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COVID-19 HOSPITAL
& HEALTH SYSTEM SURVEY
The Impact of the Pandemic on Provider
Revenues, Elective Procedure Volumes,
Telehealth Use, & Working Arrangements
May 2020
2 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Respondents
Responses were fielded May 4 - May 8, 2020
40% C-level
10% Vice President
50% Director
174 Respondents
1%
12%
22%
65%
Ambulatory care clinic Medical group or
specialty practice
Health system
headquarters /
corporate offices
Hospital or medical
center
3 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Providers projecting revenue & patient volume drops,
incremental improvements by year’s end
Q: How do you expect your future revenues to compare to pre-pandemic revenue levels?
Compared to pre-COVID-19, 89%
of executives predict their
organizations’ revenues will be
lower at the end of 2020.
Among respondents, almost two-
thirds project decreases of
greater than 15%, and one-in-
five forecast decreases of more
than 30%.
6%
14%
42%
27%
8%
3%
–45.1% to –60% –30.1% to –45% –15.1% to –30% –0.1% to –15% 0% to 15% 15.1% to 30%
4 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Providers projecting revenue & patient volume drops,
incremental improvements by year’s end
Q: When do you anticipate your elective procedure volumes returning to pre-COVID levels?
15%
36%
35%
12%
3%
Within 3
months
3-6
months
6-12
months
More
than a
year
Never
Half of respondents
anticipate it will take through
the end of the year or
longer for their organizations’
elective procedure
volumes to return to
pre-COVID-19 levels.
5 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Majority of providers not yet ready for post-COVID-19
telehealth push
Q: How prepared is your organization to meet
the increasing demand for telehealth serves?
36%
56%
7%
1%
We’re fully prepared
with all needed
capabilities
We're somewhat
prepared, but need to
enhance our
capabilities
We’re somewhat
unprepared, need to
enhance/acquire
capabilities
We aren’t prepared,
need to
acquire/develop most
capabilities
67% of executives predict their organizations will use telehealth at least five times more than
pre-pandemic, but only ~one-third believe they have all needed telehealth capabilities.
Q: By the end of the year, how much do you
predict your organization will be using
telehealth compared to last year?
4%
29%
31%
17%
19%
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
About the
same
Twice (2X) as
much as we
used to
5 times (5X)
as much as we
used to
10 times (10X)
as much as we
used to
More than 10
times (10X+)
as much as we
used to
6 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Providers preparing for significant changes
to working arrangements
Q: How will the work-from-home experience impact your strategy for flexible work and space
planning in the future?
16%
20%
43%
22%
It is too early to tell We expect to return to
pre-pandemic work
arrangements with most
employees working onsite
We’ve decided to institute
more work-from-home
options & reassess our
future space use needs
We’ll continue to evaluate
more work-from-home
options & the effect on our
future space use needs
Just 1-in-5 executives
expect their organizations
will return to the
primarily onsite work
arrangements
established pre-pandemic.
22% of executives have
already decided to institute
more work-from-home
options, reassess
future space needs.
7 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Just 11% of all executives –
and only 3% of health
system respondents –
believe federal funding
will be enough to cover
COVID-19-related costs.
Federal funding won’t cover COVID-19-related costs
Q: Do you project government funding will be enough to cover the additional costs
associated with COVID-19 ?
68%
20%
11%
1%
No, we believe it will cover
some, but not enough
No, we believe it will cover
most, but not all
Yes, we believe it will be
enough
We will not receive federal
funding
8 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Increase in thoughtful M&A, partnerships
Q: How does the pandemic change your M&A plans?
71%
14% 15%
Does not change Increases our likelihood of seeking new
partnerships
Increases our likelihood of M&A activity
29% of executives say the
pandemic has increased the
likelihood of their
organization participating in
M&A or seeking new
partnerships.
9 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Providers targeting capital expenditures, labor,
& purchased services for cost reduction
Q: What areas are you likely to target for intermediate- and long-term cost-reduction opportunities?
(Please select all that apply.)
76% 76%
69%
55%
52% 51%
38%
Capital expenditures
(reduction in new or
existing construction,
acquisitions of high-cost
medical equipment and
technology)
Labor (e.g., furlough,
layoffs, hiring freeze,
reducing hours and/or
contract labor
Purchased services (e.g.,
canceling contracts,
renegotiating contracts,
co-management
agreements)
Corporate services (e.g.,
consolidating, automating,
selective outsourcing,
migrating to mobile or
remote work)
Wages and benefits (e.eg.,
pay, canceling 401K
match, delaying or
canceling bonuses)
Supply chain (e.g.,
GPO/pricing, utilization,
variation)
Revenue cycle (e.g., cost
to collect, consolidating
business office)
10 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Digital & service line strategies, revenue cycle enhancements
targeted for revenue growth
Q: What tactics are you implementing or enhancing to grow revenues? (Please select all that apply.)
71%
66%
57%
39% 37%
31%
24%
20%
Digital strategies (e.g.,
telehealth, contact
centers)
Service line strategies
(growing core
business, exiting losing
business)
Revenue cycle
improvement (enhance
accounts receivable
collections)
Payer-rate negotiations Develop new strategic
plan
Physician hiring M&A, partnerships,
joint ventures
Growth into new
geographies
11 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
Cybersecurity preparedness
Q: To what degree have new COVID-19-related work-from-home arrangements and possible new
cyber attacks influenced your focus on cybersecurity capabilities within your organization?
40%
45%
15%
We’re comfortable with our current
cybersecurity capabilities & protocols
We’ll probably enhance our
cybersecurity capabilities & revisit our
protocols
We’ll significantly enhance our
cybersecurity capabilities & revamp
our protocols
40% of executives
say they’re comfortable with their
organization’s current
cybersecurity capabilities, protocols.
15% of respondents think their
organization’s current cybersecurity
capabilities and protocols will require
significant enhancements.
12 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
“Healthcare has largely been insulated from previous economic disruptions,
with capital spending more acutely affected than operations. But this time may
be different since the COVID-19 crisis started with a one-time significant
impact on operations that is not fully covered by federal funding.”
“Providers are facing a long-term decrease in commercial payment, coupled
with a need to boost caregiver- and consumer-facing digital engagement, all
during the highest unemployment rate the U.S. has seen since the Great
Depression. For organizations in certain locations, it may seem like business
as usual. For many others, these issues and greater competition will demand
more significant, material change.”
David Burik
Guidehouse Partner and Payer/Provider Consulting Division Leader
13 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
“Through all the uncertainty COVID-19 has presented, one thing
hospitals and health systems can be certain of is their business
models will not return to what they were pre-pandemic. A
comprehensive consumer-facing digital strategy built around
telehealth will be a requirement for providers. Moreover, shifting
hardware and physical assets to the cloud and use of robotic
process automation has proven to be successful in improving
back-office operations in other industries. Providers will need to
follow suit.”
Chuck Peck, MD
Guidehouse Partner & Former Health System CEO
14 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY
About Guidehouse Commercial Health*
healthcare@guidehouse.com
linkedin.com/showcase/guidehouse-health
twitter.com/GuidehouseHC
Guidehouse’s Commercial Health segment is comprised of consultants, former provider administrators, clinicians, and
other experts with decades of strategy, operational/clinical consulting, public health, managed services, revenue cycle
management, and outsourcing experience. Professionals collaborate with hospitals and health systems, physician
enterprises, payers, local and federal government, and life sciences entities, providing performance improvement and
business process management solutions that help them meet quality and financial goals. For more information, please
visit: www.guidehouse.com/capabilities/industries/healthcare.
* Navigant was acquired by Guidehouse in October 2019.
15 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY

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COVID-19 Hospital & Health System Survey

  • 1. COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY The Impact of the Pandemic on Provider Revenues, Elective Procedure Volumes, Telehealth Use, & Working Arrangements May 2020
  • 2. 2 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Respondents Responses were fielded May 4 - May 8, 2020 40% C-level 10% Vice President 50% Director 174 Respondents 1% 12% 22% 65% Ambulatory care clinic Medical group or specialty practice Health system headquarters / corporate offices Hospital or medical center
  • 3. 3 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Providers projecting revenue & patient volume drops, incremental improvements by year’s end Q: How do you expect your future revenues to compare to pre-pandemic revenue levels? Compared to pre-COVID-19, 89% of executives predict their organizations’ revenues will be lower at the end of 2020. Among respondents, almost two- thirds project decreases of greater than 15%, and one-in- five forecast decreases of more than 30%. 6% 14% 42% 27% 8% 3% –45.1% to –60% –30.1% to –45% –15.1% to –30% –0.1% to –15% 0% to 15% 15.1% to 30%
  • 4. 4 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Providers projecting revenue & patient volume drops, incremental improvements by year’s end Q: When do you anticipate your elective procedure volumes returning to pre-COVID levels? 15% 36% 35% 12% 3% Within 3 months 3-6 months 6-12 months More than a year Never Half of respondents anticipate it will take through the end of the year or longer for their organizations’ elective procedure volumes to return to pre-COVID-19 levels.
  • 5. 5 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Majority of providers not yet ready for post-COVID-19 telehealth push Q: How prepared is your organization to meet the increasing demand for telehealth serves? 36% 56% 7% 1% We’re fully prepared with all needed capabilities We're somewhat prepared, but need to enhance our capabilities We’re somewhat unprepared, need to enhance/acquire capabilities We aren’t prepared, need to acquire/develop most capabilities 67% of executives predict their organizations will use telehealth at least five times more than pre-pandemic, but only ~one-third believe they have all needed telehealth capabilities. Q: By the end of the year, how much do you predict your organization will be using telehealth compared to last year? 4% 29% 31% 17% 19% 0 0.05 0.1 0.15 0.2 0.25 0.3 0.35 0.4 About the same Twice (2X) as much as we used to 5 times (5X) as much as we used to 10 times (10X) as much as we used to More than 10 times (10X+) as much as we used to
  • 6. 6 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Providers preparing for significant changes to working arrangements Q: How will the work-from-home experience impact your strategy for flexible work and space planning in the future? 16% 20% 43% 22% It is too early to tell We expect to return to pre-pandemic work arrangements with most employees working onsite We’ve decided to institute more work-from-home options & reassess our future space use needs We’ll continue to evaluate more work-from-home options & the effect on our future space use needs Just 1-in-5 executives expect their organizations will return to the primarily onsite work arrangements established pre-pandemic. 22% of executives have already decided to institute more work-from-home options, reassess future space needs.
  • 7. 7 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Just 11% of all executives – and only 3% of health system respondents – believe federal funding will be enough to cover COVID-19-related costs. Federal funding won’t cover COVID-19-related costs Q: Do you project government funding will be enough to cover the additional costs associated with COVID-19 ? 68% 20% 11% 1% No, we believe it will cover some, but not enough No, we believe it will cover most, but not all Yes, we believe it will be enough We will not receive federal funding
  • 8. 8 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Increase in thoughtful M&A, partnerships Q: How does the pandemic change your M&A plans? 71% 14% 15% Does not change Increases our likelihood of seeking new partnerships Increases our likelihood of M&A activity 29% of executives say the pandemic has increased the likelihood of their organization participating in M&A or seeking new partnerships.
  • 9. 9 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Providers targeting capital expenditures, labor, & purchased services for cost reduction Q: What areas are you likely to target for intermediate- and long-term cost-reduction opportunities? (Please select all that apply.) 76% 76% 69% 55% 52% 51% 38% Capital expenditures (reduction in new or existing construction, acquisitions of high-cost medical equipment and technology) Labor (e.g., furlough, layoffs, hiring freeze, reducing hours and/or contract labor Purchased services (e.g., canceling contracts, renegotiating contracts, co-management agreements) Corporate services (e.g., consolidating, automating, selective outsourcing, migrating to mobile or remote work) Wages and benefits (e.eg., pay, canceling 401K match, delaying or canceling bonuses) Supply chain (e.g., GPO/pricing, utilization, variation) Revenue cycle (e.g., cost to collect, consolidating business office)
  • 10. 10 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Digital & service line strategies, revenue cycle enhancements targeted for revenue growth Q: What tactics are you implementing or enhancing to grow revenues? (Please select all that apply.) 71% 66% 57% 39% 37% 31% 24% 20% Digital strategies (e.g., telehealth, contact centers) Service line strategies (growing core business, exiting losing business) Revenue cycle improvement (enhance accounts receivable collections) Payer-rate negotiations Develop new strategic plan Physician hiring M&A, partnerships, joint ventures Growth into new geographies
  • 11. 11 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY Cybersecurity preparedness Q: To what degree have new COVID-19-related work-from-home arrangements and possible new cyber attacks influenced your focus on cybersecurity capabilities within your organization? 40% 45% 15% We’re comfortable with our current cybersecurity capabilities & protocols We’ll probably enhance our cybersecurity capabilities & revisit our protocols We’ll significantly enhance our cybersecurity capabilities & revamp our protocols 40% of executives say they’re comfortable with their organization’s current cybersecurity capabilities, protocols. 15% of respondents think their organization’s current cybersecurity capabilities and protocols will require significant enhancements.
  • 12. 12 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY “Healthcare has largely been insulated from previous economic disruptions, with capital spending more acutely affected than operations. But this time may be different since the COVID-19 crisis started with a one-time significant impact on operations that is not fully covered by federal funding.” “Providers are facing a long-term decrease in commercial payment, coupled with a need to boost caregiver- and consumer-facing digital engagement, all during the highest unemployment rate the U.S. has seen since the Great Depression. For organizations in certain locations, it may seem like business as usual. For many others, these issues and greater competition will demand more significant, material change.” David Burik Guidehouse Partner and Payer/Provider Consulting Division Leader
  • 13. 13 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY “Through all the uncertainty COVID-19 has presented, one thing hospitals and health systems can be certain of is their business models will not return to what they were pre-pandemic. A comprehensive consumer-facing digital strategy built around telehealth will be a requirement for providers. Moreover, shifting hardware and physical assets to the cloud and use of robotic process automation has proven to be successful in improving back-office operations in other industries. Providers will need to follow suit.” Chuck Peck, MD Guidehouse Partner & Former Health System CEO
  • 14. 14 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY About Guidehouse Commercial Health* healthcare@guidehouse.com linkedin.com/showcase/guidehouse-health twitter.com/GuidehouseHC Guidehouse’s Commercial Health segment is comprised of consultants, former provider administrators, clinicians, and other experts with decades of strategy, operational/clinical consulting, public health, managed services, revenue cycle management, and outsourcing experience. Professionals collaborate with hospitals and health systems, physician enterprises, payers, local and federal government, and life sciences entities, providing performance improvement and business process management solutions that help them meet quality and financial goals. For more information, please visit: www.guidehouse.com/capabilities/industries/healthcare. * Navigant was acquired by Guidehouse in October 2019.
  • 15. 15 COVID-19 HOSPITAL & HEALTH SYSTEM SURVEY