Life after ramp-up: How COVID-19 will change ASCs forever

In certain states, the COVID-19 pandemic curve is shrinking and calls to restart elective surgery programs are growing louder by the day.

Surgical Directions CEO Jeff Peters and Senior Physician Medical Director Tom Blasco, MD, explained how ASCs can prepare for the ramp-up and explored how the effects of COVID-19 could change the ASC landscape forever.

ASCs should start preparing for the coming influx of patients demanding elective surgeries today. It's essential that ASCs stay in constant contact with surgeons during the shutdown. Administrators should have a sense of what the surgical backlog could be and create an oversight committee to begin developing methods to accommodate that backlog, Mr. Peters said.

Administrators need to look at their existing operating room capacity and blocks and come up with ways to handle the surge. Mr. Peters suggested expanding block times during the week and even adding a "surgre Saturday" to handle the increased demand.

When elective procedures can resume, ASCs should implement increased COVID-19 screening practices to ensure the health and safety of everyone in the center.

While patients may be reluctant to go into hospitals because of COVID-19, Mr. Peters said ASCs will be openly embraced because they've largely been isolated from COVID-19 responses. However, the unemployment situation spurred by COVID-19 may affect finances. He suggests centers work on ways to accommodate patients who may need more financial flexibility in the coming months.

'A radical transformation'
ASCs are in a curious position because CMS greatly expanded the scope of service during the pandemic, and as the ramp-up approaches, their low overhead and high level of patient care quality could see the majority of elective procedures shifted to the ASC space to keep patients out of hospitals.

"[COVID-19] is going to speed the exodus of procedures from the hospital to the ASC," said Mr. Peters. "Eighty percent of all surgeries in this country are performed where the patient does not stay overnight, yet we've not fully utilized ASC capacity [as a nation.]"

The migration is coming. "A large number of cases will continue to leave the hospital and move to the ASC market," said Dr. Blasco. "CMS dramatically expanded the numbers of cases they'd pay for in ASCs [before COVID.] Even the government recognizes that a lot of cases that were performed in hospitals can be done with minimally invasive surgical techniques in ASCs."

When elective procedures resume, COVID-19 is "going to open the floodgates for business," said Mr. Peters. "ASCs are positioned for growth."

Mr. Peters said while the last month has been difficult for all healthcare facilities, Dr. Blasco said the coming months and the migration of care to the outpatient setting is the beginning of a movement that'll change ASCs forever.

"With COVID-19 and recent trends, there's been a radical transformation of who the customer is for these payers," Dr. Blasco added. "It's no longer just the surgeon, it's the patients and the payers, and they're directing their care to the ambulatory environment."

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