covid-19 recovery perspective · huron is a global consultancy and not a cpa firm, and does not...

COVID-19 RECOVERY PERSPECTIVE

Don’t Just ‘Recover’, Reposition & Redesign

Health Management Academy Town HallMay 12, 2020

Confidential: © 2020 Huron Consulting Group Inc. and affiliates. Huron is a global consultancy and not a CPA firm, and does not provide attest services, audits, or other engagements in accordance with standards established by the AICPA or auditing standards promulgated by the Public Company Accounting Oversight Board (“PCAOB”). Huron is not a law firm; it does not offer, and is not authorized to provide, legal advice or counseling in any jurisdiction. Huron is the trading name of Pope Woodhead & Associates Ltd.

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DISCUSSION OUTLINE

1. Introductions

2. Recovery Framework

3. Ambulatory and Elective Ramp-up

4. Federal Funding

5. Questions

© 2020 Huron Consulting Group Inc. and affiliates.

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INTRODUCTIONS

Amanda BonserManaging Director, Huron

Federal Government

Andy Waldeck Senior Partner, InnosightInnovation and Strategy

Larry StuckeyManaging Director, Huron

Elective Services


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UNDERSTANDING BIG EVENTS

W H Y W E N E E D TO T H I N K A N D A C T D I F F E R E N T LY


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#1. THERE IS A SILVER LINING: Past disruptions indicate signs of hope

T H E S I L V E R L I N I N G C O M P A N I E S F O R M E D I N R E C E S S I O N Y E A R S

P R O D U C T S F O R M E D I N C R I S I S Y E A R S

Source: “The Silver Lining”, 2009, authored by Innosight Senior Partner Scott Anthony, #9 on Thinkers-50, 2019

1 9 5 7 T r a n s i s t o r R a d i o

1 9 6 1 D i s p o s a b l e D i a p e r s

1 9 8 1 P e r s o n a l C o m p u t e r s

2 0 0 1 i P o d M P 3 P l a y e r

“There is no better time to start a new company or a new idea than a depression or recession… There [are] a lot of people who need to get really creative to create something new”

-- Jack Dorsey, CEO & Founder, Twitter

Valuation of the 15 unicorn companies founded in 2007-2009

~ $ 2 4 0 B


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#2. DON’T JUST RECOVER, REPOSITION & REDESIGN: Crises can shape new patterns of consumption behavior and drive moderate-to-significant changes in an industry

Source: Innosight Secondary Research; The Telegraph; Modern Healthcare; Bloomberg


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WHAT BEHAVIOR CHANGES HAVE YOU SEEN?


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#3. NOT ALL BEHAVIORS ARE EQUAL: Organizations need to observe, understand, and learn quickly to influence favorable behaviors that stick

J O B D I S L O C A T I O N D R I V E S N E W B E H A V I O R S S Y S T E M I M P L I C A T I O N S

What new behaviors are we seeing across both internal and external stakeholders?

What do these new behaviors tell us about changing consumer jobs and will these changes “stick”?

Which behaviors do we want to ”stick” long-term and how can we innovate to reinforce them?

O B S E R V E

U N D E R S T A N D

I N F L U E N C E

Rearranges priorities and goals→ Concerns for personal and

family safety increase

Shifts the circumstances surrounding an individual → Social distancing and shelter

in place

Encourages higher levels of experimentation → Learning how to be productive

on video

Crises like COVID-19 ... … can substantially shake up Jobs(and what people do to solve them) Changes which jobs are most important

→ Prioritize family time over work

Triggers an individual to seek out a new solution to an important Job → Day 1 of a new fitness routine

Shifts the “hiring criteria” consumers use to evaluate different solutions to the job → Home delivery becomes really important

Imposes or removes system-level barriers that shape how someone can solve the job → Airport security post 9/11


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#4. BE CAREFUL, THIS TOO WILL PASS: Move swiftly to utilize window of high receptivity to make bold internal changes and big strategic moves that leapfrog progress

O B S E R V E C O N S U M E R B E H A V I O R C H A N G E S …

Changing external and internal influences create conditions that begin to loosen up entrenched behaviors …

... followed by a short period of high receptivity and rapid experimentation to transition to a new set of of behaviors ...

... that quickly lead to newhabits formed, and loyalties established that will largely persist until a new discontinuity emerges

U N F R E E Z I N G

E X P E R I M E N T A T I O N

R E F R E E Z I N G

T I M E

T I M E

… A N D U T I L I Z E W I N D O W F O R B O L D M O V E S

Take advantage of this narrow EXPERIMENTATION window to simultaneously Reposition and Redesign operations

“Adventist Health Hospital@Home will admit its first patient on May 11th”


https://www-kget-com.cdn.ampproject.org/c/s/www.kget.com/health/coronavirus/adventist-health-to-launch-its-first-virtual-hospital-amid-covid-19/amp/

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WHAT BOLD MOVES HAVE YOU MADE OR PLAN TO MAKE?


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GUIDING PRINCIPLES: Principles that influence how to think about crisis recovery based on past learnings and historical patterns of disruption

THERE IS A SILVER LINING:Despite significant challenges, breakthrough innovations often emerge during crises

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DON’T JUST ‘RECOVER’, REPOSITION & REDESIGN: Crises reshape individual behavior, altering demand and how companies compete

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NOT ALL BEHAVIORS ARE EQUAL:Certain new behaviors become habitual, while legacy habits can reemerge post crisis 3

BE CAREFUL, THIS TOO WILL PASS:Experimentation and openness to learning subsides as individuals define a new normal4

P R I N C I P L E S

Adopt a growth mindset; focus on capturing share and repositioning for long-term growth

Observe behaviors to understand how priorities and the basis of competition are shifting

Innovate in ways that reinforce key behaviors that are favorable to your sustained success

Pursue Bold Moves to accelerate redesign and enhance long-term sustainability

I M P L I C A T I O N S


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RESPONSE APPROACHH O W T O C A P T U R E L O S T V A L U E

A N D C O M P E T E D I F F E R N T L Y


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INTEGRATED APPROACH: In addition to rapid response and recovery, reposition to capture lost value and gain share, while redesigning the System to win in a new environment

D U R A T I O N

MA

GN

ITU

DE

OF

IM

PA

CT

R A P I D R E S P O N S E & R E C O V E R Y

Immediate must-do actions to deal with the management and oversight of the crisis

3 – 6 months R E P O S I T I O N & R E D E S I G N

Note: Illustrative, not intended to prophesize number of future curves

Strategic initiatives to recapture lost value and

capture new demand while redesigning to compete in a

new environment

T I M I N G I S E V E R Y T H I N G

N O T E : It is critical for organizations to act swiftly and identify overlap of timing between Rapid Response and Reposition & Redesign. Common Blockers that inhibit ability to accelerate include: (1) not dedicating sufficient resources to Reposition & Redesign due to over-emphasis on Rapid Response, (2) moving too slowly or waiting to act in hopes of more certainty


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REPOSITION & REDESIGN: Key considerations to develop an approach that drives both near-term resiliency and long-term sustainability

S u c c e e d i n g i n a N e w N o r m a l

R E P O S I T I O NDrive near-term Resiliency

R E D E S I G NCreate long-term Sustainability

• How have our external and internal assumptions changed, what are our new goals and priorities?

• How has demand for priority services changed, how does this impact our portfolio of services and assets?

• Is our Digital Front Door optimal? Does our access strategy support the shift to virtual and alternative sites of care?

• How successful are we in delivering high value care? Can we support high- and rising-risk populations’ complete needs?

• How do we address emerging capability gaps and ensure sufficient capacity to support our expanding virtual services?

• How do we stabilize supply chain while also building needed capabilities to support evolving sites and modalities of care?

• How do we deliver a safe environment that meets the heightened demands of our workforce and consumers?

• Is our revenue cycle optimized for maximize cash acceleration? • What is the new workforce model that drives needed productivity

while also mitigating burnout and turnover risk?

• What role do we want to play in the evolving health landscape and how does that change the nature of our relationship with consumers, sponsors, regulators and other key stakeholders?

• Given our role and the changing basis of competition what are new sources of differentiation, how does this impact our scope of services, definition of scale and required capabilities?

• How do our care teams and the clinical organization need to change to support the delivery of high value, personalized care seamlessly across a wide array of physical and virtual locations?

• Who are the partners we need to engage with in order to meet the holistic health (physical, mental, social) needs of consumers?

• What is our new revenue and cost model?

• How are we transforming our cost structure through automation, utilization of advanced analytics and workflow re-design?

• How are we reimagining our work, the environment we create and the implications for our workforce?

Care Delivery Operations

P e o p l e , O p e r a t i n g M o d e l , a n d C h a n g e M a n a g e m e n tHow can we ensure our response becomes an enduring source of inspiration, hard-wire the agility learned during the crisis and ensure we don’t revert to legacy behaviors?

Business Services

Consumer Operations

Technology Operations

Demand, Experience, and Access

Care Delivery

Leadership & Governance


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REPOSITION – ELECTIVE SERVICES: Documenting both demand and supply needs will ensure an integrated strategy

Convert Existing Demand

Assess and Pursue New Demand

Care Delivery Development

Assess Internal and External Capacity

• Quantify referral backlogs as well as deferred services; leverage dynamic tools to update assumptions frequently

• Establish a committee to determine surgical and procedure case prioritization using scoring criteria

• Model demand scenarios via dynamic forecasting tools

• Leverage dynamic worklists to prioritize surgical cases, procedures, and appointments

• Launch surgical case, procedure, and appointment reschedule outreach

• Identify patient acquisition opportunities within each specialty/service line

• Assess and sustain consumer preferences/demands (digital/virtual preferences); Leapfrog competition by ensuring frictionless access

• Position to enhance consumer accessand resource utilization

• Define key metrics requirements for “new normal” operations (conversion of new demand/care retention)

• Forecast required care needs and altered workforce skills

• Optimize virtual health services; determine ability to sustain and build-upon shift to telehealth/virtual care/remote home services

• Coordinate with physician outreach, population health, and marketing to optimize patient health management

• Review responsibilities by licensure to expand care delivery options where possible

• Determine short-term and long-term capacity of workforce to reflect impact of personal recovery from pandemic

• Realign provider and staff needs, compensation, benefits, and training

• Develop phased operations schedule for extending clinic, procedural, and surgical operating hours

• Determine site of care capabilities for fulfilling existing/future demand

• Explore opportunities to expand clinical capacity (e.g., partnerships, affiliated providers)

• Model reimbursement implications

D E M A N D O B J E C T I V E S S U P P L Y O B J E C T I V E S

Example Access Enablers Required

Revised Access Policies & Procedures

Restructured Scenario Modeling

Reconfigured Work Drivers & Technology

Updated Dashboard Reporting, Analytics,

Targets & Accountability

Revised Provider, Resource,

OR Availability

Convert existing demand into volume, and pursue new demand through targeted consumer outreach

Identify care setting(s), team, tools and technology needed to deliver market need while assessing additional capacity for future surges

Revised/New Partnerships & Collaboration


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REDESIGN – ELECTIVE SERVICES: Understanding gaps in enablers can facilitate the successful set-up of a redesigning effort.

Change Management Restructured Scenario Modeling

Reconfigured Work Drivers & Technology

Revised Provider, Resource, OR

Availability

Revised/New Partnerships & Collaboration

1. Are dynamic data models that input constantly changing variables employed to model supply and predict demand?

2. Are dynamic visuals used to drive decision-making?

3. Are more diagnostic procedure centers needed to address consumer worries that going to a hospital may not be safe?

1. Does a coordinated point of contact exist for a consumer to engage (connected care center, centralized scheduling, etc.)?

2. What is the maturity of the virtual care and/or telehealth infrastructure?

3. Are you able to prioritize pro-active out-reach campaigns to patients that are seeking care?

1. Are physician templates and scheduling instructions similar for like providers that see like patients?

2. Are referring providers aware of your availability?

3. Are APPs deployed effectively?

1. Does the existing physician network promote the needed growth strategies?

2. Are new partnerships or collaborations needed to advance technology needs?

3. Is the primary care model tailored to the current needs?

1. Have dyad leaders (physician and administrative) been assigned to lead these efforts? Who are key decisions makers?

2. Have you developed scripting (and completed the training) for staff to engage with consumers effectively?

3. Have you aligned resources, goals, and incentives around new priorities/new workstreams?


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FEDERAL STIMULUS: Ensure you are exploring all possible sources of potential financial relief to help position you for recovery

P o t e n t i a l F i n a n c i a l R e l i e f T a c t i c a l N e x t S t e p s

• CMS Medicare Advance Payment Programo Healthcare organizations can apply for an advance equal to six months of Medicare

paymentso Funds are typically received within two weekso Can be done at any time through the Medicare intermediary

• HHS Stimulus Fundso $100 billion was authorized to be distribute by HHS to cover “lost revenues”o Initial $30 billion of funding distributed around April 10/April 17 based on Medicare

Part A and B reimbursemento Another $20 billion distributed based on total patient revenue around April 24

• FCC Covid-19 Telehealth Programo Adopted $200 million COVID-19 Telehealth Program in a Report and Order released

April 2, 2020o Will distribute appropriated funds to help health care providers provide telehealth

services to patients at their homes or mobile locations in response to the pandemic• FEMA Grants

o For emergency medical care, workforce training, medical transport, specialized medical equipment, etc.

• Higher Education Emergency Relief Fundo 75% on enrolled Pell Grant and 25%on non-Pell Grant recipientso 50%+ of funds must provide emergency financial aid grants to studentso Provides flexibility for select federal aid programs

• Paycheck Protection Program (PPP)o Loans / advances available to small business (if funds available)o Most health systems are too large to be eligible, but may help medical groups

1. Research all possible sources of financial relief, keeping an eye on upcoming traunches of relief coming from the HHS Stimulus Fund

2. Designate centralized team to coordinate all financial relief efforts across your enterprise, including communication and governance

3. Conduct a review of the current chart of accounts and system data elements to identify areas to closely monitor and track, in addition to creating a single source of financial data that is visible and auditable, to support federal funding requests

4. Ensure there is detailed reporting within your healthcare billing offices, including any medical groups, long-term care, etc., to facilitate accurate claim submission for COVID reimbursement, federal funding requests, etc.

5. For healthcare organizations that are part of larger enterprise, including universities, ensure there is broader coordination and alignment across relief efforts

6. Engage with state-level FEMA officials if pursuing FEMA funding


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KEY TAKEAWAYS: Questions to discuss as a leadership team

QUESTIONS?

F r a m e w o r k

1. How are you balancing your redesign and reposition efforts?

2. Are you being aggressive enough to take advantage of the opportunity?

3. What specific behaviors, internal and external, are you trying to influence?

E l e c t i v e S e r v i c e s

1. Have you pressure tested the strength of your enablers?

2. Do you have the right data models in place to be responsive to changing dynamics?

3. Have you assigned dyad leadership on point to lead the effort?

F e d e r a l F u n d i n g

1. Have you completed a full scan of the potential relief funds available to you?

2. Do you have the right systems in place to track expenses and other data?

3. Have you assigned a centralized resource to manage your relief efforts and monitor new developments?


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CONTACT INFORMATION

Amanda BonserManaging Director, Huron

Federal [email protected]

678-468-0221

Andy Waldeck Senior Partner, InnosightInnovation and Strategy

[email protected]

Larry StuckeyManaging Director, Huron

Elective [email protected]

317-408-0058


mailto:[email protected]



Confidential: © 2020 Huron Consulting Group Inc. and affiliates. Huron is a global consultancy and not a CPA firm, and does not provide attest services, audits, or other engagements in accordance with standards established by the AICPA or auditing standards promulgated by the Public Company Accounting Oversight Board (“PCAOB”). Huron is not a law firm; it does not offer, and is not authorized to provide, legal advice or counseling in any jurisdiction. Huron is the trading name of Pope Woodhead & Associates Ltd.

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covid-19 recovery perspective · huron is a global consultancy and not a cpa firm, and does not...

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