The New Normal: How Healthcare Transformation Prepared Healthytown for a Pandemic

As we begin to emerge from the country’s initial response to COVID-19, from every sector comes the question, “What is the new normal”? For healthcare organizations who are at the frontline of this pandemic, it is a pivotal moment to re-examine strategies that will need to adapt for “The New Normal.”

Despite the pause in normalcy, we believe the industry remains on a path to healthcare transformation, which—once we are out of immediate crisis mode—will be accelerated by COVID-19.  So how does a transformed Healthytown respond to a pandemic?

First, to be clear:  Healthytown^TM is not a panacea and cannot solve all pandemic-related problems.  Healthytown cannot mass produce testing supplies; Healthytown cannot address a shortage of PPE; Healthytown cannot keep the sickest that have succumbed to a dreadful virus out of its ICUs; and, Healthytown cannot miraculously develop a vaccine overnight. But we would suggest that hospitals and health systems in Healthytown—having experienced healthcare transformation—are positioned much more strategically to withstand the challenges of a pandemic than are most providers in today’s environment.  We offer five lessons learned from Healthytown to challenge your organization as we move forward into The New Normal.

1. Hospitals and health systems remain financially secure. Providers’ revenue streams are fixed in Healthytown and generally calculated based on the health of the attributable population, quality and outcomes.  A pause in non-essential admission and procedural volume does not affect revenue and certainly does not result in monthly revenue losses that total in the billions and threaten to bankrupt hospitals across the US.

The New Normal Challenge:  Proactively push to fixed revenue payment models that enable delivery of the right care, in the right place, by the right provider, at the right time and subsequently mitigate downside risk when volume evaporates during a pandemic.

2. Virtual care and telehealth care is the standard of practice in Healthytown. Most primary care providers in Healthytown “see” 50 to 70 percent of patients via a non-traditional visit, enabling providers to surge to even higher proportions of distance care more readily during a pandemic.

The New Normal Challenge:  Sustain the virtual and telehealth platforms established or expanded during COVID-19 to effectuate primary care done right and to improve practice efficiencies.

3. Inpatient volume is lower in Healthytown. Providers in Healthytown already keep out of the hospital those patients that can be monitored effectively and treated remotely, enabling them to continue caring for many of those patients even under stay-at-home orders.  Patients who so choose are given more opportunity to treat their conditions medically and with low-intensity interventions, which in turn reduces the demand for high-intensity procedural interventions that may be considered “non-essential” in the midst of a pandemic.

The New Normal Challenge:  Through the lens of COVID-19, re-examine “essential” care to determine what clinical care protocols may need to be modified, particularly once fixed revenue payment does not disproportionately reward high-intensity interventions. 

4. Health systems have automated infrastructure. Because financial incentives have been turned upside down in Healthytown, health systems have adopted practices learned from the airline and banking industries to streamline operations, requiring fewer person-to-person touchpoints and reducing costs.  With fewer direct touches built into their operations, Healthytown providers find it easier to maintain normal contact with their patients during a pandemic.

The New Normal Challenge:  Avoid re-establishing person-to-person touchpoints that you eliminated during the COVID-19 crisis. Look for ways to expand digital and remote connections.

5. Healthytown’s inpatient capacity has been reduced. Because care delivery has transformed to the most effective setting with the lowest cost, inpatient demand in Healthytown has been reduced.  Financial wherewithal does not exist to maintain inpatient bed capacity that may be needed only once every few decades.  In the alternative, Healthytown providers have a surge plan that is regularly updated and includes internal modifications to create more capacity, as well as external alternatives.

The New Normal Challenge:  Resist the temptation to abandon transformational facility strategies and planning because of the recency effect of COVID-19.  Now that you have an active surge plan, keep it active, set a schedule for regular updates, and move forward with transforming your care delivery platform.