May 14, 2020

ASC Industry Awareness

New Season of Entrepreneurship for ASCs and OBSs

The last few years have been good for growing new ASCs/OBSs. Then came the pandemic and the CMS recommendation to delay elective surgeries on March 18. Now states are deciding their timeframes for reopening various businesses, activities, and elective surgeries. Grappling with how to get patients with critical elective surgery needs back to centers is paramount. Some states have been officially open for surgery for three weeks. Some are still waiting for better data. This has patients, officials, and surgery centers in places like New York and New Jersey pushing to resume surgeries. Reopening is much more challenging than closing and requires ASCs to take an entrepreneurial approach to resuming operations. Even with the pandemic in full stride, eight ASCs opened or announced in April and new ASCs are in planning stages.

ASCs after the Pandemic

Like other entities, ASCs will adapt to changes that the past two months brought. Healthcare is particularly affected by the epidemic and will have to make more adjustments than many industries do. Biomimicry may offer some hints to entrepreneurial approaches that some independent ASCs may take in order to grow into their preferred futures. Many believe that a shift is occurring in the way patients think of hospitals that will elevate the standing of surgery centers in the American healthcare marketplace. The growth of telehealth and greater reliance on remote healthcare technologies should have staying power after the pandemic. Shifts in modes of orthopaedic education are likely to follow suit.


Healthcare Industry Trends

On Bouncing Back

Patient volume took a hit as healthcare set aside work as normal to attend to the needs of the nation. However, one third of independent practices expect volumes to recover this month. That is good news. However, there are three basic requirements for volumes to bounce back and not all of those are in healthcare’s control. Facilities have to adopt new practices, medical professionals have to return to providing care, and patients have to be willing to come back.  Facilities and providers have to take up more work than meets the eye to be ready for that bounce back. Some need financial help to reopen. Certain patient types need to be prioritized. Screening procedures and visitor protocols have to be established. Staffing must be adjusted to match the numbers of patients served and patients’ trust must be rewon.

Healthcare Typically a Jobs Haven in Foul Weather

Healthcare was a bright spot for American labor during the Great Recession (Dec. 2007 – Jun 2009), as it has been throughout previous economic downturns. However, high volume losses for ambulatory and hospital service lines have caused massive health system layoffs, furloughs, and pay cuts. Over 250 hospitals have gone on record for reducing staff in response. In the month of April alone, healthcare lost 1.4 million jobs. There’s hope the losses are temporary, but there’s little doubt that the response to the pandemic has caused a deep financial and staffing burden for many in healthcare.


Healthcare Digital Transformation Watch

Cities Saying “No Thanks” to Contact Tracing Apps

Last month we reported that Apple and Google were hard at work, collaborating on a contact tracing app to put into play by late May to help entities to police individuals encountering others who have tested positive for COVID-19. Apps like these provide daily symptom surveys, privacy-preserving systems, automatic geo-tracing, 2nd and 3rd degree contact tracing, and hazard proximity notices. Officials in cities all over the country are saying, “No Thanks,” to the apps and are going old school analog, hiring people by the thousands. Check out this video if you are curious about how these apps work and why cities are taking a pass.


Out-of-Network Watch

Economist Groups Weigh in on Dangers of Health Care Price Controls

In the last couple of years, states have addressed surprise medical bills with a variety of solutions from direct price controls (as in California) to baseball-style arbitration (as in New York). As pivotal federal lawmakers increasingly appear to be leaning toward the price control model, economists have been warning about the dangers inherent in that approach. These economists, under the banner of the Coalition against Rate Setting, are urging Congress to reject those price controls in coronavirus relief bills. Major concerns of the rate-setting model include the lessened access to medical care, poor physician reimbursement, and the enriching of large health insurers.



CMS and COVID-19

   by Sean Laffey, Contego Legal Analyst, from the office Jon Sistare, JD, Contego Attorney

The Centers for Medicare and Medicaid Services have issued several new policies in order to combat the potential surge of patients due to COVID-19. In March, the agency passed, “CMS Hospitals without Walls,” which permits hospital services outside of hospital walls and grants ambulatory surgery centers greater flexibility to operate during the crisis. It authorizes ASCs to contract with hospitals to provide services from the ASC premises and gives ASC owners the option to lease their facility to a hospital or provide services and bill as a hospital.

In April, CMS ordered blanket waivers of sections 1135 and 1877 of the Social Security Act, effectively allowing ASCs to enroll temporarily as hospitals. The agency’s actions are “part of the ongoing federal response to provide regulatory flexibility to healthcare providers in order to, among other things, increase hospital bed capacity during the public health emergency.” ASC owners must consider whether such transitions are appropriate for their facilities’ operations as well as whether compliance with Medicare’s participation requirements for hospitals is achievable. To explain these waivers in policy, CMS Director, Seema Verma, stated the organization is “making sure there are no regulatory obstacles to increasing the medical workforce to handle the patient surge during the COVID pandemic.”


At a Glance

Some States Reconsider Their CON Laws
What Are the Thirty-Five States That Have CON Laws Thinking Now?

Despite Pandemic, Insurers Are Optimistic about 2020
Deferred Elective Surgeries Create Savings for Carriers

Staten Island Podiatrist and Tavern Owner Wonders…
“When Will I Be Allowed to Open My Office and Bar Full-Time?” 

Rural Hospitals Get Surprise Virus Supplies from an Unusual Source
A Sixteen-Year-Old Cessna Pilot!

Telehealth May Just Have Staying Power
Increased Use + Decreased Cost + Lasting Regulatory Changes

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