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COVID-19 & The Future of Ambulatory Surgery Centers

Insights featured by Beckers from Andrew Lovewell, Administrator of The Surgical Center at COG, a 2021 Newsweek top ASC.

Hospitals and Ambulatory Surgery Centers (ASCs) are searching for strategic solutions, and predictions about what is next for healthcare as reverberations of the COVID-19 pandemic still echo through the hallways and trickle down into patient care and clinical outcomes.

Ambulatory Surgery Centers PodcastAmid the disruption, The Surgical Center at COG emerged as the seventh-best ambulatory surgery center (ASC) in the United States and the best in Missouri on Newsweek's America's Best Ambulatory Surgery Centers 2021 list. Becker's Healthcare turned to Andrew Lovewell, Administrator of the facility, to uncover best practices and insights from Lovewell that could help other ASCs navigate the path forward. Lovewell participated in Becker's ASC Review and their Ambulatory Surgery Centers Podcast.

The focus of those interviews was how Lovewell and his team developed their COVID-19 strategy. COVID-19 protocols were also one of the criteria catapulting The Surgical Center at COG to these top rankings in 2021.

Best practices
The biggest thing that's made us successful is the ability for all of us to cohesively pivot together in a direction that was best for our patients. We have an outstanding group of surgeons and providers that work collaboratively. This has created an environment where we've been able to be nimble and make decisions as needed based on what was happening in our local area.

Regional Insights and National Roadmap
Missouri was behind the national curve as far as exposure and viral spread, so we got a good idea of what other places were doing. We looked at areas that were considered hot spots from the beginning — New York, New Orleans, California — and then saw what was working and what wasn't. We adapted our policies to do something similar but further adapted to minimize COVID-19 spread.

ASC Perspective
Before joining the COG team, I previously worked as an administrator for Southern Illinois University Medicine in Springfield before deciding to move into the ASC industry.
There's this innate ability of ASCs to be out on the forefront and progressive, as opposed to big behemoth groups. With ASCs, it's easier to "shift on a dime" and be more adaptable to the changing industry.

Organizational Takeaways
It takes a village to do all of this. You've got to have a good team in place and work with them. We have a great board president, a great vice-chairman, and great managers and leaders at my facility that have been able to help rationalize decisions with employees.

COVID-19 and The Future of Ambulatory Surgery Centers

Trends and Predictions
Our physicians transitioned a tremendous number of patients into the telehealth world. This is a huge opportunity, and we need to continue to dive deeper into it.

Remote patient monitoring and telehealth will continue to be a trend. Expect more at-home monitoring capabilities, so patients receive the best care possible. More patient-focused platforms will assure when something like this happens again, patient outcomes won't be affected.

Innovation Challenges 
At the Surgical Center at Columbia Orthopaedic Group, we are early adopters of a lot of technology enhancements and cutting-edge implants. However, sometimes being progressive creates challenges with insurance companies not being up to speed with the latest technologies or coding guidelines.

We have a robust and impressive business office that are heavily involved all "behind the scenes" aspects of getting prior authorization for high-cost implants and procedures for patients. This insures patients an exceptionally smooth process.  

We have a unique advantage toother facilities as we are 100% responsible for the patient experience. From the first visit with COG physicians, to planning all aspects of a patient's surgical needs and post-surgery recovery plans, the patient does not have to go anywhere else. Because we have increased communication, we have less case denials post-surgery which is comforting to patients to not having surprises for out-of-pocket costs for their healthcare.

It is integral that all our healthcare teams understand obtaining prior authorization assure every detail or possible detail specified prior to surgery is in place to avoid any postsurgical billing complications. 

Next Steps
Innovation will continue, especially in the outpatient and private world. Many practices will be ramping up services and appropriate migration to outpatient surgery. Here at COG, we've been doing outpatient surgery for years. Now we're going to invest more in it, maximize patient opportunities, and there will be a dramatic push to deliver value to patients in a way we've never seen before.

Andrew Lovewell, MHA, MSHI, LSSGB, is an innovative, results-driven health care leader with extensive experience in operations, finance, and management. Lovewell has been innovating and improving patient opportunities as the administrator of The Surgical Center at Columbia Orthopaedic Group since 2018.