How ASCs can thrive in a post-pandemic world: 3 Qs with Cardinal Health's Darren Marani


Even before the COVID-19 pandemic, the rise of consumerism and pressure to lower costs was fueling the shift of care to non-acute care settings. However, the COVID-19 pandemic is expected to accelerate the push, explained Darren Marani, senior vice president of U.S. non-acute and inside sales at Dublin, Ohio-based Cardinal Health.

With the right strategic approach, ASCs may become the go-to sites for elective and semi-elective procedures after the pandemic, according to Mr. Marani. 

"Some [patients] won't feel comfortable entering the four walls of a hospital treating COVID-19 patients, so ASCs could position themselves as a safer, more appealing environment," he said. 

Here, Mr. Marani discusses the changing healthcare landscape amid the pandemic, shares how ASCs can thrive in a post-pandemic world and explains how distributors can help support surgery center growth.

Question: How will the healthcare landscape evolve post-COVID-19?

Darren Marani: The COVID-19 pandemic has shown that the healthcare industry is able to adjust, adapt and act with urgency. These three attributes and additional crisis management planning will help the industry be better prepared for future outbreaks and disruptions. The pandemic also increased the visibility, prominence and acceptance of several transformative trends.

Most notably is the rise of telemedicine. Customers and providers are acclimating well to this new way of conducting clinical-patient visits. Clinicians at physician offices, hospitals and other areas of care now use technology to meet with patients, and it is quickly being accepted as a way to increase the number of patient visits per day with similar effectiveness of in-person visits. The high patient satisfaction rates, convenience and safety that telehealth provides has led to the Federal Communications Commission investing $200 million to improve connectivity between patients and virtual healthcare providers.We've also seen increased reimbursementsduring the pandemic, with 191 physician procedure codes now billable via telehealth. The industry must advocate for the retention of increased telehealth reimbursement rates. Even with a slight decline in current rates, telehealth is here to stay and will become a permanent fixture in healthcare moving forward. Providers must invest in technology to support the surge in patient demand.

In addition, people around the world have learned new ways to connect. Almost everyone has been on a virtual meeting for professional or personal reasons since mid-March. Children and adults are having birthday parties over Zoom, Skype and Microsoft Teams. The acceptance rate has increased dramatically, and this has the potential to change how we interact with providers. Cardinal Health has greatly increased its use of digital technology to provide continued support for healthcare professionals while adhering to strict social distancing protocols. Our medical device and distribution representatives play an important role in informing healthcare professionals on new technologies and services, as well as providing on-site support. Similar to the successful adoption of telehealth, we've seen that we can successfully support our customers with more robust digital and on-demand services. This will likely create opportunities for hybrid-like roles or increased virtual sales calls, which could accelerate the speed to implement and demonstrate products. Additionally, consumers' outlook on sharing and use of personal data might be more tolerated in the future. 

COVID-19 has also heightened the need for substantial and sustainable measures to help limit cross contamination. Infection control practices, training and product selections will be a top concern as providers consider changes to patient waiting and recovery rooms and evaluate how rooms are turned over. This evolving behavior will include more scrutiny of product selections with patient and staff safety reigning as the utmost concern.

Finally, we will continue to see surgical volumes migrate to outpatient settings. Payers will continue to drive more procedures out of the acute setting, and hospitals will increase their affiliations, joint ventures or acquisitions of non-acute care settings. We expect to see an even more blatant and accelerated shift of elective procedures to non-acute settings post-COVID-19, and patient choice will demand this increase. 

Q: How can ASCs position themselves for success in a post-COVID-19 world? 

DM: The shift to outpatient care is apparent. Even before COVID-19, surgeries shifted to the outpatient space and CMS dramatically expanded the number of cases they would reimburse at surgery centers. COVID-19 will accelerate the growth as more cases will be performed outside of hospitals.3

ASCs will play a greater role than ever before in healthcare post-COVID-19. We predict elective procedures will not return to normal rates until 2021; however, if positioned correctly, ASCs could become the leading provider for elective and semi-elective surgeries moving forward. 

Outside of the clinical need and urgency for a procedure, patient choice and hospital constraints will force specific cases to the outpatient setting. We should prepare for the rebound; ASCs are primed for a surge.

The top three drivers of the accelerated growth of ASCs are unemployment, the economy and consumerism. If patients choose to undergo an elective procedure, they will most likely do so with an abundance of newly found caution. Some won't feel comfortable entering the four walls of a hospital treating COVID-19 patients, so ASCs could position themselves as a safer, more appealing environment. With this, ASCs should do the following: 

  • Build a network. This meansnot only building a network with patients, but with other sites of care within their community. The industry has learned that "we're all in this together," and when we work together, we can improve healthcare. Connect with local hospitals, physician offices, reference labs and other ASCs.
  • Develop strong vendor relationships. Strong relationships with vendors will help ASCs plan for future supply disruptions with applicable substitutions and service offerings. 
  • Market appropriately. Consumerism will continue to rise, and ASCs will compete with each other to gain patients' trust and acceptance. Surgeons and ASCs should market themselves to expand their reach and increase awareness and visibility in the markets they serve. 

Q: How will distributors support this accelerated growth?

DM: ASCs will expect distributors to help manage proper inventory levels, find suitable alternatives, support cost-saving initiatives, mitigate risks and establish creative contracting models. 

Distributors should act in conjunction with their ASCs to forecast and help ensure product needs are met with proactive and frequent planning meetings. Distributors also need to communicate with the organization's leaders to share information and present innovative approaches that support the market, including reprocessing and decontamination. Additionally, distributors can help existing surgery centers grow by helping them handle the increase in volume with an experienced team. The right team can help with new initiatives, expansion projects, optimizing existing space, and increasing efficiencies with clinical and representative-led reviews to spotlight and improve inefficiencies. 

To learn more about Cardinal Health and how it can help ASCs accelerate growth, click here. To learn how Cardinal Health is helping surgery centers navigate a new-normal post-COVID-19, click here.


  1. Federal Communications Commission News Release
  2. Provider Impact of COVID-19 Telehealth Policies by Specialty
  3. Becker's ASC Review: "Life after ramp-up: How COVID-19 will change ASCs forever"

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