How the coronavirus will permanently reshape the healthcare industry, according to 26 top industry leaders
Jun 24, 2020, 9:50 PM
From left to right: CVS Health CEO Larry Merlo, Bristol Myers Squibb CEO Giovanni Caforio, Epic Systems CEO Judy Faulkner, and Kaiser Permanente CEO Gregory Adams. CVS Health; Bristol Myers Squibb; Epic Systems; Kaiser Permanente; Shayanne Gal/Business Insider
The healthcare industry is on the front lines of the effort to treat coronavirus patients and cure the disease.The pandemic presents unprecedented challenges for the entire industry, from doctors and hospitals to drugmakers.We talked to 26 top leaders in healthcare about how the pandemic is changing their companies, the industry, and the world.This feature is part of a series based on conversations with more than 200 CEOs on how business will be transformed by the coronavirus. To read more, click here.
The healthcare industry has been forced to confront the scourge of the coronavirus like no other part of the US economy.
Healthcare workers are on the front lines of the battle against the pandemic, treating sick patients flooding hospitals. At the same time, the outbreak halted many of the most lucrative parts of the industry, such as surgeries and procedures, threatening the financial futures of hospitals and leading to pay cuts and furloughs for workers.
Even as visits and procedures start to resume, doctors are taking extra precautions, limiting the number of patients they can see and raising the cost. Online visits seem to have carved out a permanent place in the system, too.
Meanwhile, biotech and pharmaceutical companies are scrambling to come up with a treatment or a vaccine to halt the coronavirus. More than 140 vaccines are in the works, and dozens of drugmakers are working on treatments for the coronavirus.
At the same time, coronavirus has exposed the industry's vulnerabilities: hospitals ran short of protective gear, leaving workers without masks and gowns to protect them from the virus. While the worst predictions haven't materialized, hospitals in hard-hit areas took extraordinary measures to make space for coronavirus patients, turning lobbies and surgery suites into rooms for patients.
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Some of the industry's challenges, though, aren't unique. Doctors and nurses are trying to figure out how much of their work they can do over video and by phone, a task similar to the one facing office workers worldwide. And more broadly, executives are trying to navigate a future in which more work, and more healthcare, happens virtually.
We asked top leaders across healthcare three questions:
How will the coronavirus change your company, your industry, and the world.
Their answers, edited for length and clarity, follow.
This article was published on May 12 and has been updated.
Ido Schoenberg, co-CEO of American Well: 'We are in for a challenging period as a nation.'
Ido Schoenberg. American Well
People tend to think that the main challenge of this crisis relates to the viral infection, but the biggest burden has actually been on traditional care. The seniors and those who are chronically ill are suddenly stuck at home. Their ability to access the care they need through technology has been an enormous relief.
The demand for telehealth skyrocketed. On average we are now operating at more than 10 times last year. There were lots of barriers that prevented this wonderful tool from being truly adopted that have since been removed.
The current crisis is horrific. It's horrific from a health standpoint. It's also horrific from an economic standpoint. We see that many people are losing their jobs. Many businesses may or may not survive this. And a recession is likely.
In a situation like that, lots of problems happen, right? Healthcare is funded by a lot of self-insured employers, for example. Healthcare is funded by the government, and the government may have a lot on its plate going forward. So I think that we are in for a challenging period as a nation, and everybody will feel the impact in one way or another.
But telehealth is also very, very efficient. And there is a lot to be said about the enormous clinical waste that we see in healthcare today.
Digital connectivity isn't just about videoconferencing.
That ability to connect data from patients, move it into the cloud, analyze it in real time, and send the right intervention back into their most convenient location, which typically is the home, is this fundamental change.
And there is a word for that. What you are going to see is the democratization of healthcare.
Giovanni Caforio, CEO of Bristol Myers Squibb: 'We are learning valuable lessons on being nimble, collaborating in new ways and leveraging talent.'
Bristol-Myers Squibb CEO Giovanni Caforio Getty Images
COVID-19 has the potential to enhance the strong collaboration among academia, government and other companies as we focus on treatments and vaccines for the virus.
During this pandemic, it has been abundantly clear that the biopharma industry plays a critical role in the prevention and treatment of viruses like COVID-19. Our industry is working around the clock to find treatments and a vaccine and we are sharing those findings with governments and other companies.
I believe that our ability to partner with other scientific organizations, our development expertise and manufacturing capabilities are what will ultimately help us treat and prevent this virus, and I have been impressed by the collaboration and speed with which our industry is responding. My hope is that collaboration will continue.
As I reflect personally, I see that the COVID-19 pandemic has affected our society and communities and caused everyone to look at life differently. The virus has brought out some of the best in humanity, through a strong focus on philanthropy and relief efforts, science and innovation, and incredible support for the health care workers and those on the front lines.
This is an unprecedented time and it is my belief that we are learning valuable lessons on being nimble, collaborating in new ways and leveraging talent in new and different ways. Understanding that every person is navigating this crisis with a different personal reality, our work policies account for flexible hours and schedules, which enables our colleagues to better juggle their responsibilities at home with work.
We are open to taking these lessons and applying them to work in the future. I believe we will be an even stronger company because of the pandemic.
Mark Ganz, CEO of Cambia Health Solutions: 'We're going to have a mental health epidemic that's going to follow this virus.'
Mark Ganz, CEO of Cambia Health Solutions Cambia Health Solutions
We will be probably more of a remote-working company than we were before, because we will learn that we can.
We're going to have a mental health epidemic that's going to follow this virus. We've put a lot of thought into how can we proactively work to address that.
There's an opportunity for this country to realize that mental health and physical health are not so different. They are completely interrelated and one of the paths to people getting physically healthy is going to be paying better attention to their mental health.
We are in the middle of a game change around more convenient forms of care.
Why is it that when someone's sick, they must go to the bricks and mortar palace, wait in a waiting room for a long time and then be told, Oh, the doctor will see you now. We could do better than that.
I believe that the only way we're going to come up with a resilient, long term workable solution is going to be public-private partnerships work where businesses can kind of work cheek to jowl or hand to glove with public health agencies and we solve these challenges together.
I'm hopeful that one of the things that will come out of this is that there'll be a reset of the social compact between those in 'the healthcare industry' and those who we serve and that it will be much more focused on the human experience and recognizing that what we're supposed to be doing is taking care of the individual.
[I'm hopeful that COVID] will unleash a human centered level of innovation because we have to have that in order to be able to get through this. As hard as the Great Depression was, that was also what bore the greatest generation. I believe that something like that is at work here.
Seema Verma, administrator of the Centers for Medicare and Medicaid Services: 'Our focus is on providing high-quality care.'
Seema Verma, administrator at the Centers for Medicare and Medicaid Services Michael Brochstein/SOPA Images/LightRocket via Getty Images
We're having those conversations [with health systems and insurers].
One example that we hear about all the time is telehealth, and that's a great example of a service that is creating greater flexibility and accessibility for our patients. And so we're continuing as part of this effort to really think about what should be maintained and what is part of our longstanding effort, "Patients over Paperwork." That really fits into a lot of what we've been trying to accomplish over the last three years.
We continue to hear from healthcare providers on the front lines about what's burdensome. It has created a lot of discussion even within CMS about some of these items — do they really need to be continued? We will be assessing this fully after we get past the pandemic.
One of the things that we're also focused on is to make sure that we have strong program integrity and that the changes that we make aren't going to have a negative impact on the Medicare trust fund. Our focus is on providing high-quality care and making sure that we are leveraging technology and modernizing the program to provide high-quality care to our Medicare beneficiaries.
Brent Shafer, CEO of Cerner: 'It's like the foundation is there, the wiring has been laid, but often it's not utilized to its fullest extent'
Brent Shafer. Cerner
Moving our almost 30,000 employees to a virtual organization — while also helping providers address different surges and needs around the world — has been a very intense effort.
We deal with about 250 million patient records from around the world. And there's about 3 million users on our systems each day. Putting providers in a position where they can deliver the care that's needed through this is really key.
We often say that, in a way, healthcare is mostly digitized — because we were one of the companies that helped to make that happen. On the other hand, it's like the foundation is there, the wiring has been laid, but often it's not utilized to its fullest extent.
When put to use, it can accomplish a great deal. A health system in Seattle, for instance, was one of the first hit with a surge of coronavirus patients in the US. Through a forum on Cerner's platform for patient data, they were then able to share some of their emergency department protocols with a broader group of providers.
I think healthcare groups around the world will show more interest in really using the capabilities around data analytics. So that they can then anticipate what's coming, anticipate the needs, and look at the health of populations in a more organized way than we have in the past.
Neil de Crescenzo, CEO of Change Healthcare: 'Things are just moving a lot faster than they used to.'
Neil de Crescenzo. Change Healthcare
Everybody in the country is trying to figure out what's going on with the spread of COVID, literally on a daily, if not hourly basis. And historically, the healthcare system hasn't been that dynamic or fluid.
There's about $350 billion of payments made to providers with paper checks in this country.
We've been working with our customers to make all of that electronic for a long time, but suddenly — when they're looking at how to minimize the need for people to come into the office — it becomes an even bigger priority. We've also helped people virtually enroll for Medicaid or disability using capabilities like DocuSign. A lot of the regulators required things to be done in person, but now people are finally doing away with those restrictions.
Whether it's operating the clinic or the hospital, whether it's dealing with getting people the financial support they need, or even having payments be facilitated between payers and providers — things are just moving a lot faster than they used to.
Hospitals and regulators have had to adapt very quickly to greater data liquidity and the capabilities we provide to put that data in the hands of anybody, with appropriate consent, who needs it. They're realizing that we, perhaps, should have been even more aggressive and in that coming to pass. And I think that ethos will remain long after the crisis is over.
Janice Nevin, CEO of ChristianaCare: 'We accomplished two to three years of work in about two to three weeks.'
Dr. Janice Nevin, CEO of ChristianaCare Courtesy of ChristianaCare
Our pre-COVID mantra was: "Everything that can be digital will be digital. Everything that can be done in the home will be done in the home."
We expected that work to be the core of our next several years' strategic plan. We accomplished two to three years of work in about two to three weeks once we found ourselves needing to address the COVID-19 issues.
We had one virtual practice. We now have 160 virtual practice sites. We also have a sophisticated data platform called CareVio that aggregates, analyzes, and uses predictive analytics to set alerts to manage populations.
We created a COVID-19 monitoring practice that uses secure texting and alerts to elevate a patient who has a deterioration in their symptoms to do a virtual visit for appropriate management.
One of my colleagues said, "Now that the genie is out of the bottle, we won't be putting it back in."
I do see providers and patients who are now having a very different experience. They will want to continue to have that experience and to be able to get significant parts of their care digitally from home.
Everything we learned about managing COVID-19 on the virtual monitoring practice can be applied to multiple chronic diseases, including diabetes, congestive heart failure, chronic obstructive pulmonary disease, and asthma.
This move to digital technology, to a virtual platform, will be something that the industry as a whole will embrace to various levels of sophistication depending on where a particular health system might have been before this. This is one of the ways that we create value, impact health, and make care more affordable.
The other thing that we've learned from this experience is how hospitals play an incredible role in the public health infrastructure and the economy in their communities.
Steve Miller, chief medical officer of Cigna: 'This is actually going to be the permanent opportunity to lower the cost, improve the quality of healthcare.'
Express Scripts Chief Medical Officer Steve Miller Reuters
There's going to be actually some really interesting, good things for healthcare to come out of this.
We really believed that telehealth was going to be important for the future. But as you know, telehealth was off to a really slow start. But now it has gone nuts. The amount of telehealth we're doing now is extraordinary.
We believe that this is actually going to be the permanent opportunity to lower the cost, improve the quality of healthcare.
We've seen an explosion in mail-order pharmacy. So people truly are taking advantage of not only the longer fill you get, the 90-day fill that gives you piece of mind for supply, but they loved the idea that it comes directly to their home.
Because we have employer-based healthcare in the US, people losing or having to shift their benefit obviously is a challenge for us. We're seeing a real growth in people moving to the exchanges and also we've developed pharmacy capabilities for those recently unemployed.
I think what we're seeing is a level of cooperation both within the industry but also with our provider partners. I think that some of it will go back towards normal when the crisis passes because this is a really expensive way to manage healthcare.
For the industry we're going to see both challenges, challenges by more people moving to the exchanges. more people moving to Medicaid. But we're going to see advances that are actually going to make for better healthcare system that's lower in cost and personalized.
We were all moving towards more common areas. Now if you actually have a private office you're feeling a little better about it. We're going to need quite a while until we have a vaccine, so how you social distance in the worksite is going to change.
Tom Mihaljevic, CEO of Cleveland Clinic: 'We are going to see the resurgence of manufacturing domestically.'
Dr. Tomislav Mihaljevic, president and CEO of Cleveland Clinic Courtesy of Cleveland Clinic
Before the pandemic, about 2% of our visits were based on the digital interface. Right now, 75% of our ambulatory care is being provided through digital. That's definitely here to stay.
What is also going to change is that a lot of care will be delivered at home rather than in hospital to keep the hospital environment safe as well as patients way less exposed to infections like this.
Every country, the US in particular, will make sure our dependency to provide healthcare isn't completely dependent on getting supplies from foreign sources. We are going to see the resurgence of manufacturing domestically that will provide critically important items, including pharmaceuticals, personal protective equipment, and technology. This will allow us to be not so easily exposed to the shortages that we're currently experiencing.
We are very likely going to see an accelerated decline in individual private practices or group practices that will simply not be able to withstand the financial pressures of a large pandemic like this.
We're going to see fewer, yet larger, integrated healthcare delivery systems that will be caring for a larger number of patients, and a declining number of smaller systems and some smaller standalone hospitals as well.
People about to start their medical careers will be thinking twice about whether they're going to go into a private practice or join a large integrated healthcare system. One reason is financial, but the other reason is the dependency of technology.
Provision of care through telemedicine, through data analytics and artificial intelligence, is going to be difficult to source if you're a private practitioner. A large integrated healthcare delivery system has the ability to provide the tools for the delivery of 21st century healthcare.
Lloyd Dean, CEO of CommonSpirit Health: 'We must more effectively meet patients where they are.'
Lloyd H Dean CEO of CommonSpirit Health CommonSpirit Health
The new future will be one in which our operations will need to anticipate and meet the demand of rapid surges. Our sustained resilience in the face of unanticipated stresses on our system is going to be more important than ever.
We are taking the lessons from these past few months and undergoing serious planning so we can flex our system in ways we haven't needed to in more than a generation.
More than ever, the spread of COVID-19 has also brought to light how much our health depends on the local environment around us. Healthcare should be more responsive to the needs of everyone, especially vulnerable and underserved populations who have been disproportionately affected by this virus.
We must more effectively meet patients where they are when mobility is limited if brick and mortar care sites are impaired for any reason. One of the positive things that can come out of this tragic pandemic is if we use data to target necessary health services locally and make care more convenient and accessible to our communities.
We now have the tremendous duty to walk with our most vulnerable patients through their medical, behavioral, and social health needs that may have gone unattended during this crisis. My greatest hope is that we will rebuild the healthcare system so that it is stronger and serves all people.
As a global society, there is a realization that we aren't invincible. All of the benefits of our global economy also left us more exposed to the transmission of viruses such as COVID-19. We need to prioritize cooperation on a global scale to ensure early monitoring and detection of outbreaks.
Larry Merlo, CEO of CVS Health: 'We're reaching consumers, we're helping them stay safe'
CVS Health CEO Larry Merlo Courtesy Forbes
We've got a new strategy as part of CVS and Aetna becoming one company. For us it's really more about the affirmation of the strategy, the role that we want to play in people's health.
We're reaching consumers, we're helping them stay safe. We've waived fees around home delivery, we increased access to critical offerings like telemedicine. We are confident that the strategy that we've been working on building is the right one for the future. This convenience-based model, it's not going to go away.
A lot of what we're doing will become part of the new normal.
We've talked about three important goals as part of that strategy. The first one being local, whether it's in the community, in the home, work, or now for many in the palm of their hand through digital devices.
We're seeing terrific examples of public-private partnerships. Obviously there's a lot of discussion currently in the news around the role of testing. Are we adequately testing people today? What will be testing needs for the future?
We've forged partnerships, both at a federal and state level in terms of responding to the needs for testing.
That's something that we absolutely don't want to lose. The private sector plays a critically important role in innovation and competition. I hope we can continue to capitalize on any opportunities that can create to bring solutions to unmet needs.
The world has to work together to avoid the next pandemic. I hope that's something that all of us will never forget what we're experiencing, and how we can avoid that.
Judy Faulkner, CEO of Epic Systems: 'There are going to be bankruptcies. It's going to be a tough, tough time.'
Judy Faulkner. Epic Systems
The health systems in general are in financial distress right now. So that's going to affect their staffing levels and morale, their capital expenditures, and their operating expenditures. There are going to be bankruptcies. It's going to be a tough, tough time.
A lot of our customers have seen a 35% to 55% drop in revenue. That's a lot. And if you do that month after month, you can't keep affording to pay your staff. So that's going to be a big problem. There's already been at least one bankruptcy. And there'll be mergers and acquisitions, as some of the smaller providers will get purchased by larger health systems who can afford to stay afloat.
There may be more interest in doing HMOs and other arrangements where the patients are capitated, because those folks didn't get hit as hard financially. Because they get paid a regular amount every month, and it doesn't matter whether there's a virus.
There's a lot of nice things, too, and more creative thinking. There's been better reimbursement models for digital health, new infection control processes, and far more video visits. We calculated there are 100 times as many video visits as there were in months before the pandemic.
We'll see more remote training, remote patient monitoring, and faster implementations of technology. We ended up doing a whole bunch of implementations in three to five days. They normally take months. We did the Javits Center in New York, we did McCormick Place in Chicago, we did the Navy ship Comfort — all in just a few days.
I think there'll be more of a focus on public health surveillance and more of a focus, too, on capacity and resource management. For Epic, I think that we will be helping some of the governments in the states and maybe the federal government with their health information.
Jaewon Ryu, CEO of Geisinger: 'Hospitals will think about their supply chain differently.'
Dr. Jaewon Ryu, CEO of Geisinger Geisinger
What will we do differently coming out of COVID? I actually think communication. I always thought we did it pretty well, but wow. We never could have imagined how much we could take it to a different level.
[On telemedicine and mail order pharmacy program] The program has just kicked into a different gear as a result of COVID. And I don't think that we'll go back on that because once consumers, once patients have a taste of the convenience andof the experience itself, I don't see them going backwards.
I do think hospitals will think about their supply chain differently. The name of the game in supply chain was always 'just in time supply' and making sure that you didn't keep too much of an inventory.
But I think this has made most hospitals think about, well that may be fine, but then you've got to be able to tap on a whole lot more capacity in your supply chain pretty quickly in the event you face an emergency.
I think this will change the whole world, but it's this notion that we're all in it together. I do think there's more of that. I see more systems working together. I see more folks working together.
I think going to large, crowded kinds of environments, even after we're on the other side of COVID, I think people will exercise a little more caution before they're going to the big venues.
I think people will be a lot more careful around things like hand hygiene, keeping surfaces clean and, and covering their mouths if they're coughing or sneezing.
George Hager Jr, CEO of Genesis HealthCare: 'Our industry will be much better prepared for the next pandemic.'
George Hager Jr, CEO of Genesis HealthCare Courtesy of Genesis HealthCare
We will make sure in our emergency planning that we have a greater ability to cohort patients and isolate patients upon admission that are potentially COVID-positive or are impacted by whatever the next pandemic is, so that we can do a better job — a more effective job — of protecting that part of our population that is already frail and compromised in the skilled nursing setting from those affected by the virus.
We have at least five facilities that are dedicated COVID-only buildings. We are admitting directly from the hospital patients that have tested positive for COVID-19. Concerns you have here, especially in your hotspots, is that the hospital beds get backed up, and there needs to be a discharge source that is a protected and safe site of service for those patients that tested positive but are stable.
Our industry will be much better prepared for the next pandemic, and we will be able to react much more quickly, to create and establish those dedicated units that are isolated from the rest of a population that is congregating in an institutional setting.
We have a segment of our business that we call PowerBack, which was constructed more recently to handle a short-term, more therapy-oriented population. They're all private rooms. The common space is much larger. The clinical capabilities in these buildings are typically much higher, with a much greater presence of physicians and physician-extender type of clinical skill. The average length of stay in those buildings is 15 to 20 days.
We know that if we have a pending crisis, what we could do now empty those buildings out very quickly and have them ready — in relatively short notice — to accept affected people by any infectious disease or virus.
David Feinberg, the head of Google Health: 'Access to the right information, at the right time, can save lives.'
Dr. David Feinberg, the head of Google Health Courtesy HLTH
We learn a lot during times like this. It can help us break through the status quo and support efficiencies and innovations that mean better care and outcomes.
For example, it's amazing to see the quick and massive rise of virtual care, coupled with regulatory support for doctors practicing across state lines, that have arisen due to providers reducing or ceasing in-person visits.
The pandemic has also brought to the forefront the usefulness of data towards anticipating healthcare needs and resource allocation. Just as public health authorities cast a wide net to understand COVID-19 and what public and environmental factors may help in predicting its spread, there will be a greater appreciation for how data could also help communities respond to other conditions — whether that's cancer, heart disease, diabetics, poor nutrition, and more.
I think that the industry will come away with more interest, and higher expectations.
We think about how we can bring the best of Google expertise, people and technologies to help connect people to the right resources when they're sick, keep them healthy, and solve big healthcare challenges. In times of an emerging global health threat, this means doing things like boosting authoritative content in Search and YouTube tailored to people's information needs around the pandemic and helping people connect to safe and convenient virtual care.
Access to the right information, at the right time, can save lives. In addition to Google's Cloud offerings for healthcare, we've also been able to stand up new initiatives to help public health officials respond to COVID-19.
I am particularly proud of our COVID-19 Community Mobility Reports which uses anonymized, aggregated location data to help officials make decisions to prevent further spread of the virus.
William Fleming, president of Humana's clinical and pharmacy solutions segment: 'We need to take telehealth to the next level.'
Humana segment president of Humana’s clinical and pharmacy solutions William Fleming Humana
The transformational power of telehealth was steadily rising prior to the pandemic, but its usage has significantly accelerated. If a primary care practice wasn't using telehealth six weeks ago, chances are it is well-versed in it today.
At Humana, we've been on the telehealth journey for some time, but we need to take telehealth to the next level so we can improve both health and health care.
Now, more than ever, the general public understands and can empathize with things like social isolation. We've long identified this as a social determinant of health that, in particular, affects seniors in our society. But today, it's more real for many of us.
Going forward, we will be able to work in a different, and hopefully more accepting, way to provide whole-person health care – care that encompasses both body and mind, taking into account the many social factors that play a significant role in our overall health and well-being.
The world needs to be prepared for the potential re-emergence of the coronavirus, either later this year or in 2021. We have a real-world case for change, and it starts with industry and government enhancing our innovation and readiness. This will enable us to build stronger partnerships that will help physicians and other clinicians protect people from the virus as we race towards new treatments and a vaccine.
We have all been reminded about the importance of caring for one another.
