News: Providers encouraged to cancel elective procedures during COVID-19 pandemic

CMS has released voluntary recommendations for elective surgeries in an effort to encourage providers to cancel non-essential procedures until the COVID-19 pandemic subsides, HealthLeaders Media reported. The administration urged everyone to conserve critical resources such as ventilators and personal protective equipment (PPE) during the pandemic while also limiting the spread of COVID-19

"Decisions remain the responsibility of local healthcare delivery systems, including state and local health officials, and those surgeons who have direct responsibility to their patients," the recommendations say. "However, in analyzing the risk and benefit of any planned procedure, not only must the clinical situation be evaluated, but resource conservation must also be considered."

CMS offers a tiered framework to help health systems consider the best use of resources, HealthLeaders Media says. Among the factors to weigh in considering cancelling all procedures:

• Current and projected COVID-19 cases in the facility and region
• Supply of PPE to the facilities in the system
• Staffing and bed availability, especially intensive care unit beds
• Ventilator availability
• Health and age of the patient, especially given the risks of concurrent COVID-19 infection during recovery
• Urgency of the procedure

CMS says the initiative has the support of the American Medical Association (AMA), according to HealthLeaders Media. The AMA Code of Medical Ethics offers detailed advice to physician regarding how to approach the allocation of limited healthcare resources.

The CMS initiative to cancel non-essential procedures could have a negative effect on hospitals’ bottom line and result in a lower case mix index (CMI) for organizations over the coming months. “When a facility does the same amount of the same procedures on the same type of patient population their surgical CMI will remain the same or become ‘flat’,” wrote Sharme Brodie, RN, CCDS, CDI education specialist for HCPro/ACDIS in a Q&A from June 2019. This means that by eliminating elective surgeries, facilities would generally be treating patients with lower weighted DRGs.

While CDI departments cannot be held responsible for this type of CMI drop, leaders should be aware of how this surgery reduction will affect their CMI metrics they report to organizational leadership.

Editor’s note: This article originally appeared in HealthLeaders Media. The CMS initiative can be found here. The previous Q&A with Sharme Brodie can be found here. To learn more about a CDI program’s effect on CMI, click here.