Becker's ASC Review

47 JOINT VENTURES Envision hires law firm, considers bankruptcy: 4 details By Laura Dyrda E nvision Healthcare, a physician staffing firm, is consider- ing filing for bankruptcy, according to an April 20 Yahoo Finance report. Four things to know: 1. Envision hired investment bank Houlihan Lokey to advise on its $7.5 billion debt restructuring earlier this year, and since then it has also become clear that the company hired law firm Kirkland & Ellis. KKR, the private equity company that owns Envision, is working with Paul Weiss Rifkind Wharton & Garrison lawyers to advise on the restructuring, which could include Chapter 11 bankruptcy. 2. The company made the move to restructure its debt and pos- sibly file for bankruptcy after the COVID-19 pandemic halted elective surgeries. Envision includes AmSurg, a large ASC chain with about168 centers. 3. Envision has $1.23 billion of unsecured bonds due 2026, which traded for 30 cents on the dollar last week, according to the report. It had $650 million in cash at the end of March. 4. Envision's business dropped 65 percent to 75 percent due to the cancellation or postponement of elective surgeries. n How COVID-19 affected procedure volume for 25+ specialties By Eric Oliver T he Accreditation Association for Ambulatory Health Care provided guidance for ASCs choosing to tem- porarily close, contract with a hospital or convert to a hospital during the COVID-19 pandemic. Strata Decision Technology used its National Patient Procedure Volume Tracker to examine how the COVID-19 pandemic affected procedure volume for 28 specialties. Researchers analyzed 2 million patient visits from 228 hospi- tals in 40 states over a two-week period in March and April in both 2019 and 2020. ese 28 specialties suffered procedure losses: Ophthalmology: 81 percent Spine: 76 percent Gynecology: 75 percent Orthopedics: 74 percent ENT: 72 percent Endocrine: 68 percent Dermatology: 67 percent Gastroenterology: 67 percent Rheumatology: 66 percent Neurosciences: 66 percent General medicine: 64 percent Urology: 62 percent Genetics: 60 percent Vascular: 59 percent Hepatology: 58 percent Cardiology: 57 percent Pulmonology: 56 percent Breast health: 55 percent General surgery: 54 percent Nephrology: 52 percent Hematology: 49 percent Allergy: 48 percent Behavioral health: 45 percent Burns and wounds: 44 percent Cancer: 37 percent Obstetrics: 30 percent Infectious disease: 23 percent Neonatology: 20 percent n Patient visits down at least 50% for 2 in 3 physicians, survey shows By Angie Stewart T wo-thirds of surveyed physicians said patient visits are down 50 percent or more because of stay-at-home orders, according to a recent MDLinx survey of 670 physicians. About one-third of respondents were primary care specialists, and the rest represented other specialties such as anesthesiol- ogy, cardiology and surgery. Nearly 60 percent of respondents were in private practice. Seven statistics to know: 1. Stopped seeing patients or closed practice: 14 percent 2. Reported a decline in patient visits of 75 to 100 percent: 30 percent 3. Reported a 50 to 75 percent decrease in patient visits: 23 percent 4. Reported a 25 to 50 percent drop-off in patient visits: 13 per- cent 5. Reported a decline in volumes of less than 25 percent: 9 percent 6. No change in patient office visits: 3 percent 7. Other: 8 percent n

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