Business Advisor: Capitalizing on the Coronavirus

As elective procedures resume during the COVID-19 outbreak, you need to tactfully communicate with anxious patients, help financially strapped individuals afford surgery, manage uncertain caseloads and make sure your facility is on firm financial ground as concerns of a second wave persist. The efforts you make to address these challenges will set your facility up for future success when the surgical landscape eventually returns to normal.

1Improve your revenue cycle
Patients whose procedures were approved by insurers before their surgeries were canceled now might not have enough disposable income to pay out-of-pocket expenses. “It will be a different world, clinically and financially,” says Keith Gruebele, president of BHG Patient Lending.

“Facilities will have to do their part to provide patients with creative ways to get their surgeries done in ways that will fit into their new budgets.”

When creative financing options for patients are found, it’s important to collect every penny of copays and deductibles, because they’re the quickest and likely urgently needed payments your facility will receive. Mr. Gruebele estimates that reimbursements from insurance companies overtaxed from COVID-19 claims will take two to three times longer to arrive than before. The key to remaining fiscally sound in the short-term is to have at least three months, and preferably six, of operating expenses in a rainy-day fund. Mr. Gruebele estimates that most ASCs have less than one month in their reserves. Unless your physician-owners are willing to dip into their own pockets to create the reserve fund, you should be working to secure long-term financing now.

“The truth is that the halt in income has been catastrophic for some centers,” says Mr. Gruebele. “My fear is that facilities will get their Paycheck Protection Program Loan and some advances from the Centers for Medicare & Medicaid Services (CMS) and be on a stimulus high that makes them think they’re in a better financial strait than they really are. That money will be spent very quickly.”

Mr. Gruebele says restart costs could be almost as high as a facility’s startup costs: Devices needs to be recertified; new meds have to replace expired ones; emergency and backup gear must be tested; and additional PPE must be purchased.

“The industry needs to awaken to the reality that the post-COVID-19 world will not be solely felt in the clinical setting,” says Mr. Gruebele.

“It will be felt primarily in the revenue cycle, in your ability to bill and collect from patients, and in how you can manage your claims to insurance companies.”

2Welcome patients
Monticello Community Surgery Center in Charlottesville, Va., could have reopened all four of its ORs on May 4, but opted for two instead. The facility wants time to test the new COVID-19 screening measures, patient registration processes and cleaning protocols. “We’d rather start smaller and build up rather than go full-bore and find out that we have to dial things back,” says CEO Andy Poole.

Mr. Poole says there hasn’t been a huge number of patients putting off getting surgery because of a fear of contracting the coronavirus, but there has been some. Staff at Monticello therefore created a written document for physicians to distribute to patients at their pre-op evaluations.

“It includes a rundown of the additional precautions we’ve taken and a list of new things they can expect, such as having their temperatures taken and having to wear masks and gloves, and informing them that their visitors will have to wait in the car,” says Mr. Poole. “The message is that these things are all being done on their behalf, to keep them safe while they’re here.”

3Market your services
It’s now more important than ever for surgery centers to put on their marketing and promotional hats, says Mr. Gruebele. “ASCs have become accustomed to patients following physicians into their facilities,” he adds. “This is an opportunity to start telling patients about how outpatient surgery produces lower infection and readmission rates.”

Even though elective surgeries have been allowed to resume, it’s important to remember that many patients had been avoiding needed surgeries for financial reasons, even before COVID-19 hit. In a coronavirus world, it will be critical for outpatient surgery centers to tout the many benefits of undergoing surgery in outpatient ORs, according to Mr. Gruebele.

The entire outpatient surgery community can unite behind promoting the standard industry talking points of efficient care, low readmission rates and lower risks of infection. “The is a great opportunity for outpatient facilities to differentiate themselves from inpatient settings not only on the clinical front, but from ease-of-process and convenience perspectives,” says Mr. Gruebele.

The messaging for hospital outpatient departments will be different than for ambulatory surgery centers. HOPDs will have to focus on the additional steps they’ve taken to contain the coronavirus and keep it out of perioperative areas. ASCs can highlight that they’re not treating COVID-19 patients, and specialize in performing the very surgeries their patients need.

“While quality of care, good outcomes and a good patient experiences always come first, the outpatient surgery industry must adopt a consumeristic approach and start to view the people they serve as customers as well as patients,” says Mr. Gruebele. “If you can’t get a patient in the door because you don’t know how to market to their financial pain points right now, you’ve got problems.”

More facilities should consider paid advertising campaigns extolling the benefits of same-day surgery. “If surgery centers don’t start differentiating themselves in their markets and offer specific reasons that show patients how eager they are to do business with them, they might not have a market left to position themselves in,” says Mr. Gruebele.  OSM