across
most specialties, while all regions saw growth in psychiatry
Ortho-
pedic
surgery
Plastic
surgery
Derma-
tology
Ophthal-
mology
–3%
Oncol-
ogy
Neuro-
surgery
Cardio-
vascular
surgery
ENT2
–4%
Urol-
ogy
Neur-
ology
–6%
GI3
Gen
surgery
OB-GYN4
Gen
int
med
Pedia-
tric
Cardi-
ology
Psych-
iatry
–11%
–6%
–3%
–8%
–1%
–7%
–1%
–6%
0%
–5%
1%
–2%
–1%
2%
3%
Fam
med
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14–18, 2022)
Current as of February 18, 2022
1%
Plastic
surgery
ENT
0%
Urol-
ogy
0%
Ortho-
pedic
surgery
Gen
surgery
Derma-
tology
Peds
–4%
GI
Cardio-
vascular
surgery
Neuro-
surgery
OB-GYN
–6%
Neur-
ology
Ophthal-
mology
Gen
int
med
Onc-
ology
Cardi-
ology
Psych-
iatry
–11%
0%
–6%
–2%
–8%
–6%
0%
–2% –2%
3%
2%
1%
8%
Family
medicine
ENT Oncol-
ogy
Plastic
surgery
–5%
Ophthal-
mology
Ortho-
pedic
surgery
–8%
Gen
surgery
–3%
Cardio-
vascular
surgery
Derma-
tology
Neur-
ology
Neuro-
surgery
Peds GI Fam
med
Gen
int
med
Urol-
ogy
Cardi-
ology
Psych-
iatry
3%
–13%
–5%
–6%
–4%
–9%
–4%
–5%
–1% –1%
0%
–1%
–2%
0%
7%
OBGYN Cardio-
vascular
surgery
–1%
–6%
Ophthal-
mology
–4%
ENT
Plastic
surgery
Peds Ortho-
pedic
surgery
Derma-
tology
Urol-
ogy
Gen
surgery
–5%
–7%
Oncol-
ogy
OBGYN
–2%
Neuro-
surgery
GI Cardi-
ology
–11%
Neur-
ology
Psych-
iatry
Fam
med
Gen
int
med
–1%
–8%
–3%
–7%
–5%
1%
–6%
–1%
4%
–6%
–4%
Northeast: Percentage change in outpatient volume in
January 2022 vs 2019 by specialty1
Midwest: Percentage change in outpatient volume in
January 2022 vs 2019 by specialty1
South: Percentage change in outpatient volume in
January 2022 vs 2019 by specialty1
West: Percentage change in outpatient volume in
January 2022 vs 2019 by specialty1
1. Q15: For January 2022, what was the percentage change in outpatient volume for each of the following specialties compared to 2019 (eg, 10% decrease in orthopedic surgery volume in June 2021 vs June 2019)? | 2. Ear, nose, and
throat (otolaryngology). | 3. Gastrointestinal. | 4. Obstetrics and gynecology.

11. McKinsey & Company 11
More than half of hospitals surveyed report new specialist
appointments take more than 14 days on average to schedule
22-28 days
31
5
Less than 7 days 29-45 days
7-14 days 15-21 days More than 45 days
17
34
9
5
Average number of days for a new patient to schedule a specialist appointment with employed
physicians, % of respondents1
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022); “Survey: US hospital patient volumes move back towards 2019 levels,” McKinsey, November 2021
Note: Figures may not sum to 100%, because of rounding.
1. Q23: For specialty care, how many days on average does it take for a new patient to schedule an appointment with your employed physicians (eg, days from appointment)?
2. Q25: Are your current patient access metrics (eg, days to 3rd available appointment) better or worse than in 2019?
About 60% of
respondents
indicated access to
specialty care is
worse today than in
20192, up about 5
percentage points
from the Oct 2021
survey
Current as of February 18, 2022

12. McKinsey & Company 12
More than one-third of respondents expect demand to exceed
provider capacity in several specialties over next 6 months
Gastroenterology
19
Orthopedic surgery
ENT2
Psychiatry
Urology
General internal medicine
Cardiovascular surgery
25
Cardiology
General surgery
Oncology
Family medicine
OB-GYN3
Neurosurgery
Ophthalmology
Dermatology
18
Neurology
35
Plastic surgery
Pediatrics
55
39
35
39
20
30
16
20
9
27
9
16
19
16
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022)
1. Q17: In which of the following specialties do you anticipate patient demand will exceed provider capacity within your hospital at some point in the next 6 months due to pent-up demand (eg, increasing patient demand leading to longer wait times for care)?
2. Ear, nose, and throat (otolaryngology).
3. Obstetrics and gynecology.
Current as of February 18, 2022
Respondents who anticipate patient demand will exceed provider capacity in next 6 months due to pent-up
demand, % respondents1

13. McKinsey & Company 13
About 60 percent of respondents said they have expanded hours of
outpatient clinic sites to try to increase patient access
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022)
1. Q21: When did you add additional hours?
2. Q22: How have you incentivized physicians to work shifts outside of typical business hours?
Current as of February 18, 2022
After 7 p.m. on weekdays
Sunday mornings
5–7 p.m. on weekdays
Prior to 8 a.m. on weekdays
33%
Saturday mornings
Saturday afternoons
Sunday afternoons
20%
64%
25%
61%
8%
5%
n = 61
Times when respondents expanded hours,
% of respondents1
Other
Additional physicians were
hired for these shifts
21%
Physicians have meaningful
productivity pay and thus
were interested in additional hours
No additional incentives offered 25%
Physicians were paid a fixed
amount for each additional shift
on nights or weekends
54%
33%
3%
n = 61
Physician incentives provided to work shifts outside
typical business hours, % of respondents2

14. McKinsey & Company 14
Support staff availability most frequent barrier to increasing
outpatient volume; providers are hiring more staff and offering
more virtual health in response
81%
Other
COVID-19 protocols
28%
Availability of clinical support staff
Physician capacity
Patient-driven deferred care
Physical space
Cancellations
50%
37%
33%
33%
1%
57%
Revising physician schedule templates
Increasing marketing to patients
72%
Offering more virtual health appointments
Hiring additional APPs
Hiring additional clinical
support staff (eg, techs, nurses)
Proactively calling patients who
have delayed care
Expanding clinic hours
Hiring additional physicians
Increasing physician productivity
expectations to expand capacity
Expanding affiliations with
nonemployed physicians
42%
Other
69%
47%
51%
31%
47%
29%
18%
1%
Barriers to increasing outpatient clinic volume in
upcoming months, % of respondents1
Actions respondents are pursuing to increase outpatient
clinic volume, % of respondents2
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022); “Survey: US hospital patient volumes move back towards 2019 levels,” McKinsey, November 2021
1. Q18: What challenges do you expect your hospital to face in trying to increase outpatient clinic volume in the upcoming months?
2. Q19: What actions are you pursuing to increase outpatient volumes?
Current as of February 18, 2022
Change since
Oct 2021 survey
–1%
+3%
–3%
+8%
0%
+1%
–3%
Change since
Oct 2021 survey
–10%
–10%
–5%
+11%
+4%
–9%
+5%
–2%
–1%
+13%
0%

15. McKinsey & Company 15
Respondents use virtual care for about 15% of
outpatient visits, with about a fifth of psychiatry and
family medicine expected to remain virtual
Percent of outpatient (OP) visits occurring via virtual
care, % of total OP visits1
17 16 15 14 13 14 14 15
97
83 85 85 87 87 87 87 85
3
Q4 2021
Q3 2021
2019 2020 Q2 2021
Q1 2021 Jan
2022
2022
(remainder)
2023
100%
In-person care
Virtual care
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022)
Note: Figures may not sum to 100%, because of rounding.
1. Q29: What percent of outpatient visits occurred, or are expected to occur, via virtual care in each time period (eg, 10% of all outpatient
visits were conducted via virtual care in Q1 2020)?
2. Q30: For each of the following specialties, what percent of care do you expect to be delivered virtually in Q1 2022?
3. Obstetrics and gynecology. 4. Ear, nose, and throat (otolaryngology).
Current as of February 18, 2022
23
20
18
14
13
11
10
10
10
9
9
8
8
8
7
7
7
6
Neurology
Psychiatry
Neurosurgery
Plastic surgery
Family medicine
Gastroenterology
Pediatrics
Dermatology
General internal medicine
Cardiovascular surgery
Cardiology
OB-GYN3
Oncology
Orthopedic surgery
Urology
ENT4
General surgery
Ophthalmology
Percent of care expected to be delivered virtually in Q1 2022,
% of total OP visits2

16. McKinsey & Company 16
Scheduling elective procedures in dermatology, plastic surgery, and
orthopedic surgery is taking longest among all specialties
9
21
11 8 7 5 7 4
12 9 10 7 7
11 10
25
24
11 18 19
15
15
17
26
12
19
15
23 19
11
20
22
37 31 29
32
35
27
23
24
32
25
26
21
30
35
27
30 36
30 35
30
26
26
32
30
33
31
34
30
12
7
12
8
16 14 14
27
14
24
10
21
14 16
20
Urology
OB-GYN3
Ortho-
pedic
surgery
Plastic
surgery
Neuro-
surgery
Cardio-
vascular
surgery
General
surgery
ENT2
Ophthal-
mology
Pediatrics Cardiology
Neurology Oncology Gastro-
enter-
ology
Dermatology
Source: McKinsey survey of 100 large US hospitals (survey conducted Feb 14-18, 2022)
Note: Figures may not sum to 100%, because of rounding.
1. Q44: How soon can patients schedule an elective procedure for each of the following specialties?
2. Ear, nose, and throat (otolaryngology).
3. Obstetrics and gynecology.
Current as of February 18, 2022
Average number of days for a new patient to schedule an elective procedure,
% of respondents1
Within 1 week
More than 4 weeks
3-4 weeks
2-3 weeks
1-2 weeks

17. McKinsey & Company 17
Workforce shortages are greatest challenge to increasing elective-
surgery volume; systems are taking variety of actions, especially
hiring staff
Suboptimal allocation
of OR block time
Last-minute cancellations
of procedures
Workforce shortages
Inpatient bed availability
Operating room (OR) capacity
Limited patient demand
Access for outpatient visits
COVID-19 protocols (eg, testing)
PPE3 shortages
Other
90
56
47
35
25
21
12
11
3
1
Optimize room turnover times
Establish hospital command center
Hire additional staff
Reimagine the continuum of care
Optimize length of stay
Reevaluate OR block allocation
3
Other
Schedule elective procedures on weekends
Extend typical hours of operation each day
6
Increase inpatient bed capacity
5
Increase use of virtual care
Improve analytics capabilities in perioperative services
Build additional operating rooms
Reevaluate productivity of employed physicians
Proactively contact patients a day in advance
Reimagine OR experience
4
Increase affiliations with independent surgeons
64
46
27
27
24
26
23
18
9
7
5
4
4
0
Stock up on PPE3 and testing supplies
Barriers to increasing elective surgery volume in
upcoming months, % of respondents1
Actions respondents are pursuing to increase OR
utilization, % of respondents answering in top 3 actions2
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022); “Survey: US hospital patient volumes move back towards 2019 levels,” McKinsey, November 2021
1. Q27: What are the top three challenges your hospital may face in trying to increase elective surgery volume in the upcoming months?; respondents indicating the issue is 1 of their top 3 challenges.
2. Q28: What actions is your hospital planning to take in the medium term (eg, next 12 months) to increase operating room utilization? Rank all that apply in order of importance.
3. Personal protective equipment.
Current as of February 18, 2022
–2%
Change since
Oct 2021 survey
–1%
–17%
–4%
+11%
+4%
+8%
+6%
–4%
0%
Change since
July 2021 survey
+4%
–1%
–1%
+7%
–4%
+8%
+2%
0%
–2%
+3%
+4%
–3%
0%
–2%
–4%
+2%
–10%
–1%

18. McKinsey & Company 18
Providers report they have reduced elective procedures but can now
increase operating-room throughput by 14%
1. Q6: Due to COVID-19, which of the following actions has your hospital taken with respect to elective care in the past two months?
2. Q16: If patient demand for surgical care were to increase in the coming years, to what extent could you increase OR throughput at your facility compared to a 2019 baseline?
Current as of February 18, 2022
20%
None of the above unless mandated
54%
Pause elective admissions
Reduce the number of outpatient
elective procedures
Stand down all outpatient care
Reduce the number of inpatient
elective procedures
Other
63%
61%
37%
17%
3%
Actions respondents have taken with respect to elective care in the past two
months, % of respondents1
If patient demand for surgical care
were to increase, respondents
report they could increase
operating-room throughput by
14%, relative to 2019 baseline, in
the next 12 months and by 19%
over the next 12-36 months2
Source: McKinsey survey of 101 large US hospitals (survey conducted February 14-18, 2022)
Stand down nonurgent outpatient care