There was an unprecedented level of collaboration and coordination between healthcare providers during the pandemic to care for patients with COVID-19.
Last spring, ASCs across the U.S. temporarily halted operations to devote resources, including personal protective equipment and staffing, to hospital partners. Other ASCs collaborated with hospitals to take on additional patients who needed surgery in a clean and COVID-19-free facility. During the pandemic, CMS granted ASCs the ability to temporarily become certified as hospitals and provide inpatient care as part of the Hospitals Without Walls initiative, which at least 85 centers participated in last year.
The number of ASC procedure claims noted by Definitive Healthcare dropped in March, April and May by millions of claims. When ASCs largely reopened nationwide, claims shot up from 1.3 million in April to 3.8 million in June and July.
Surgeons who hadn't previously considered performing cases in an ASC began transitioning appropriate cases to the outpatient setting, and in some cases ASCs saw an increase in physicians seeking privileges at the centers. In December, there were 3.5 million ASC procedure claims filed.
But did the pandemic change how hospitals relate to independent surgery centers? For two large health systems, it underscored the need for ASCs but didn't change their strategy.
"The pandemic underscored the importance of having an integrated health system positioned to treat patients in the most appropriate setting based on their health status," said Deborah Schiff, executive vice president of strategy and business development, ambulatory services for New Hyde Park, N.Y.-based Northwell Health. "We have found that the pandemic has accelerated consumer acceptance of ambulatory surgical care and believe this will prove to be a lasting change to consumer preference. It did not, however, formally change our ASC strategy or our relationship with local independent centers."
She said Northwell's outpatient surgery strategy focuses on strengthening its ambulatory footprint within the communities it serves. The health system constantly assesses surgical capacity across all settings to align availability with market demand. It also considers patient needs, willingness to travel and overall surgical experience.
"In general, we expect outpatient surgical volume to continue to increase as surgeries historically performed in inpatient hospital settings continue to shift to the ambulatory environment," said Ms. Schiff. "Northwell seeks to add surgical capacity in key strategic areas and markets where we anticipate accelerated growth."
Philadelphia-based Jefferson Health has taken a similar approach to outpatient surgery. The system has a long-standing relationship with Philadelphia-based Rothman Orthopaedics, Philadelphia Hand to Shoulder Center and other partners for specialty services and outpatient surgery. The system also made recent investments in two ASCs: Jefferson Health-Navy Yard in Philadelphia and Cherry Hill (N.J.) ASC.
"Long before the pandemic, Jefferson Health recognized the ever-increasing demand for convenient outpatient care in a variety of specialties," said Stephanie Conners, BSN, RN, COO of Jefferson Health. "And as with our early investment in telehealth, the pandemic crisis has shown us that Jefferson's vision of healthcare at any address — including virtual and at-home care — is where medicine is headed."
The cornerstone of the health system's ambulatory model is the Specialty Care Pavilion, which is in early stages of construction. The facility will support multispecialty care delivery for seamless care.
"Especially in the backdrop of the pandemic, facilities like the Specialty Care Pavilion not only make sense for patients, they also make business sense," said Ms. Conners. "Keeping these services separated from our flagship hospital buildings helps to keep core functions up and running instead of managing the large-scale curtailing of procedures many health systems endured in the early stages of COVID-19."