In 2012, Eastman Kodak Co. filed for bankruptcy. During its peak, the company supplied nearly 85% of the cameras and 90% of all film sold globally. But ultimately, the company was a victim of its own success. When faced with the crossroads of modernization versus history, the company chose to double down on its fee-for-film approach rather than pursue digital photography.
Healthcare, too, is standing at a crossroads. The COVID-19 pandemic has brought unprecedented disruption and poses a threat to long-standing revenue streams. And in the face of a recession to which healthcare was particularly vulnerable, it discovered new agility. Telehealth programs emerged in a matter of days, new programs were started to provide care outside hospital walls, and well-being programs emerged and expanded.
Many organizations have viewed these interventions as bridging measures, set up to assist them in returning to their primary focus: elective visits and procedures. As systems face current harsh financial realities, many are tempted to jettison the very programs that helped ensure their initial adaptability—yet outlining budgetary and operational priorities that will ensure organizational resilience is key to ensuring success in the peri- and post-COVID world.
Research over the past decade has illuminated the high levels of burnout and low levels of professional fulfillment experienced by healthcare workers and their effect on staffing and productivity. These issues are clearly being exacerbated by COVID-19.
Outside of the moral imperative to address burnout in healthcare, investing in well-being also presents a unique financial opportunity, as every $1 invested in workplace wellness programs leads to a decrease in medical costs of $3.27 and absenteeism costs of $2.73. Given the extensive workforce shortages already affecting healthcare due to the pandemic, investments in healthcare worker well-being are also necessary to secure the staffing necessary to have a resumption of elective clinical activities that hospital budgets depend on.
Prior to COVID-19, alternative payment models sought to align provider incentives around value and improving health rather than on the number of services provided. Uptake of such models had been slow due to continued pressure for volume to drive revenue. The pandemic flipped these incentives as hospitals raced to keep patients out—using care managers and community health workers to engage with high-risk populations, and partnering with skilled-nursing facilities to prevent outbreaks.
Even though many of these interventions do not generate an E&M or CPT code for billing, they are vital in the current environment. Providing the right care at the right time and place is essential for achieving the fine balance of maintaining volume and managing capacity, when hospitals must juggle performing hip replacements alongside treating COVID-19. And by establishing hospitals in leadership roles in their communities, such activities not only improve health, but also help systems capture increased market share.
Organizational agility and growth often hinge on strategic investments that do not coincide with short-term returns in the core business. A prominent example of this during this pandemic is telehealth, a largely nascent endeavor that proved to be critical for healthcare resilience during the pandemic.
Investments in innovations that do not have an immediately apparent return—whether due to restrictive payment policies, legal hurdles or cultural/workplace inertia—are difficult to justify for short-term budgetary forecasts, especially in the current environment. However, this is also the moment where innovation's role is most critical. Continued investment is necessary not only for continued shocks with the current pandemic, but also for shocks that will be created by other industry disrupters now and into the future.
In 1977, 35 years before filing for bankruptcy, Kodak's innovation team filed a patent for the "electronic still camera." Kodak leased this technology to Apple for its first commercial digital camera, the QuickTake, convinced that digital photography would never catch on. And while the QuickTake ultimately wasn't a success, it was the first step toward the eventual takeover by digital photography.
Despite being uniquely positioned to succeed, Kodak chose the path of least resistance. In the same way, the question for healthcare organizations now is: Will health systems recognize the power of transformation and leverage it to enact long-term changes?