The grueling presidential campaign disrupted the patterns of patients and physicians, at least for those at Bon Secours Health System.

Bon Secours — a $3 billion not-for-profit Catholic system that operates in six states — told bondholders earlier this week that its operating margin fell by almost half in the first quarter of its fiscal year, from 2.4% to 1.3%, due in part to "the uncertainties of the presidential election" and the mass shift toward more outpatient procedures. The system's quarter ended Nov. 30, three weeks after Trump and Republicans swept the field.

Other big factors: the pending changes to Medicare physician payments through MACRA and higher pharmaceutical costs, especially for oncology drugs.