10 issues every healthcare leader should be thinking about

Healthcare organizations demonstrated tremendous vision, innovation and flexibility as they navigated unprecedented challenges brought on by the pandemic. However, the challenges and changes to the healthcare industry will continue long after Covid-19 disappears.

As the toll of the pandemic has continued to be evident, many are contemplating what lasting changes healthcare providers and health systems may face at the end of pandemic. But what should healthcare leaders be thinking about now to prepare their organizations for the post-pandemic environment.

  1. Staffing
  • Review your strategy for recruiting and retaining key clinical staff and critical talent for your organization. Recognize the mental health, stress and work-life balance issues facing clinical staff emerging from the pandemic and develop a workplan that supports staff well-being while ensuring patient coverage. Ensure your organization’s staffing strengths and address staffing weaknesses immediately; be prepared with a contingency plan because staffing shortages and recruiting challenges will continue.
  1. Balancing public health needs with cost-effective care delivery
  • The pandemic revealed the need for a baseline of ICU beds, respirators, PPE and infrastructure essential to public health needs that were lacking at the onset of the pandemic. Federal, State and local governments may require that some of these services remain in place going forward. Review your organization’s plan for managing the cost of these baseline services as government financial support subsides or disappears.

3.  The evolution of care delivery – what changes are here to stay?

  • Recognize telehealth as an ongoing platform but understand the potential challenges for reimbursement, patient interaction and clinical design.
    Identify near- and long-term patient volume trends, post-COVID, addressing the anticipated changes in utilization across your organization.
    Reimbursement changes for remote patient interactions must be integrated and assessed into your care delivery plan as you consider which services your organization should develop, partner with other organizations or outsource.
    Finally, organizations must ensure preparation for patient health information (PHI) and data integrity to continue to be stretched and tested.

4. IT Transformation – leverage technology and assess the following:

  • IT Effectiveness: The increased volume in remote care has shifted skillsets required to maintain and deliver necessary tools with reliability, speed-to-market and security. IT departments must focus on refining their talent pool, revising delivery disciplines to a more agile mindset and stretching their capabilities, to ensure IT effectiveness.
  • IT Performance: By delivering increased and broader technology, rationalizing application portfolios of disparate, legacy technology and converting to cloud-based enterprise solutions with better price points (sharing the scale), your technology can provide more efficient access to critical information.
  • Digital Enablement: Effective IT organizations double-down on patient engagement tools including, virtual visits and custom apps/solutions, that when integrated with core technology, can more efficiently meet patient and provider needs.
  • Analytics, Insights and Interoperability: Collecting robust, trustworthy, clean and secure data from across the technology ecosystem, including the Internet of thing (IoT) devices, is the cornerstone of delivering information that leads to better care and enhanced performance. Consider developing a data governance strategy with enforceable procedures and tools that translate data to information.
  • Automation: Robotic process automation and artificial intelligence in revenue cycle (scheduling, claim edit rules, work queues), disease management (automated diagnosis, error prevention, personalized medicine) and other areas can improve efficiency and reduce risk.
  • Cyber and Information Security: Increasing cyber-attacks, and the significant costs of a breach, require role-based provisioning/access, vulnerability scanning, penetration testing and ongoing training.
  1. Balance sheet structure for the post-COVID world
  • Review and evaluate your pre-COVID capital plan and access to capital to ensure it supports changes to the patient population, new patient access portals, new volume projections and shifting needs of the market.
  • Determine new priorities for investment.
  • Assess your current real estate footprint for space planning and shifts in utilization needs.
  • Determine near- and long-term liquidity needs.
  1. The post-COVID compliance reckoning – thinking through your actions
  • When the government comes to check on allocation of CARES dollars, Paycheck Protection Program (PPP) and other grants/funds, and they will come to check, have you appropriately and accurately submitted information in support of these dollars? Have you tracked spending and documented use appropriately? Determine if any reporting requirements might be missing.
  • Are you capable of an accurate, timely and appropriate response to questions from the Centers for Medicare & Medicaid Services (CMS), the Office of Inspector General (OIG), and other regulatory agencies going forward?
  1. Am I a hunter or am I prey?
  • Consolidation is likely to increase. Have the competitive aspects of your market shifted?
  • Evaluating your organization’s place as a likely consolidator or likely to get consolidated is key. This may influence near-term and longer-term strategic thinking.
  • Determining the Federal and State regulatory and licensure implications that may either promote or restrict consolidation could factor into your decisions.
  1. Re-evaluating your pre-pandemic strategic priorities and determining where they fit in a post-pandemic world
  • Provider risk: Has the pandemic changed the urgency or timing in your market? Should your organization lead or follow?
  • Assessing the impact of Surprise Billing Legislation and ongoing price pressures of in-network insurers and ensuring you are prepared for the risks and challenges.
  • Consumer-driven care: How has the pandemic changed/accelerated this dynamic of care delivery? What are next steps in building a consumer-facing organization?
  1. Insurance, Payers and Reimbursement
  • Analyzing where gaps in coverage will emerge and how those gaps can be addressed in the near- and long-term will help your strategic plans: Medicaid, re-emergence of Exchange Plans, other government plans, charity care or other forms of reimbursement?
  • Assess which services may be exposed to reimbursement shifts or challenges and determine how to navigate those shifts to ensure ongoing care delivery and appropriate reimbursement.
  • Are your revenue cycle processes and systems flexible enough to navigate current and future challenges?
  1. Develop new metrics for your organization
  • Rather than refreshing the old metrics of average length of stay (ALOS), utilization and case volumes, recognize this opportunity to change your organization’s metrics and determine how to fit into and help drive your community’s health and wellness going forward.
  • Some key questions to consider when reimagining your metrics:
      1. What metrics will help shape the vision of your organization for the future?
      2. How can you use the well-deserved recognition of healthcare providers as heroes to further establish and cement your organization as a vital part of its community?
  • Is your entire organization aligned behind well-defined metrics that truly represent your organization’s vision?

Healthcare organizations demonstrated tremendous vision, innovation and flexibility as they navigated unprecedented challenges brought on by the pandemic. However, the challenges and changes to the healthcare industry will continue long after Covid-19 disappears. Understanding and addressing these issues requires healthcare leaders to ask the appropriate questions of themselves, and their organizations, and act now, to thrive in the post-pandemic world.

Photo: Nuthawut Somsuk, Getty Images



Martin McGahan is a Managing Director and co-Head of Alvarez & Marsal’s Healthcare Industry Group. Martin has more than 15 years of healthcare operations and finance experience. He works with healthcare organizations to drive operational and financial performance improvement. With deep expertise in corporate finance, restructuring and capital raising, he advises healthcare services, pharmaceutical and biotechnology organizations on strategically re-engineering their balance sheet to ensure long-term stability and growth.

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