This story was updated Aug. 11, 2017.
The rise of high-deductible health plans is starting to cut into hospital admissions and threaten record hospital margins boosted by the Affordable Care Act.
Patients avoiding elective surgeries and other procedures because of skyrocketing out-of-pocket costs were cited by hospital chains as a primary cause of softening hospital volumes in the second quarter.
Giants HCA, Community Health Systems, Tenet Healthcare and LifePoint Health felt the sting of flat to lower admissions in the second quarter, causing earnings declines. They also all cut earnings guidance for the year.
The few not-for-profit hospital systems that disclosed their results this week fared little better. Fourteen-hospital Indiana University Health posted a 46% drop in operating income in the quarter on a year-over-year admissions decline of 2%.
WellStar Health System of Marietta, Ga., saw flat admissions across its 11 hospitals for its fiscal year ended June 30, though six hospitals acquired a year ago drew down the average, said WellStar Hospital Division Chief Operating Officer Carrie Owen Plietz.
That said, operating margins for the system's hospitals rose a notch to a respectable 4.7% from 4.6% the year earlier on strong cost controls and a higher-acuity case mix.