Safely Reopening and Ramping Up Your Ambulatory Surgery Center After the COVID-19 Recess
Ambulatory surgery centers (ASCs) are included in phase 1 of the federal government's "reopen the economy" plan. This means that many ASCs will be reopening soon or have already opened (depending on state regulations).
Unfortunately, some marginally profitable ambulatory surgery centers may not reopen after this forced COVID-19 recess. For those that do, COVID-19 necessitates important changes in patient care and employee safety. In addition, due to the fear of contracting the COVID-19 virus in a hospital inpatient or outpatient setting, coupled with many hospitals focusing on treating COVID-19 patients and other emergency cases, industry sources predict more patients will choose to undergo their elective surgery in an ASC. Commercial payers are also likely to steer patients in this direction.
Therefore, ambulatory surgery centers will not only encounter their backlogs of postponed and delayed elective surgery when they reopen, but also confront the increase in case volume carrying over from hospitals and possibly those ASCs that do not resume operations. Some centers will need to do so while dealing with insufficient staff. Due to fear of contracting the COVID-19 virus, many health workers are choosing not to return to work, with some expressing a desire to wait until a vaccine is available. Some have found other jobs that can be performed from home, while others are remaining at home and drawing unemployment.
To keep up with increasing surgical demand while maintaining safety precautions and overcoming scheduling and staffing challenges, ambulatory surgery centers will need to be inventive. Some may choose to limit the number of procedures performed to eliminate a high volume of patients being present in the center simultaneously. Others may choose to maintain the same caseload but spread it over increased hours and days of operation. With the expected need for higher caseload capacity, centers will need to decide whether to maintain a caseload they are comfortable with or step up to the increasing demand and take their center to the next level. That means a combination of more providers, more specialties, more support staff and longer hours of operation (including evenings and weekends). All the decisions on what business plan is best for your ASC are profoundly affected by the COVID-19-induced financial strain on your center.
"New Normal" of ASC Revenue Cycle Management
With a sudden increase in ambulatory surgery center case volume comes increased revenue cycle management (RCM) tasks. Closure of ASCs has resulted in a backlog of coding, claims submission, follow up on denials, payment posting and collections efforts — both third party and patient balances. Before your ASC resumes normal operations and the demand for increased caseload begins, this is the time to consider outsourcing.
A good outsourcing partner will immediately focus on addressing your backlog of unpaid claims and successfully restart your cash flow to assist in meeting new, higher-volume expenses (e.g., additional staff, new safety measures). This requires constant communication between your outsourcing partner and your ambulatory surgery center about your plans for moving forward. They will ensure you have the appropriate levels of in-house and support staff to develop and execute the effective business office procedures required to meet the revenue cycle management challenges of an increased case volume. When doing your research into outsourcing partners, check references and enquire if the company offers other included services (no additional fee), such as help with employee selection (e.g., job descriptions, how-to instructions for specific positions) and development of business office policies and procedures, financial policies, compliance plan and fee schedule and managed care oversight.
Whatever path your ambulatory surgery center chooses to follow, safety for your patients, staff and providers must be the priority. With that in mind, develop a "going-forward" business plan based on what is best for your ASC and the community it serves. Outsourcing your revenue cycle management can help strongly position your ASC for short- and long-term success coming out of and well after this health crisis.
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