What ASC leaders should know about the pandemic's effect on industry growth, finances and more:
1. Outpatient growth. Since the start of the pandemic, Becker's ASC Review has reported on six ASCs introducing robotics and seven ASCs that have opened. These investments could reflect mounting belief that COVID-19 will significantly accelerate migration to the outpatient setting. According to a McKinsey & Co. report, 40 percent of private practice physicians are more likely to refer patients to non-hospital settings due to the pandemic.
"A possible rationale is that physicians may be wary of the safety of hospital-based care in the return from COVID-19, although the survey did not include questions to that effect," McKinsey & Co. said in its analysis of responses from private-practice physicians six weeks into the pandemic.
2. Staffing. Rising numbers of COVID-19 patients in U.S. hot spots could strain availability of critical care physicians and nurses, giving non-hospital providers "an instrumental role in the pandemic response," according to a Kaiser Family Foundation report.
For ASCs in particular, top personnel challenges at this point in the pandemic include determining when to bring back furloughed staff as COVID-19 case numbers rise; identifying who is likely to return to work; and recruiting top talent to replace any workers who move on to other opportunities, according to experts from Talentcare and Henry Schein Medical.
3. Safety. An outpatient surgery nurse with Quincy, Ill.-based Blessing Hospital went into isolation after testing positive for COVID-19. The nurse, Kathleen Birsic, RN, said it was a "horrifying moment" when she found out she tested positive on July 16. Twenty-four employees at Blessing Hospital have tested positive for COVID-19 since March.
At Gainesville-based University of Florida Health's anesthesia department, 14 junior anesthesiology residents, two senior anesthesiology residents, a fellow and an administrative employee tested positive for COVID-19 in July.
Complicating efforts to minimize COVID-19 transmission among patients, healthcare workers and their communities, the FDA has added 77 hand sanitizers to its recall list due to the presence of methanol.
4. Financial relief. Ninety-seven percent of U.S. medical practices have taken a financial hit from the COVID-19 pandemic, according to a survey by the Medical Group Management Association. Many ASCs and specialty groups have secured funding to offset losses, and Becker's compiled a list of 425 surgery centers that received Paycheck Protection Program loans of more than $150,000.
Despite financial assistance programs, businesses such as San Antonio-based Babcock Surgical Center weren't able to make ends meet. The ASC filed for voluntary Chapter 7 bankruptcy June 11 in the Western District of Texas.
When it comes to collections, several pandemic-related factors could boost patient payment rates. Revenue cycle management services provider Mnet Health reported a 1.6 percent year-over-year increase in patient payments in June, attributing the rise to more contact with patients, patients' interest in protecting their credit scores, the consequences of widespread uncertainty and gratitude toward front-line healthcare workers.
5. Recovery strategies. By late June, volumes were back in full swing — or nearly there — for more than a dozen surgery centers polled by Becker's. The administrators shared helpful strategies for resuming elective surgeries, including electronic communication with patients and rigorous preoperative screening. For Wichita Falls (Texas) Endoscopy Center, reopening hinged on maintaining adequate supply levels, convening regular meetings and keeping a flow of referrals.
Expected surgical backlogs facilitated a "V-shaped" recovery for many ASCs, according to Frank Raneri, senior vice president of Paradigm Specialty Networks. However, renewed restrictions in some areas could affect the rebound trajectory. Facing climbing rates of COVID-19 in late June, Texas quickly reinstated bans on elective procedures in more than 100 of its 254 counties. Mississippi followed suit, while some healthcare operators in Florida and Arizona voluntarily halted elective cases or prepared for surges by barring additions to the surgical schedule. In Iowa, several hospitals reintroduced visitor restrictions to head off COVID-19 surges.