CMS Issues Recommendations for Returning To Elective Procedures

F.J. Thomas

Washington, DC ( – In response to the COVID-19 crisis, some providers were required to cancel their patient’s elective procedures in an effort to stem the ever-growing tide of infection, and to preserve supplies that were in high demand due to shortages. Earlier this week, the Centers for Medicare and Medicaid Services (CMS) released new guidelines for individuals and businesses in an effort to re-open the country. Phase I of the tiered plan includes resuming elective outpatient surgeries at facilities that follow CMS Guidelines. Phase 2 will progress to include inpatient elective surgeries with the same guideline requirement.

Although utilization of phases will be in coordination with state and local governments and based on the number of positive COVID-19 cases, CMS has issued practical guidelines to be utilized by healthcare workers returning to provide non-essential and elective care. Some of those guidelines include:

  • Providers should prioritize procedures based on level of need and condition.
  • Routine screening of staff should occur with consideration of exposed risk. Any staff member exhibiting symptoms should be tested and quarantined.
  • Patients should be screened for symptoms prior to entering for procedures.
  • Employees and patients should wear masks. Additional consideration should be taken for procedures on the mucous membranes and respiratory tract and include face shields and N95 masks.
  • Efforts should be made to preserve adequate PPE. The CDC has a Burn Rate calculator to assist employers in planning and optimizing their use of PPE.
  • Facilities should have a thorough protocol for cleaning and disinfecting patient areas, and decontaminating equipment such as anesthesia machines.

While some areas may have seen a slight spike in at home injuries, 97 percent of practices have seen a negative impact on their financial bottom line with the cancelling of elective procedures according to statistics from the Medical Group Management Association (MGMA). Overall, providers have seen at least a 55 percent reduction in revenue and a 60 percent decrease in patients. Additionally, due to required furloughs to mitigate costs, the workload is much higher.

In an April 13th report from the Green Center, 20 percent of primary care practices were predicting closure due to financial instability, along with staffing and supply challenges, and logistical hurdles in seeing patients.

PPE was a main concern as 58 percent of practices saying they lacked PPE or were relying on homemade protection. Telehealth capabilities were another barrier in staying afloat as 65 percent of providers reported having patients that did not have technical capabilities for telehealth visits.

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