How to chart a course to success in the evolving post-COVID-19 healthcare landscape

Chas Roades, co-founder and CEO, Gist Healthcare

Health systems require a viable strategy that will enable them to respond to consumer-focused trends in the aftermath of the COVID-19 crisis and emerge as successful organizations, Chas Roades told attendees at his featured general session today, June 26, the second day of HFMA’s 2020 Digital Annual Conference.

Roades, the co-founder and CEO of the Washington, D.C.-based Gist Healthcare, presented his the session, “Into a brave new world: Health systems strategy for the COVID-19 era.”

Where things stand today

The time is rapidly approaching when health systems will need to embark on strategies for the world after COVID-19, Roades said. As of mid-to-late June, he noted, the nation has seen the number of positive cases of COVID-19 in U.S. beginning to plateau, giving cause for hope that we are beginning to emerge from the pandemic.

“We seem to have gotten this pandemic under control,” Chas Roades said. “The good news is that there has been a big decrease in the seven-day rolling average death rate from the disease, and we are doing more testing,” he said, noting that our lack of testing was the “original sin” of our initial response to the crisis.

Roades also acknowledged that uncertainties still lie ahead, and that today’s numbers could change over time. With the current reopening phase, he said, we have seen a resurgence in in some places that may have opened up soon.

“The main takeaway here is that we may be done with this virus, but the virus is by no means done with us,” he said.

The nation’s experiences of the pandemic also have differed widely, Roades said, referring to it as a “patchwork pandemic” — a complex web where some localities, demographic groups and facility types are disproportionately affected. Roades provided data, for example, showing a disproportionate impact on African Americans, which he attributed to the historical societal inequities to which this group has be subjected.

The drivers of health system strategy after COVID-19

In the immediate years ahead following the pandemic, Roades said, health system strategy will be shaped by three levels of interconnected drivers:

• Environmental (e.g., policy, economy, global)
• Healthcare (e.g., government, insurers, employers, workforce and COVID-19)
• Provider-specific (e.g., payment and care models, clinical workforce, care technology and surge needs)

He also suggested accounting for these drivers will require scenario planning over three time horizons:

1. Near (2020) — Reopening and recovery
2. Next (2021) — Healthcare “land grab”
3. Far (2022-25) — “Brave new world”

Planning scenarios must recognize uncertainties

Over these horizons, providers will need to address two types of uncertainties, he said. Initially, they will face market uncertainties stemming from questions about how quickly the industry will recover:

• When will consumers return?
• When will COVID-19 actually subside? (Will there be a second wave, and if so, how severe might it be?)
• When will the economy recover?
• How will policy change?

These uncertainties will gradually give way to industry uncertainties driven by the actions of healthcare stakeholders, including potential disrupters. Roades touched on the success story of telemedicine, and the high percentage of healthcare executives (67%) who predicted their organizations would increase their use of telehealth at least fivefold compared with pre-COVID-19 levels.

An important part of healthcare organizations’ strategy during the reopening as they seek to bring consumers back into their systems will be to engage directly with patients to rebuild trust in the healthcare system, Roades said. Consumers will need to hear from physicians and hospitals, and be able to see for themselves, that the healthcare system is safe. In particular, they will want to see that infection areas are well isolated in the hospitals.

Regarding healthcare system disrupters, Roades closed with a bold prediction: Walmart appears to be poised to become a leading primary care provider as it opens stand-alone primary clinics targeting uninsured and underinsured populations offering the attraction of convenient, familiar locations. This strategy will enjoy the advantage of proximity to healthcare consumers, given that 90% of the nation’s population lives within 10 miles of a Walmart store.

The ultimate strategic goal

“What we need to be asking ourselves is, ‘What really matters to consumers?’” Roades concluded. Health system executives today are focused more on that question in terms of safety. But in the future, they will need to be focused more on accessibility of care, how affordable it is, how trustworthy and reliable it is and how personalized it can be.