American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Late-breaking news: This morning, the Centers for Medicare & Medicaid Services (CMS) announced that hospitals, physicians, and other health care providers would be receiving $30 billion in grants directly from CMS. The American College of Surgeons (ACS) has been actively advocating for these grants. In short, it appears that each physician who participated in the Medicare program in 2019 will receive approximately 6.1 percent of their 2019 Medicare revenue. These are payments, not loans, to health care providers, and will not need to be repaid. The specific announcement including the formula of how much each individual will receive, how the payments will be made and other details regarding the program can be found here.  

Efforts to provide resources and practical suggestions for surgeons to consider as they strive to combat the financial pressures resulting from the COVID-19 pandemic, the Practice Protection Committee met this week by videoconference and has developed an updated resource document found in this issue. Fellows will find information and links to application information for three federal programs that provide financial resources, a list of questions to consider for discussion with their professional tax advisor, a document to assist surgeons who provide telehealth services, and perhaps most importantly, a section on practical suggestions and options to consider using in these unprecedented times.

In addition, this issue of Bulletin: COVID-19 Updates responds to some of the critical challenges facing members of the ACS. Questions continue regarding clinical and ethical decisions. Among the most wrenching are decisions regarding end-of-life and resuscitation maneuvers such as cardiopulmonary resuscitation (CPR). Throughout this epidemic, patients and their families must trust that CPR will be administered fairly and without restraint to all patients who need it. The Alden March Bioethics Institute of Albany Medical College, NY, has developed a framework to guide CPR decision making, which is highlighted in this issue. We also provide guidance on providing ventilator care to patients with acute respiratory distress syndrome.

We review new therapies for COVID-19 patients in this issue, including the use of convalescent plasma, which has been used successfully in the past to treat patients suffering from Ebola, polio, mumps, and severe acute respiratory syndrome. More specifically, a consortium of more than 50 hospitals and universities has created the National COVID-19 Convalescent Plasma Project to pool efforts to investigate the use and efficacy of convalescent plasma from COVID-19 patients who recovered from the disease.

Telemedicine is increasingly used to protect the health and safety of both health care professionals and their patients, to share knowledge across borders, and to ensure access to care for individuals in rural and other under-resourced areas. The Coronavirus Aid, Relief, and Economic Security (CARES) Act, enacted March 27, appropriated $200 million to the Federal Communications Commission (FCC) for an emergency program to provide funding so health care providers can purchase services and devices necessary to provide telehealth care. Additionally, the FCC separately allocated $100 million to create a Connected Care Pilot Program, which will provide monies to cover 85 percent of the costs of broadband connectivity. These efforts are summarized in this issue of the newsletter.

The ACS is concerned that African Americans are disproportionately affected by COVID-19 and are dying from the virus at higher rates than whites. This issue includes an analysis of the problem.

The public service announcements asking people to stay home to stop the spread of COVID-19 continue. Today, former Los Angeles Chargers placekicker Rolf Benirschke partnered with ACS to ask people to help their communities by practicing social distancing.

It has been said that great challenges bring great opportunities. The COVID-19 pandemic has proven to be perhaps the greatest challenge many ACS members have experienced. This newsletter continues to serve as a valuable resource for members who are on the frontlines and points them toward opportunities to create a better future for their patients. Be sure to stay tuned for the next edition, when we start to ramp up hospital capacity in the coming weeks.