The COVID-19 crisis has been emotionally and financially devastating for America. The pandemic has hit healthcare particularly hard. Healthcare providers stand on the front line of this battle by caring for COVID-19 patients, putting their own health at risk. Hospitals and ASCs have cancelled elective surgeries, reducing hospital revenue and net income up to 60% and forcing staff reductions.
There is help on the way, however. The US Government has responded to the stress this crisis has created by making over $100 billion available to healthcare providers under the Public Health and Social Services Emergency Fund (PHSSEF). PHSSEF was established to cover health providers non-reimbursable expenses and lost revenue as a result of COVID-19. Hospitals, Ambulatory Surgery Centers, and physicians have access to these needed funds. The funds can be used to cover:
- Lost revenue from cancelled elective surgery and diagnostic procedures
- Increased staff training to prepare for the crisis
- Personal protective equipment
- Building and retrofitting ICUs
- Increased medical supplies
The US Department of Health and Human Services is currently developing an application for all health care providers to apply for these funds. Funds will be released as soon as an application has been received and deemed to meet the flexible requirements. Everyone understands the financial stress healthcare is under and wants to get the funds to providers, so they can continue to provide care and remain viable.
The journey back begins now. Funds will be released as applications are submitted and reviewed, so there is a financial advantage to doing some preliminary work before the application process is finalized. This is what your organization should be doing now to prepare to submit an application:
- Establish a PHSSEF Task Force
Establish a task force to track the application process and collect information expected to be required. The task force should include leadership in Finance/Accounting, Information Technology, Operations, Medical Staff, and Nursing. A key role of the task force will be to identify all areas where revenue has been negatively impacted, such as reduced ambulatory testing and cancellation of elective surgical procedures, along with increases in non-reimbursable costs.
- Collect Information
Anticipate the information that the PHSSEF application will likely require and begin collecting information on:
- Lost revenue on cancelled elective surgical procedures
- Reduction in revenue because of restrictions in physician office hours and outpatient departments
- COVID-19 preparedness training of physicians, nurses, and hospital staff
- Increased costs for housecleaning and Central Sterile Supply
- Building /retrofitting ICUs
- Building /retrofitting emergency services
- Purchase of personal protection equipment
- Overtime for physician, nursing, and support staff caring for COVID-19 patients
- Assign a team to write the PHSSEF Application
It is not too early to appoint a team to develop the PHSSEF application. Ideally the team would be led by the Chief Financial Officer. The team should have members who can provide the documentation and an explanation of lost revenue and increased expenses. The membership would vary based on the organization’s size. For a large hospital, include: Chief Operating Officer, Chief Nursing Officer, Chief Medical Officer, Chief Information Officer, Pharmacy Director, Director of Material Management, and Director of Perioperative Services. The actual application would probably be drafted by a financial or business analyst.
- Prepare for the surgical case volume surge
As difficult as it is to imagine, eventually the COVID-19 crisis will resolve and there will be a need to provide care to patients whose testing and surgery has been deferred. Forward thinking organizations are preparing for this surge and focusing on capturing deferred elective surgery procedures. The goal is to build organizational consensus on a process to expand surgical capacity and allocate this capacity to surgeons whose cases have been deferred.
- Govern for success
Collaborative, multi-disciplinary governance is a key to success in this process. The hospital Surgical Services Executive Committee should be utilized to create organizational consensus and empower a small group to operationalize the application and overall post-COVID-19 recovery planning process. The Surgical Services Executive Committee is typically the perioperative services governance body where surgeon, anesthesia, nursing and administrative leadership come to together to set a direction for surgical services. For this effort, the SSEC will need to focus on:
- Identifying opportunities to expand capacity, including extending blocks during the week and adding Saturday blocks
- Communicating with surgeons and their schedulers on the availability of surgical time
- Identifying anesthesia and nursing personnel interested in working additional hours
- Communicating with patients whose cases were deferred
- Re-evaluate financial and scheduling polices
Patients will want their hernias repaired, or knees replaced, but being off work for months so soon after possibly having wages lost or reduced due to COVID-19 restrictions will present challenges in meeting out of pocket and deductible payments. Healthcare providers need to be flexible in asking for upfront payments. Hospital charges are typically higher than in Ambulatory Surgery Centers, so the out of pocket costs for the same procedure are higher in a hospital than an ASC. If possible, expanding hours in ASCs will better meet the needs of patients and their surgeons.
We can help!
Surgical Directions has developed Rapid Response Teams to help hospitals, ASCs, and physician groups apply for funds from the Public Health and Social Services Emergency Fund and develop plans to meet the post COVID-19 surge in surgical volume. We can help your facility with any of the following:
- Applying for PHSSEF Emergency Funds
- Our deep knowledge of surgical costs will help you accurately maximize your share of the emergency fund dollars while completing the application process much more quickly than would otherwise be possible
- Our team has the tools, focus, and expertise to properly structure your information and expedite the entire application process
- Preparing for the post COVID-19 surgical volume surge
- Our predictive analytics can help you quantify the expected increase in surgical volume, giving you insight to aid in scheduling and staffing
- Our proven clinical know-how can help you expand surgical capacity and determine how to equitably allocate that capacity across your surgeons
- Our governance tools can help you put oversight and communication structures in place to keep surgeons and all other clinical staff well-informed while facilitating the necessary operational changes for optimizing your recapture of post-COVID surgical volume
If you have any questions or are interested in assistance, please feel free to contact me at jpeters@surgicaldirections.com.
Concluding Thoughts
The COVID-19 crisis had made the country appreciate the importance of having a well-functioning health care system with the flexibility to handle unexpected emergencies. Hopefully the national discussion will move from how can we reduce funding for hospitals, ASCs, and physicians to the importance of ensuring our healthcare delivery system is financially healthy. In the meantime, healthcare providers can begin working toward their own recovery with some thoughtful planning aimed at optimizing both their participation in PHSSEF funding and reopening their facilities for surgical care.
