Even deep in COVID-19 crisis, start planning now for what follows

The crisis surrounding COVID-19 is more consuming than anything our industry has faced in recent history. In response, the country is rallying behind the idea of flattening the pandemic's curve using social distancing and mandatory quarantines.

While we see extraordinary support from the federal government (Navy hospital ships and the tireless work of the Army Corps of Engineers are just two examples) and the states (transforming convention centers, closed hospitals and other vacant buildings into treatment facilities)— the lion's share of expanding capacity is still falling to the private delivery system.

To meet this need to increase capacity, health systems are leaving no stone unturned. In just the past few weeks we have seen systems stop all elective procedures, turn ambulatory surgery suites into intensive-care units, convert neonatal ICU space into adult ICU beds, expand virtual care clinics, and many other adaptations.

The purpose of these changes is to prepare for the worst-case scenario, but the associated cost to our health systems is never-before-seen decreases in revenue. Many health systems have lost half or more of their revenue in just a matter of days. If every geographic location gets hit with this as hard as New York City or Italy, we will certainly be unable to provide adequate care. Still, if we are able to lower demand for health services (by flattening the outbreak's curve) while simultaneously increasing supply (by creating additional capacity), we will be able to get through the next few months.

Nevertheless, this leaves the unfortunate reality that the very best-case scenario is that our health system suffers a financial disaster as opposed to the country suffering a medical catastrophe.

Although we're deep in crisis mode, we believe it's a necessity for healthcare leaders to start now to prepare for the post-COVID-19 era. Eventually, the country will come through this crisis and we believe that organizations that start now to prepare, while not sacrificing the current mandate to provide all the immediate care, will be better positioned.

To that end, we suggest three priorities for healthcare leaders to prepare for the post-COVID-19 landscape:

A detailed review must quickly occur to engage with the Federal Emergency Management Agency in preparation for assistance for all health systems and hospitals. Even though it's hard to see past the vast immediate needs, this declaration of a disaster is meaningful, and organizations that file early will be better prepared in the future. Losses, including revenue, labor cost, housing, increased materials, etc., need to be tracked and accounted for. The time will come when all healthcare organizations understand this benefit; those who accessed the system first will be advantaged.

For over a decade, industry alarms have been sounding about the inability of hospitals and health systems to decrease expenses. While revenue has been dropping faster than costs throughout the industry, many health systems have been able to insulate themselves with non-operating income from investments. However, success in the future will be more closely related to the fiscal discipline of the health system rather than investment returns. Look at the state of the markets. This, of course, is not to say that anyone will tolerate lower-quality healthcare in exchange. Both high quality and lower costs will be expected. Organizations that have been avoiding those hard choices while relying on their endowments will be forced to solve that problem, starting now.

For more than a decade, the industry has been working to improve telemedicine to a level where insurers were willing to pay, and patients felt comfortable using the technologies to receive care. With increasing acceptance of industry disruptors in "digital front door" technology, whatever hesitancy there was toward utilization of digital care has been removed in the past few weeks. No longer will payers or government agencies express hesitation to endorse this service, and organizations that are better prepared to use these technologies will have advantages. As an industry, we have been waiting a long time for the digital healthcare transition. Over the past few weeks, society instantly accepted that inevitability.Job 1 for the next several weeks is doing everything within our power to flatten and then drive drown the curve of new COVID-19 cases—and save countless lives. That must be the primary goal of every person in the country. If we are successful in that effort and once the crisis has passed, then a different kind of hard work begins.

Healthcare leaders should start planning now.