The COVID-19 pandemic has created a more than $11 billion problem spanning all 6,146 hospitals in the U.S., but recovery is not lost, as long as facilities begin taking steps today to prepare their surgical services departments for tomorrow.
How hospitals can rebuild these departments in a post-COVID-19 world was the topic of an April 23 webinar, hosted by Becker's Hospital Review and sponsored by Surgical Directions, featuring Surgical Directions' CEO Jeffrey Peters as well as President and COO Leslie Basham.
While the response to COVID-19 has strained intensive care units across the country, the loss of revenue from departments like surgical services could endanger the financial viability of the rest of the hospital. If the average hospital makes between $1.3 million to $1.9 million a month from surgical services, multiplying that out on a nationwide-level creates $7.8 billion to $11.6 billion in lost operating income, according to estimates based on Surgical Directions benchmark data.
And even though elective procedures are resuming in some regions, a portion of surgical revenue will remain lost because not all elective procedures will return to the facility which had to postpone them. Factors like unemployment, decreased rates of insured patients, and even surgeons moving the procedure to other facilities because of urgency will limit revenue once elective surgeries resume.
Yet, hope is not lost and the deficit is not crushing. Health systems can recoup some of the $11.6 billion in lost operating income by taking advantage of available federal resources, and preparing and implementing plans for when surgical procedures can resume.
Capturing federal resources
The federal government established the Public Health and Social Services Emergency Fund which facilities can apply for to make-up revenue lost because of the COVID-19 pandemic. The funding — which is available to hospitals, ASCs, private physicians and group practices — is in incredibly high demand, and may end-up only covering a portion of the $11.6 billion in lost operating income.
For facilities to capture the funding, administration must begin documenting why the funds are justified now. The funds are meant to make up for foregone revenue, like that from decreased surgical procedures, closed clinician offices and personal protective equipment or ICU-related infrastructure upgrades.
"In a healthcare crisis, the government depends on its providers to keep the country healthy and viable," Mr. Peters said. "There is a recognition that there's a huge problem, but just like the small business loans, [the $175 billion the government has earmarked for practices] is nowhere near close enough to keep organizations viable and it can't bridge that financial gap from lost elective procedures."
While all facilities should prepare applications to capture federal funds, the availability of funding is fluctuating and hard to plan for. While the funds are fruitful when captured, the long term solution lies in the return of elective procedures.
The long term solution
Facilities should create COVID-19 recovery councils today to prepare strategy plans to restart elective procedures when appropriate, Mr. Peters said. The council should feature leadership from the financial, operational, medical and administrative departments, and while the post-COVID-19 landscape will be drastically different, steps taken today will help those facilities reclaim lost income.
To recapture surgical volume, facilities must use data and engage with patients and clinicians alike, said Mr. Peters. To do this, Surgical Directions has created a framework, "the six Ps," that should be the basis of any recovery plan, Ms. Basham said. They include:
- Planning: determining what restarting an elective surgical program would look like and collaborating to make that plan a reality;
- Policy: familiarizing administration with changing reimbursement and safety precautions and capturing data to take advantage of government relief packages;
- Procedures: creating and maintaining a database of backlogged procedures, coordinating with patients and clinicians to determine the most urgent cases that should be addressed first;
- Process: updating patient safety protocols and existing surgical protocols to accommodate COVID-19-related precautions;
- Place/PPE: modifying practices to comply by COVID-19-related precautions, adopting new practices designed prevent potential infections
- Patient: communicating with the patient now every change that can affect them
Jumpstarting surgical volume will help solve the $11.6 billion problem, but the key to success now, more so than ever before, is patient communication.
"To recapture surgical volume, we must engage the key stakeholders," Mr. Peters said. "Someone scheduled to have their hip replaced in May may be experiencing a lot of changes in their life. [We must] communicate with patients and talk about when you'll be open and what'll be like. … Ask if they have concerns and address them. Ensure them you're doing everything possible to make it a safe environment for them to get care. … The key to getting things going is patient outreach."
A copy of this webinar is available here.