Developing a Proactive Recovery Plan for ASCs

April 17, 2020

Proactive Recovery Planning for ASC Elective Procedures

During this phase of the COVID-19 pandemic, healthcare professionals in ambulatory surgery centers (ASCs) are explaining the value of having a proactive recovery plan for postponed non-essential procedures and screenings. COVID-19 forced many ASCs nationwide to suspend elective procedures such as colonoscopies. Part of this strategy conserves vital resources like personal protective equipment (PPE).

“Medical professionals are the soldiers in this war,” gastroenterologist Dr. Mark Pochapin said in a recent interview with TIME.

The Ambulatory Surgery Center Association (ASCA) revealed new federal rules and temporary waivers for ASCs during the pandemic, such as “Hospitals Without Walls.”

ASC backlogs for critical elective procedures such as colonoscopies in the gastroenterology (GI) space are expanding daily, nationwide. Experts explain there are proactive recovery plans ASCs can create now for when elective procedures can continue.

“Crisis is Opportunity”

Dr. Louis Wilson’s wrote, “Crisis is Opportunity,” in his article “COVID-19 Crisis Action Plan for Gastroenterology Practices: 10 Actions Your Practice Should Be Taking.” Dr. Wilson’s online piece for the American College of Gastroenterology broke down these actions to take, both during and after the COVID-19 pandemic.

Action: Maintain Outpatient Endoscopy Access for Urgent Indications

  • ASCs are in a unique position to provide safe and efficient outpatient services, including necessary or emergency endoscopy procedures.
  • This is not the time to push such procedures to the hospital setting.
  • As the pandemic stretches from weeks to months, the pressure of patients with urgent or urgent-elective will most likely increase.
  • The basic infrastructure of the endoscopy center needs to be protected for future use.
  • There is likely going to be a tremendous increase in demand for routine endoscopy, possibly as soon as June.

Action: Support Your Staff

  • The staff at ASCs and medical offices are critical and must be protected during these difficult times.
  • Protecting staff jobs and wages are a top priority in all practices.
  • The Payroll Protection Program through the Small Business Administration in the CARES Act should be of considerable help.
  • Businesses with fewer than 500 employees who do not reduce payroll by more than 25% are eligible for substantial loan forgiveness.

Dr. Wilson says the physicians at his practice are willing to work for little or no compensation to meet payroll despite substantial revenue reductions.

Post-Pandemic Proactive Recovery Planning:

The Becker’s ASC Review article, “5 Ways ASCs Could Be Affected Long After the Pandemic,” explained the following factors:

1. Utilization

  • CMS’ “hospitals without walls” initiative allows hospitals to provide inpatient care in ASCs and other temporary expansion sites.
  • This could help ASCs demonstrate their quality and gain public trust.
  • The COVID-19 pandemic will make people more infection-conscious, leading them to seek out care in ASCs that offer a lower risk of exposure.*
  • Surgical Management Professionals President and CEO Mike Lipomi says ASCs’ capabilities “are wholly underutilized.”

*According to St. Louis-based Atlas Surgical Group CEO Shakeel Ahmed, MD

2. Finances

  • Elective procedure restrictions in more than 30 states have led to steep declines in patient volumes.
  • This forced surgery centers to forgo an important revenue stream.
  • Some ASCs can seek financial relief from the Small Business Administration.
  • They still may need to develop financial contingency plans and operate on minimum cash flow to stay afloat.
  • Next Services’ Paycheck Protection Program loan calculator is designed to help centers plan accordingly.

3. Patient payments

  • One-fourth of Americans have either lost their job or taken a pay cut.
  • An additional 9 percent expect to find themselves in that same situation, according to a recent CNBC survey of 800 people.
  • That means more than 30 percent of Americans may be at risk of losing coverage under employer insurance plans.
  • Patients may delay elective procedures indefinitely or skip them altogether if forced to pay out of pocket.

4. Staffing

  • Surgery centers are laying off or furloughing employees to offset elective case ban financial loss.
  • Most ASCs in Minnesota cannot guarantee unemployed workers will get their jobs back.
  • Surgery centers will grapple with ensuring they’re sufficiently staffed for a post-pandemic surge.

5. Telemedicine

  • 75% percent of medical practices and clinics surveyed by medical technology company Kareo are either using a telemedicine solution or plan to deploy one soon.
  • The COVID-19 crisis could create long-lasting changes in telemedicine because patients are getting more comfortable with the technology.**
  • Providers could use technology to track postoperative progress.**

**According to orthopedic surgeon Geoff Van Thiel, MD.

When could be the right time to put your proactive recovery plan in action?

An Association of periOperative Registered Nurses (AORN) webinar on April 10th, 2020 discussed the impact COVID-19 is having on a wide swath of the U.S. healthcare system.

  • The online event revealed that among 1,200 AORN members surveyed, their healthcare facility cancelled at least 85% of elective surgeries.
  • The webinar explained a “ramp-up” in elective surgery could start in May to address the backlog.
  • The timeline is fluid due to the challenges and rapid developments surrounding COVID-19.

“There is going to be a huge pent-up demand for elective surgery once we get through this crisis,” RN Judith Pins, the President of AORN subsidiary Pfiedler Enterprises said.

The AORN webinar referenced a list called, How Will We Know When It is Time to Reopen the Nation, from the ‘American Enterprise Institute.’ The factors included:

  • Sustained reduction in cases in the city/state for at least 14 days
  • Hospitals in the state must be able to safely treat all patients requiring hospitalization without restoring crisis standards of care
  • A state needs to be able to at least test everyone who has symptoms
  • A state is able to conduct monitoring of confirmed cases and contacts

For information about an affordable health IT solution for your COVID-19 proactive recovery plan designed to quickly and efficiently chip away at your patient back-log, minimize staff burnout and has virtual implementation capabilities, visit Provation’s portfolio of medical procedure documentation software, including cloud-based Provation® Apex.

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