In the roughly 12 months since the COVID-19 pandemic emerged, America’s hospitals have borne a huge amount of the pressure and accountability for managing the effects of an unknown and unpredictable virus, and more recently for the complex process of disseminating vaccines. Our nation’s hospitals are doing all of this with relatively little public or political credit, and at great expense to overworked staffs and organizational financial health.

And now perhaps, if we are fortunate, we may be starting to come out of the worst of COVID. However, for hospital executives and their boards the question is: coming out into what?

How will post-COVID America, its economy, and its culture affect the relative strengths of traditional healthcare provider organizations? And, with COVID having greatly accelerated the growth of virtual business models, how will COVID affect basic patient care delivery and the encroachment of non-traditional competitors on that traditional delivery system?

In the absence of clear answers to questions such as these, hospitals and health systems need to prepare for many paths to many alternate strategic scenarios. This preparation will require sophisticated analyses and high level discussion at both the management and board levels. The overall strategic considerations are likely to be the most complex and intricate that healthcare providers have wrestled with in contemporary times. To assist with this strategic re-consideration, I offer the following post-pandemic preparation checklist.

Costs. Every hospital and health system has come through COVID differently. Depending on the speed and absolute degree of the return of volumes and revenues, the pre-COVID cost structure still in place at many hospitals may require significant reductions. Given the general economic insecurity in towns and cities across America, any such cost reductions will need to be accomplished in a most thoughtful way.

Strategic Repositioning. What does the local and regional market now look like? What about new competitors from national companies? What does your health system portfolio now look like? Are there specific assets within the portfolio that have been damaged? Has overall competition changed? Have direct competitors been weakened or become more aggressive? Are non-traditional competitors making moves into your marketplace?

Organic Growth. Do opportunities for organic growth remain in your market? How might COVID have created new opportunities?

Inorganic Growth. A competitive marketplace damaged by COVID may offer new and real opportunities for inorganic growth. Inorganic growth, however, always requires unusual levels of both preparation and organizational aggressiveness.

Partnerships. The post-COVID environment may create and era of transformative partnerships. Last month, 14 large health systems announced a partnership to create a large-scale database to revolutionize disease prevention and treatment. Just a few days ago, Amazon Care, Ascension, and Intermountain Healthcare announced a coalition to promote care in the home through telehealth, digital therapeutics, and provider home visiting. Hospital and health system executives will need to be attentive and alert to such innovative partnership opportunities and their potential competitive impacts.

Telehealth. What is the position of telehealth in your market post-COVID? What is your own level of telehealth capability? How will telehealth impact your overall delivery system and possibly the competitive balance in your marketplace? Importantly, what is your organizational point of view relative to the role of telehealth in your post-pandemic delivery system?

For some time we may be in an economic, cultural, and clinical condition where we have many more questions than answers about organizational direction in the post-COVID environment. This suggests that any generic roadmap to the future remains unlikely to impossible. Preparation, though, is both possible and essential. Only with precise and well-thought-out strategic and financial assessment and direction can complex healthcare organizations reasonably expect to navigate the post-pandemic fog.

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Kenneth Kaufman

Managing Director, Chair
Kenneth Kaufman offers deep insights on the economic, technological, and competitive forces undermining healthcare’s traditional business model.
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