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 Welcome to this Week in Health. It, it's Tuesday Newsday, where we look at the news which will impact health. It. Today you're gonna get to help me with my homework. We have a live, uh, uh, a YouTube live session today for this week in health. It, it's our first one. It's at noon eastern time, 9:00 AM Pacific, and uh, it's gonna be with Drexel Ford, Che David Munz.

And myself. And we're gonna talk about what's next in healthcare. And as part of that, I'm doing homework. I'm looking at stories like the day after implications for hospitals and payers. Uh, after the Surge five Health System imperatives. Uh, we take a look at, uh, money that's available for telehealth and some other stuff, uh, that is going on.

So I'm going to, uh, share some of those stories. It's just part of my homework that I'm doing for the show that we are gonna do later. This morning, so make sure you mark it on your calendar. Make sure you show up. I'm looking forward to, uh, fielding your questions. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health.

It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. This episode and every episode since we started the c Ovid 19 series has been sponsored by Sirius Healthcare. They reached out to me to see how we might partner during this time. And that is how we've been able to support producing daily shows.

Special thanks to Sirius for supporting the show's effort during the crisis. Okay. Tuesday, Newsday, I, I actually have 15 stories. I've read a bunch of stuff in preparation for, uh, tomorrow. I will not get through all of them. I will only get through about 20 minutes of them. So we will see what happens. Uh, well, let's just get right to it.

One of the first things I did, uh, in preparing for tomorrow was to see who was talking about what's next in healthcare. and, uh, the consulting firms are talking about what's next in healthcare, which makes sense. They're trying to get out ahead of it. Uh, they are, uh, pulling their, their collective thinking and thought processes together to try to determine, uh, you know, who, what, what, what are going to be the implications across the healthcare sector.

Uh, one of the better ones, one of the things that, uh, one of the ones that I really got a lot out of. Was from a company called Recon Strategy, which I've never heard of. It's a blog article that talks about the day after implications for c Ovid 19 on the industry. And they have the, uh, sector impacts and averages and, and things to that effect.

Uh, they go through tele, uh, 12 sub-sectors, hospital payers, surgery centers, biopharma. Device and equipment diagnostics, pharmacy, telehealth, remote monitoring, digital health, public health, and community providers. They have a, uh, really easy to understand chart in there. Uh, up and down arrows, side to side arrows.

A number of errors indicates, uh, who's benefiting in the short term, uh, or, or who and, and who will benefit, uh, in the long term as a result of this. Obviously, uh, this is forward thinking. Um, you know, everyone will preface this by saying, uh, the most important thing is for the safety of the communities that we serve.

Um, but uh, in an effort to try to figure out what's going to happen next, uh, you know, these kinds of articles are, are invaluable. So, you know, what are they saying about the hospital sector? Lemme give you a little, uh, uh, a, a little, uh, take on that. So, hospitals, the postponement, the postponement of electives procedures will wreak havoc on hospital income statements and cashflow positions, especially when you consider these in light of the high costs as they deal with

Ramping up staffing and infrastructure to deal with covid, and they're typically razor thin margins in short term survival of many will depend on how much they're paid by commercial and government payers for covid care or what they can get from a bailout in the long term. Even assuming policymakers, uh, payers, particularly CMS and the public are much more willing to invest in supporting hospitals after their heroic response to the crisis, there's a lot of uncertainty on how.

That would translate in the real world with our mix of for-profit, not-For-profit and public facilities. There may be some future upside for their ability to acquire struggling independence, but they may not. That may not be enough. No wonder when you look at the stock market, it has pummeled, HCA and tenant.

Um, . and they go on to talk a little bit more about that. So they're painting a picture that in the short term, this is bad for hospitals in the long term. It's also not good for hospitals. Uh, we know that's not, that's true. Uh, for health systems that had poor balance sheets going into this, uh, you know, cashflow was, uh, significantly impacted.

They, you know, they talk about the upside . Is, uh, you know, they have a lot of, uh, covered lives, therefore they're receiving payments. But there's a whole bunch of exposure on the covid side, uh, for people that normally would not, especially on the Medicare Advantage side, that normally would not have, uh, taken that many dollars.

So, uh, you know, they're saying the payers short term, long term is, uh, you know, are gonna see some upside. I, I, quite frankly, I think they're missing the boat a little bit on the long term. I think the long term the payers. Uh, come out of this, uh, really well positioned. I think they can buy up, some can buy up, uh, the medical groups because the, uh, the individual medical group practices have been, uh, just pummeled by this.

And, and, uh, there's an opportunity to to buy them up. There's an opportunity for good medical groups that had good practices prior to this, to position themselves to be bought, uh, by payers and by, uh, hospitals with good, uh, balance sheets. Uh, okay. Surgery centers. Surgery centers is interesting to me. You know, ambulatory surgery centers are severely impacted.

Obviously, we, we've taken away the elective surgeries, uh, but they make the case that it's probably gonna be one of the quickest things to, uh, rebound. because you know that, that, uh, demand is, is, has just been pushed back. And then, then they're just gonna have a, a bounce as soon as we get back there. Plus there's gonna be this, uh, push away from hospitals per se, uh, for fear that they are, uh, incubators for, uh, germs and disease.

And that these, uh, ambulatory surgery centers are, are, um, uh, just a better option, uh, safer option for, uh, for the public. Uh, they go on to talk about biopharma and devices. Uh, diagnostic, um, diagnostics not impacted all that much. Devices and equipment. Short-term impacted, uh, long-term neutral biopharma, neutral short-term upside.

Uh, in the long term telehealth, huge upside right now. We're, we've, we've done a couple of episodes on this, um, that I've recorded and I will be releasing here shortly. . , um, you know, it has three, three up arrows, which is the most of anything. Uh, there, there's no other thing with three up arrows or three down arrows for that matter.

So telehealth has just, uh, gone into a different category, uh, with, with, uh, covid. As we know from the interviews that we've been doing, uh, they believe that we're gonna sustain a lot of that gain. They, they have two up arrows in the long term, which would indicate that they believe that, uh, the, the payers, um, both the um,

Uh, public and private payers are going to, uh, continue to fund it. So remote monitoring is in that same vein, and, uh, also has, uh, not as much upside, uh, upfront and long term, but, uh, is on that same, uh, glide path, if you will. Uh, digital health is really neutral right now. And, um, has some upside going forward because we have really introduced a lot of digital tools, uh, chat bots and other things into this.

Um, I think the appetite for digital tools is gonna continue. I'm not really, I mean, they're, they're saying the same thing. Um, and so I think long term we're gonna see a lot of digital health, uh, opportunities will, it remains to be seen where they will, uh, be implemented. Uh, and then they talk about public health and community providers.

I'm not gonna go into that as much. . And, uh, again, good, uh, good, great thinking. Uh, recon strategy, blog, article, um, what's the name of it? The day after Implications for hospitals, payers, biotech, and More Recon Strategy. Alright, the next one I'm gonna look at is Charters Group. I like the, I like the people at Charters group.

I think they're good thinkers and, uh. They have a, an article now it's behind a, uh, email paywall, so you have to give 'em your email address. Not the worst thing in the world. They have, uh, a lot of good materials that they put out and their thing is called after the Surge five health system imperatives.

So I'll get to the imperatives in a minute. Um, but they have co c Ovid 19 has fundamentally changed the care delivery landscape. And so what they have is 1, 2, 3, 4, 5, 6, 7. They have seven things that they think, uh, need to be addressed. The first is, uh, or that have happened as a result of Covid dual systems of care for c Ovid 19 and non c Ovid 19 patients.

Now we know that that's going on now. And in fact, I'm gonna share the next story I share with you is gonna be about that. Um, and that will likely have to continue for some period of time. Uh, consumers fear. The second one's consumers fear of infection, causing delays or foregoing of care. Uh, that's a risk.

Uh, deteriorated patients financial profiles, we know that that's happening. The number of unemployed. Uh, approaching 20% across the US a reduced overall market size for the foreseeable future. Um, that's a risk to health systems, uh, evolved clinical care delivery models, including virtual care and care at home.

So this is something that we have seen, uh, I mean, we've been talking about this. Uh, I've talked to a couple people now and we've been talking about this for decades, uh, or at least over a decade. And, uh, . It's amazing how much of that just came, came to into it existence over the last two months as a result of the pandemic.

It's like we knew we knew what to do, we had the capabilities, we had the technology, and it was just a matter of, uh, reducing the regulatory barriers, uh, implementing some, uh, pay models that worked and, uh, and those things happened. So, uh, evolved clinical care delivery models including virtual care and care at home.

Okay, the next one, shifting health, health system, economics, and changing sources of margin. Okay. We, we don't know how this is gonna play out, but, um, likely there's going to be a change in payment, uh, payment models. There's gonna be a change in, um, in how we deliver care and how we think about delivering care.

And then the final one is worsened community health status. So, uh, the, one of the results of c Ovid 19 is that, um, . You know, a fair number of people have been infected and, uh, it has worsened the overall community health status across the board. So what are the five imperatives? The five imperatives, uh, coming outta this are gonna be number one to recapture demand, right?

So the demand was at a certain level, pre covid, and that has dropped significantly. I mean, Dr. Dramatically actually. And then the question becomes how much of that can actually be recaptured? And what are your strategies for recapturing demand? Again, I really like their thinking on this. The second one fundamentally reduced the cost base.

Uh, for care. So, um, so we now have, have, uh, introduced a lot of digital tools. We've introduced a lot of different ways of caring for people, quite frankly, that are less expensive, less touch points, less travel, a lot of things to that effect. Uh, so fundamentally reducing the cost basis for care. The third one is restructure the physician enterprise.

Um, I, I would probably go a step further and say rebuild. The physician enterprise, I mean the, uh, if, if any area of healthcare has been impacted, uh, the most by this, it has to be, uh, the, the, um, the physician practice and the physician networks that existed within your community. Um, you know, especially the independent ones, they did not have the resources to, uh, or the wherewithal.

They had to lay off a, a fair number of people or furlough a, a fair number of people. Uh, now again, the demand should come back. Uh, but a lot of these, um, uh, a lot of these organizations are really struggling. So we have to re they say restructure, I will say rebuild the physician enterprise. Uh, number four, transform the clinical operating model.

So this is the thing that I've been talking to my clients about, and it, it is, uh, something that, uh, a conversation I had with, uh, somebody last week, um, gave me that, you know, when you go through a crisis, you end up with, uh. You know, three phases really, right? You react, then you stabilize, and then you reimagine.

And I love that. I love that framework, and I love that thinking. And, uh, I thank Frank for giving it to me. And, um, but the, the reality of what's gonna happen, hopefully, what's gonna happen out of this is we react, we reacted really well. Health, it reacted very well. We then, um, you know, we're stabilizing the environments.

A lot of the questions I'm getting from people right now are, okay, we did all these things sort of in a makeshift fashion. How do we, you know, how do we make these into more permanent solutions? Um, and the coaching I'm giving people is to reimagine before you put those, those, uh, solutions into a, uh, concrete before you pour the concrete and set 'em into concrete.

Uh, reimagine what's possible the clinical operating model, uh, could change, should change, especially if the reimbursement, uh, models even remotely look like what they look like today. And finally, uh, partner with purpose. There's gonna be a lot of opportunities for partnerships. Um, I have said last week I said, there's gonna be an awful lot of m and a activity coming out of this.

Um, MA activity, if there's strong balance sheets. If there's not strong balance sheets, there's gonna be opportunities for people to evaluate, uh, partnerships that might make sense that maybe didn't make sense four months ago. All right. Onto the next story. And again, I like that thinking. If you're, uh, up for the paywall, just go over to the, um.

uh, go ahead. Over to the, uh, charter group website. You can see that I wanted to share this because I think it's a, um, I think it's also an imperative. So Atrium Health, unveils, COVID Safe Care across all locations. Okay. So this is one of those things that if your health system isn't doing this today, um, it's problematic.

I would say almost . Um, you know, it, it, it, it's, it's something that you probably should have been thinking about . 30 days ago and something you should be doing right around now. And I've talked to a bunch of, uh, forward-thinking health systems that weren't ready to talk about this on the show, uh, but they were talking about the work that they were doing around this.

So, uh, atrium Health Charlotte, uh, North Carolina, atrium Health, uh, will be the first health system in the region to expand the delivery of care services starting the week of April 27th. This move comes after Atrium Health carefully evaluated the the CDCs recommendations. While also consulting with national medical experts and government leaders across the state and the country.

As Atrium Health expands its services, it is adding extensive safety measures and initiatives to provide peace of mind to patients by establishing Covid Safe Care standards for all of its locations. And then it goes on, and Eugene Woods has a quote here and so forth. Uh, I'm gonna tell you what they've done.

So Atrium Health's covid Safe Care Standards build on its deep clinical expertise. Expertise to contain the Coronavirus disease, uh, and ensure the safest environment possible at each location. Our Covid Safe Care standards include. Number one, initiating testing for all patients for C Ovid 19 prior to any scheduled procedures to pr, to preserve a covid safe care environment, and ensure safety of patients and care teams.

That's number one. Number two, achieving the fastest c ovid 19 testing results possible up to three days faster than any local provider, as one of the only, only systems in the nation with rapid testing capabilities in-house. Yeah, I think it's a little bit of hyperbole, but with that being said, um, that's number two, achieving fastest, uh, COVID 19 testing results possible.

Number three, establishing dedicated facilities, care units and clinical teams for exclusive treatment of non covid patients in the safest environment. Okay, so they are creating essentially a bubble that when you walk into that bubble, you know that your care providers. Uh, all the other patients, uh, it is a, it's a, a covid free environment to receive care.

Uh, number, that's three, number four, uh, deploying the first of its kind c Ovid 19 virtual Hospital, which allows covid patients to receive care in the comfort of their own home. Again, smart. And, uh, and I give you a little glimpse of how people are thinking. This c Ovid non covid environment. Uh, but also utilizing the digital tools that are available.

And this could be what an emerging model looks like coming out of this. And then finally, uh, leading all other regional systems with twice as many physicians, over 900 care locations and largest hospital bed capacity in the region. That is absolutely a marketing bullet point. I'm not sure what that has to do with, uh, anything, to be honest with you, but it is the, uh, it is their last bullet point for how they do a covid safe environment.

So clearly the marketing people had some . Some say into what, uh, came outta that. Alright, so, uh, so that's what Atrium Health's doing. I think, uh, to a certain extent it is, uh, management malpractice. If your health system is not thinking right now about how to do this, um, your balance sheet is getting hit every day.

This is exactly what you need to put in place. Uh, however you do that, through partnerships, through, uh, however you set up an environment like this that you can move forward, by all means, you should be doing it. Uh, okay. I'm gonna be recording tomorrow. Actually, I'm gonna be recording, actually, I'm releasing this on Tuesday.

So Tuesday afternoon I'm gonna be recording a, a session, uh, with Sirius Healthcare, with Eli Tarlow, uh, who's, who's gonna give us a lot of details on the millions available through c Ovid 19 telehealth program. Um, to sort of wet your appetite around that. There's a, uh, a story I just received in, um, in my, uh, inbox.

It is that Christian Care has received $714,000 grant from the FCC to support telehealth services during the C Ovid 19 pandemic. So, um, the CARES Act, the multiple phases of the Care Act has freed up about $200 million through the FCC. Uh, only a handful of health systems have taken advantage of this. Uh, to date about 17 have taken advantage.

There's 200 million available and, uh, it is worth looking at. I actually, um, hit the Sirius Healthcare website. They have, uh, published a blog article on it and, uh, it's worth a read. And I will do an episode, um, this afternoon. I'll record that. I'll get that out to you so you can get some details on, uh, how you can get access to some of that money.

And how I wanted to close this is. Uh, I wanted to look at how, um, other people were thinking about the impact of C Ovid 19. So I, I went to a Fast company article because they went out and looked from, uh, 30 experts or leaders, and, uh, they said all things c Ovid 19 will change forever, according to the top 30 experts.

I'm gonna give you the things they said that will change and a little snippet from each one, uh, if I have enough time. So, . Let me just check my time real quick. . I don't have time. I'm gonna do this really fast. Working from home becomes the new normal. I think we all know this. Uh, Matthew Prince, CEO of CloudFlare, the pandemic has resulted in what is effectively the largest work from home experiment ever conducted in human history.

Uh, we're seeing the effect on the internet in terms of the traffic patterns that are shifting. People are accessing more . Uh, educational resources online for their kids. Finding unconventional ways to connect with coworkers, friends and family, and employers are being more flexible in how they respond to employee needs through more dynamic cloud-based technology.

I think we'll see these shifts last well beyond the immediately immediate fallout of co covid 19 outbreak. I believe that's true, and I'm hearing that same thing from CIOs within health systems. Uh, the digital migration accelerates Michael Hendricks, partner and global design director for ideo. Uh, right now the virus seems like an accelerator for digital change that was already underway.

Uh, the surprise has been to see the resistance to the digital change suddenly evaporate. What organizations resisted for a decade is now core to survival and innovation. It is exciting because the digital mindset will persist and it is highly unlikely companies will try to return to what worked prior to the pandemic.

Uh, the next one is education goes virtual. My daughter is a, uh, freshman at Baylor. and she's home taking courses. And I'll tell you one of the things, she's not saying this, but one of the things I recognize is if they do not, if, if some of these colleges, if they don't offer that, uh, campus experience, uh, I'm not sure that the, you know, the, the, the degree is that much different across these virtual settings.

and I think a whole bunch of people, just like everything else that's going on right now, whole bunch of people are getting experience of what it is to take courses online. Now, some, it's very uneven. Uh, some of these teachers were not ready. Some of the technology was not ready. Uh, definitely the universities were, were not ready and you can't offer.

Um, I'm saying Baylor 'cause that's where my daughter goes. But you can't offer the Penn State or the Michigan or the USC experience remotely. You just can't do it. You can't go to the Saturday football game, uh, you can't have the study groups, you can't have the, uh, the, the whole experience that really takes you from a high school kid to ready, uh, to be an adult, a functioning adult.

So it's gonna be interesting to see how much of this snaps back on in the educational side. Um, but I think the thing that's at, at risk for them is the number of people that are experiencing it right now. Uh, I think if nothing else, I don't know why I'm talking about education. I should be talking about healthcare, but I, I think if nothing else, uh, the, the, uh, in-classroom experience we'll change dramatically.

We'll see more, uh, zoom stuff. We'll see more, uh, creativity just as a result of the experiment that's gone on. Uh, the next one they have is healthcare confronts the same old problems. And, uh, I, there's a whole bunch of self-serving comments in there. One of the ones I thought was really exceptional. Peter Chapman, CEO, and President of Quantum Computing Company Ion Q Ion.

Q. Um, within the next 12 to 18 months, we're expecting quantum computers to start to routinely solve problems. That's super supercomputers and cloud computing cannot. When humanity faces the next pandemic, I'm hopeful that quantum computer will be able to model the virus. Its interactions with . Within the human body that will drive possible solutions and limit the future economic damage and human suffering.

Um, I hope so as well. We've been talking about quantum computing for quite some time and, uh, there's as many things that scare me about quantum computing as, uh, excite me about quantum computing. But this is one of the things that's exciting. Uh, they also go on to talk about venture capital hunkered down, uh, that, um, a lot of companies that were burning cash.

there's not cash for them anymore. Uh, and a lot of them are trying to find ways out, uh, transportation rebounds and involves manufacturing gets a wake up call. I think this is gonna be one of the biggest changes in America is, uh, the manufacturing and supply chain. And then finally new thinking changes old businesses.

And, um, this is Will Lopez HR platform, Gusto. Uh, COVID 19 isn't at the end of brick and mortar stores. They are vital to our communities and our economy, but the way they operate will change the crisis, will force small businesses to have that have historically resi relied on foot traffic as their main source of income to develop alternative revenue streams.

So that they can weather the next major event. For example, many restaurants might permanently link up with delivery service platforms or expand their geographic reach via ghost kitchens and more boutique boutiques. Uh, we'll develop an online presence that reaches beyond the local neighborhoods. Uh, and I wanted to close with that because.

I love that thinking. I've, I, I've talked to, and I know a bunch of entrepreneurs, um, that have done really incredible stuff. You know, a, um, uh, a coffee business. They, they, uh, provided coffee for events and, uh, those events weren't happening anymore. They started roasting their own beans, selling their beans online.

They started selling . Uh, just a whole bunch of different things. I think that level of creativity I'd, I would love to see applied to healthcare instead of finding every way possible to go back to the way we were, I'd like us to, um, to reimagine. I. . What is possible with healthcare? Now that we've experienced something different?

How much of it can we retain? And how much can we, uh, move forward, uh, with new models? That's all for this week. Special thanks to our sponsors, VMware Starbridge advisors, Gail in healthcare, healthcare expert talent advisors, and serious healthcare for choosing to invest in developing the next generation of health leaders.

Don't forget at noon today, uh, Tuesday, we're gonna be doing our first live show. Uh, bring your questions. What's next in healthcare if I didn't cover it here? And you want to talk about something else, or you have a question based on what I threw out here, uh, bring it with you at noon. Love to talk about it.

This show is a production of this week in Health It. For more great content, you can check out our website this week, health.com, or the YouTube channel if you wanna support the show, the best way to do that is to share it with the peer. Send an email. Uh, let them know that you value what you're getting outta the show.

Uh, email might be old school for you, however you do it. Go ahead and do it that way. We're gonna be back again, uh, this afternoon, and we'll be back in every day, uh, with interviews for the foreseeable future, uh, until we get through together. Thanks for listening. That's all.