CMS guidelines allow some hospitals to return to relative normal

As some areas throughout the country are seeing a decline in COVID-19 cases, the Centers for Medicare and Medicaid Services Medicaid Services is issuing guidance on providing non-COVID-19 care to patients without symptoms in regions with low and stable incidence of the virus.

The recommendations update earlier guidance provided by CMS on limiting non-essential surgeries and medical procedures. The new CMS guidelines recommend a gradual transition and encourage providers to coordinate with local and state public health officials and to review the availability of personal protective equipment and other supplies, workforce availability, facility readiness, and testing capacity, when making the decision to re-start or increase in-person care.

Healthcare facilities and providers that are in areas still seeing a higher number of COVID-19 cases are encouraged to continue following the recommendations made by CMS last month. These were issued to expand capacity to care for patients with COVID-19, to reduce the risk of transmission and to conserve adequate supplies during the public health emergency.

Providers and patients are still encouraged to continue to use virtual care for services that can be managed via remote appointments.

WHY THIS MATTERS

Healthcare facilities in some areas have been stretched to the limits of capacity and surge areas have been needed to augment care. However, many parts of the country have a low, or relatively low and stable incidence of COVID-19, and it is important to allow flexibility to provide non-COVID-19 healthcare, CMS said.

Hospitals are losing an estimated 50% of their revenue due to the loss of elective surgeries and other procedures during the coronavirus crisis. CEOs have said they are struggling to meet payroll, and some hospitals have furloughed staff and reduced physician salaries to cut expenses.

Hospitals are receiving $30 billion of the $100 billion earmarked to them from the CARES Act funding to pay for personal protection and other expenses related to the pandemic and to cover revenue losses.

THE LARGER TREND

CMS said its recommendations are based on ensuring doctors are making the ultimate decision about patient care.

The new recommendations are specifically targeted to communities that are in Phase 1 of the Trump Administration's guidelines for Opening up America Again, Prior to entering Phase 1, states or regions need to pass criteria regarding symptoms, cases and hospitals.

CMS recommendations are not meant to be implemented by every state, county or city at this time. Governors and local leaders ultimately need to make decisions on whether they are appropriate for their communities.

ON THE RECORD

"By complying with our recommendations to postpone non-essential elective surgeries, our healthcare system has made a tremendous sacrifice. We owe both those on the frontlines and those who postponed procedures for the sake of their colleagues a profound debt of gratitude," said CMS Administrator Seema Verma.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com