The post-pandemic ASC landscape: 10 observations

ASCs are planning to resume elective procedures.

Here are 10 observations on where surgery centers stand today and how the pandemic will affect operations going forward.

1. Surgeons are beginning to put protocol together to start elective, non-urgent surgery again. ASCs will be ready to take those cases before hospitals in most places since many did not treat COVID-19 cases and are more nimble than hospitals to make the necessary changes.

2. Some ASCs plan to test all employees and patients for COVID-19 before surgery. Point of service testing is ideal, but that will make cases less efficient and more expensive. Not all centers plan to do this for all cases if they don't have access to tests.

3. Only patients will be allowed in the centers, not family members, and the number of people in the waiting room will be limited. In some cases, patients will wait in their cars until it's time for them to go to surgery.

4. ASCs will prioritize cases differently; some will take patients with the greatest need / risks first while others plan to begin performing low-acuity cases with regional anesthesia first to limit risk.

5. Early centers are already beginning to take elective cases again, or have plans to in the next week. Others are looking at late May or early June based on when governors lift the ban on elective surgeries; but in almost all cases ASCs are ready to open in short order and will work extended hours and weekends to make up the backlog of cases.

6. For the most part, patients are eager to have surgery and want to move forward with their procedures. Some want to wait to reschedule until June. There is some concern about patients losing their insurance if they were laid off, but so far ASCs haven't seen a mass cancellation for that reason.

7. The pandemic will likely accelerate payer tolerance to cover more in the ASC and approve higher acuity cases including more total joints and spine, etc., in the ASC setting.

8. There will likely be a big opportunity for ASCs to negotiate bundled payments or other risk sharing agreements with payers during this time. Payers will be more likely to negotiate with ASCs on this than in the past.

9. More mergers and acquisitions for ASCs and physician groups is likely.

10. In general, access to protective equipment is not a barrier for ASCs to begin performing cases again.

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