Leading Through Uncertainty: Six Imperatives for Health System Resilience

On a daily basis, we are inundated with summaries of how the Big Beautiful Bill will impact health systems today. Reductions in Medicaid, Medicare, direct and indirect research funding, as well as new challenges facing internationally-trained clinicians will be dramatic.

Leadership is never easy (although good times make it easier). We have faced significant challenges in the past, most recently COVID-19, and these are now times that true leadership reveals itself. We encourage you to explore the following 6 responses:

1. Aggressively redesign executive alignment and operational responsibilities: Most health systems are already working to reduce the size of their leadership and administrative teams. We see regionalization of roles and the combining of traditionally separate responsibilities as key opportunities.

2. Continue to explore opportunities for scale: Improved operating efficiency should be a hallmark of scale. As I noted above, regionalization of responsibilities is just one example. However, don’t limit yourself to traditional mergers and acquisitions. Consider more agile models that might include joint ventures, shared infrastructure, service line alignment, and new clinically integrated network models.

3. Boldly redesign care delivery models to improve access and service: We’ve always talked about the R’s – right care, at the right time, by the right provider, in the right setting. But when you really dig in, we continue to see EDs filled with patients that could be better cared for in other settings, primary care offices scheduling face-to-face appointments for patients who would be better treated (and prefer) a virtual visit, and specialty clinics filled with familiar patients who could be transitioned back to primary care, thereby creating more specialty capacity. We need to aggressively pursue the transformation of care models.

4. Continue to embrace data, analytics and emerging AI solutions: We have a long history of not effectively using currently available data, and now, newer approaches hold great promise. We need to continue to embrace those tools to focus resource intensity on those who most need it – whether for prevention, rising risk, or acute care.

5. Readdress your payer portfolio strategy: Nearly every health system has opportunity. Your multi-year payer work plan should diligently address rate disparities and service line reimbursement gaps.

6. Start addressing the rapidly worsening workforce challenge: Keep striving to be the preferred place for clinicians to work, but that alone won’t suffice. About one-third of all primary care physicians in the US are foreign-trained. That workforce is at even higher risk! Expanded educational relationships, pipeline programs, and loan forgiveness should be on the table for consideration.

As we face these leadership challenges, we know mistakes will be made. But doing what we have done in the past will not be enough. See Bob Dickinson and Yifan Zhang’s recent piece on creating a rapid and targeted refresh of strategy: Strategic Planning 2.0: Now is the Time to Drive Performance with a Targeted Refresh

Best regards,

Andy Ziskind, M.D.

Managing Director and CEO