Applying Lessons from COVID-19 to Cost Centers across the Phases of Surgical Care.

ABSTRACT

The financial impact of the COVID-19 pandemic has been particularly significant in surgical specialties, with an estimated loss of $22 billion due to deferrals and cancelations of procedures. Evidence suggests that alternative payment models may have reduced the financial impact of COVID-19 for some providers; however, representation of plastic surgery in these models has historically been limited. It is critical for plastic surgeons to understand cost drivers throughout the surgical care episode to design strategies to reduce costs in the wake of the COVID-19 pandemic. In this perspective, we use the American College of Surgeons Five Phases of Surgical Care framework to examine inflationary spending pressures at each stage of the surgical continuum of care. We then highlight cost-containment strategies relevant to plastic and reconstructive surgery within these stages, including those developed before the COVID-19 pandemic, such as bundled payment models and utilization of ambulatory surgery centers, and others expanded during the pandemic, including further use of telemedicine for pre and postoperative visits and expansion of enhanced recovery after surgery pathways and home-based rehabilitation for breast reconstruction. Using innovations from the COVID-19 pandemic can help plastic surgeons further innovate to decrease costs and improve outcomes for patients.