On January 31, the American Hospital Association published the 2020 Hospital Statistics report, which revealed a decrease in the number of outpatient visits delivered by U.S. hospitals in 2018. This decrease is the first decline since 1983, and was largely based on a decrease in the number of emergency outpatient visits. This report does not show a decrease in total outpatient care in all settings (e.g., non-hospital based urgent care clinics); however, the decrease notably occurs during a period in which health systems are both competing for outpatient visits with new provider types and expanding their outpatient offerings beyond the borders of the hospital campus. Net outpatient revenue for hospitals in 2018 rose 4.5% over 2017, greater than the 2.1% increase for net inpatient revenue. The decrease in total outpatient visits may indicate that patients are still turning to hospitals for their more severe and costly health treatments, but are visiting new care centers for less severe issues.