Digital Debut

ASCA Survey Confirms Operational Impacts of Pandemic on ASCs

Surgery centers report lower procedure volume and subsequent effect on facility finances

BY ALEX TAIRA | MARCH 2021

On March 3, ASCA introduced a bimonthly survey series named 60-Second Survey. The first survey asked about operational impacts of the COVID-19 pandemic in 2020 and received 314 responses in 10 days. Responses were recorded from ASCs in 44 different states.

As expected, ASCs reported severe effects of the COVID-19 pandemic on their operations in 2020. Stoppages on elective surgeries in spring 2020, though brief, caused significant declines in procedure volume. Eighty-two percent of respondents reported lower or significantly lower procedure volume in 2020 compared to 2019. This aligns with previous ASCA surveys performed last year and publicly reported numbers such as those from Envision Healthcare, which owns Amsurg, in April 2020 that reported a 70 percent reduction in ambulatory surgery services since the onset of the pandemic. The severe reduction in procedure volume had obvious effects on facility finances, with 70 percent of survey respondents reporting lower or significantly lower revenue in 2020 compared to 2019. This aligns with a previous ASCA survey in which almost 60 percent of facilities reported significantly lower revenue between March 31 and October 31, 2020, compared to the same period in 2019.

State-mandated elective surgery stoppages were not the only reason for reduced procedure volume in 2020. Seventy percent of respondents to the 60-Second Survey reported higher than usual patient cancellations. The uptick in cancellations was due to a myriad of reasons: recent exposure to a COVID-19 positive person, recent travel prior to procedure date and patient discomfort with undergoing medical treatment during the pandemic were all considerations that led to a significant number of patient cancellations in 2020.

Increased cancellations were just one of many difficulties that ASCs faced in 2020. Responses to the 60-Second Survey also showed a majority of facilities experienced difficulty maintaining staffing, navigating changing regulatory requirements and acquiring personal protective equipment (PPE). In a previous survey from ASCA, the vast majority of respondents—87.3 percent—reported “some” to “significant” issues with acquiring PPE, including having to pay more than normal to purchase. Despite these challenges, in past ASCA surveys facilities reported 100 percent compliance with universal masking and 98.1 percent compliance with social distancing and pre-operative patient screenings per recommendations from the Centers for Disease Control and Prevention (CDC).

Throughout 2020, ASCA worked with Congress, the White House and other federal officials to support ASCs and ASC physicians. ASCA advocated strongly for quick resumption of elective surgeries in states where capacity allowed, educating lawmakers and regulators that “elective” does not mean unnecessary and that delays on procedures such as colonoscopies can be detrimental to patients. ASCA also ensured that valuable, pandemic-related financial relief programs such as the Paycheck Protection Program, Provider Relief Fund and Accelerated and Advanced Payment Program funds were made available to ASCs. Via the ASCA COVID-19 Resource Center, members could find up-to-date information on local, state and federal developments that might impact their facility. Members also were able to access a host of new resources such as best practices, FAQs and a new hospital outpatient department (HOPD) Medicare Rate Calculator for those facilities that converted to hospitals via the Hospitals Without Walls program.

ASCA members can access a PowerPoint with a full breakdown of survey responses. Write Alex Taira with any questions or ideas for future 60-Second Survey themes. As the name suggests, each survey will ask fewer than 10 questions on a current topic and take 60 seconds or less to complete. The topic will change survey to survey, but each will be aimed at taking the pulse of the ASC community and helping ASCA better serve its members and the ASC industry at large.