CMS to providers: Delay elective surgeries, non-essential procedures during COVID-19 crisis

In an effort to handle the COVID-19 crisis that's showing signs of straining healthcare resources and supplies, CMS issued a memo to providers instructing them to delay elective surgeries and non-essential medical and dental procedures.
 
Issued March 18, the recommendations from CMS provide a framework that the agency hopes will "aggressively address" the surge in COVID-19 cases, primarily by maintaing much-needed supplies and resources, such as ventilators, hospital beds, and personnel.
 
Within the recommendations, CMS refers to tiered framework that serves as a decision guide for clinicians and hospitals to follow when assessing which surgeries or procedures they should keep on track or delay.
 
CMS urges providers to consider "resource conservation" in addition to clinical severity when deciding to either proceed with or forego elective and non-essential procedures.
 
The framework runs through six distinct tiers in the decision-making roadmap, each with a level of acuity, the likely location, and an advisory regarding whether to postpone or maintain a surgery. For instance, Tier 1A, which involves a low-acuity surgery and a healthy patient, is linked to a "postpone surgery" decision. Tier 3B, on the other hand, involves a high-acuity surgery and an unhealthy patient and advises providers to not postpone the procedure.
 
"Decisions remain the responsibility of local health care delivery systems, including state and local health officials, and those surgeons who have direct responsibility to their patients," the memo states. However, "the supply of personal protective equipment (PPE), hospital and intensive care unit beds, and ventilators should be considered, even in areas that are not currently dealing with COVID-19 infections."