Wisconsin hospitals made $4 billion last year, 84% more than the previous year, as federal COVID-19 relief funds flowed, the stock market boosted investments and patients returned for care delayed early in the pandemic, according to a new report.

But the state’s large health systems saw operating margin losses of 0.4% during the first half of this year, compared with gains of 4.5% last year, in part because staff burnout is requiring more hiring and inflation is driving up wages and the cost of supplies, the Wisconsin Hospital Association said in the report released Tuesday.

“Thank God for 2021 because 2022 is taking that all back,” said Brian Potter, WHA’s chief operating officer. COVID-19, which also hit hospitals hard financially in 2020, has been “a roller-coaster ride,” he said. “How quickly things can change.”

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