COVER STORY
Bigstock Plunging Into the Future, Strategically:
What Leadership Looks Like Now Industry leaders and observers all agree: the traditional methods of leading patient care organizations are going to need to fall by the wayside in order for U.S. healthcare to move forward into the future By Mark Hagland
E
veryone participating in the U.S. healthcare delivery and payment system understands that the
COVID-19 pandemic has had a dramati- cally destabilizing impact on all sectors of the industry. With ICUs filling up across the country and infection rates from the virus exploding beginning early in the year, the leaders of the nation’s hospitals, medical groups, and health systems had to shift quickly to telehealth-based care delivery to the extent possible, while dealing with a shutdown of elective procedures man- dated by the Centers for Medicare and Medicaid Services (CMS) that ran from mid-March to mid-May, and cratered the elective-procedure revenues on which patient care organizations depend for survival. But even as patient care organizations in some communities had begun to go back to semi-normal operations, others began to experience dramatic and incredibly difficult surges
in COVID-related inpatient admissions. And things remain highly unstable:
a Kaufman Hall report published on Oct. 19 and entitled “2020 State of Healthcare Performance Improvement: The Impact of COVID-19,” found, among other things: that three-fourths of hospital and health system execu- tives surveyed were either extremely (22 percent) or moderately (52 percent) concerned about the financial viability of their organizations, in the absence of an effective vaccine or treatment for COVID-19; one-third of survey respondents saw year-over-year oper- ating margin declines in excess of 100 percent from the second quarter of 2019 to the second quarter of 2020; and most patient care organizations are seeing volumes rebound slowly over time, even as the cost of personal protective equip- ment (PPE) remains a major problem. What’s more, patient care organization leaders are concerned that once the
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national emergency is declared ended by the federal government, that any return to sub-parity rates of payment for telehealth-delivered services could further imperil their longer-term rev- enues outlook. Meanwhile, beyond the immediate
crisis that leaders of the U.S. health- care delivery system are still facing around the pandemic, industry lead- ers are reflecting on longer-term issues, as the system shifts further towards value-based payment and away from fee-for-service payment—at a time of great financial and operational instabil- ity. The pandemic, those interviewed for this article agree, made it clear just how fragile the patient care organiza- tion financial outlook really is, for so very many. So, how are industry leaders nation-
wide thinking about what it will mean to lead their organizations, and the healthcare system, forward into the
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