In Q1 2026, health systems’ volume and revenue numbers declined compared to previous years. There are always some seasonality and volatility to these numbers. Some seasonality and volatility is normal. But given the fragility of health system finances, many Advisory Board members have asked us to look into this decline, we need to figure out what’s going on.

We looked at the first four months of 2026. The number of hospital visits declined in three out of those four months : January (-3%), March (-3%), and April (-7%). February was the outlier with a 2% year-over-year increase. This reduction in visits translated into same-site patient-day declines in all four months: January (-10%), February (-13%), March (-17%) and April (-17%).

We believe there are three main scenarios that could explain what’s happening.

Note: The data used in this analysis was supplied by Strata Decision Technology, LLC. We accessed the data on July 1, 2026. Any analyses, recommendations, or advice based on this data are solely that of the authors and not Strata.