Becker's Spine Review

39 OUTPATIENT SURGERY Life after COVID-19 — What the pandemic + an impending recession could mean for ASCs By Angie Stewart T he COVID-19 pandemic has made the world more "infection-conscious," which could accel- erate ASC migration down the line, according to Atlas Surgical Group CEO Shakeel Ahmed, MD. Dr. Ahmed spoke to Becker's ASC Review about how the new coronavirus has affected Atlas Surgical Group — one of the St. Louis metropolitan area's largest private surgical groups — and what it could mean for the future of ASCs. Note: Responses were lightly edited for style and clarity. Question: How has the coronavirus affected day-to-day operations at your surgery cen- ters? Dr. Shakeel Ahmed: Understandably, the ASC industry is affected in the same way that all the other fields of life are. Elective surgeries are down. e sick, of course, continue to have access to our facilities. Q: What do you believe will be the long-term financial impact for the ASC industry? SA: In the long run, there will be an exponential mi- gration of elective surgeries to ASCs, especially in light of current events. People are more infection-conscious, and ASCs are seen as lower-exposure risks for elective cases. In addition, with the impending recession, the cost value that ASCs bring to the healthcare system will come into the forefront. With the massive hit that our economy just took, the statistically proven $40 billion a year saved through ASC migration will be very visible to payers and CMS. is is the moment to realize how valuable our industry can be to the healthcare system. Q: How are your ASCs providing assistance to hospitals strapped for resources? SA: We are at the forefront of this battle, together with all our other colleagues. We are offering free access to overflow patients from the hospitals. We have listed all our facilities as volunteer sites for overflow cases, should the need arise. n Physicians may no longer need a new license to cross state lines By Laura Dyrda P hysicians and other medical professionals will no longer need a new license to care for patients across state lines, according to a statement made by Vice President Mike Pence during a White House press briefing on March 18. The briefing touched on the Trump administration's response to the coronavirus outbreak. The administration took several steps to relax regulations in an effort to streamline access to care as the pandemic spread across the country. For example, the government will no longer enforce penalties for violating certain aspects of HIPAA and HHS has expanded access to telehealth for Medicare beneficiaries. During the March 18 press briefing, Mr. Pence said, "With regard to medical personnel, at the President's direction, HHS is issuing a reg- ulation today that will allow all doctors and medical professionals to practice across state lines to meet the needs of hospitals that may arise in adjoining areas." HHS provided guidance for allowing clinicians to practice across state lines for telehealth visits. President Trump also announced March 13 there would be $42 million in funding to expand resources, including telemedicine. n MedPAC's report to Congress: Number of ASCs up 2.6% in 2018 By Laura Dyrda M edPAC released its 2020 report, including recommendations to maintain beneficiary access to ASC services and requiring ASCs, keeping providers under financial pressure to constrain costs and require centers to submit cost data. 1. e number of ASCs increased by an average annual rate of 1.5 percent from 2013 to 2017 and the number of ASCs increased 2.6 percent in 2018. As a result, the MedPAC analysis found that current ASC supply is adequate to service the volume of care for beneficiaries. 2. Medicare payments to ASCs per fee-for-service beneficiary were up 7.4 percent in 2018 aer raising an average of 4.9 percent per year from 2013 to 2017. 3. MedPAC recommended HHS collect cost data from ASCs "without further delay," as the agency cannot calculate a Medicare margin without that information. It does so for the other provider types. 4. MedPAC also concluded that the payment measures for ASCs are adequate to provide access to services and recommended no updates through 2021. 5. In 2018, 78 ASCs closed or merged. However, there were 224 new ASCs, bringing the total number of ASCs up to 5,717. n

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