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The COVID-19 pandemic has upended the practice of medicine in doctor’s offices and clinics with implications for practice operations and strategy. 

The NextGen® Advisors team has been conducting interviews with practice leaders across the country over the past couple months regarding the impact of the pandemic on ambulatory operations. In recent conversations with clients we have touched on the topic of strategy, inquiring whether the pandemic has altered their organization’s short and medium-term plans. 

Not surprisingly, all leaders described the significant effort their teams have undertaken to implement telehealth, to appropriately triage and screen patients at risk for coronavirus infection and to prioritize needs which require a face-to-face encounter. Most are now also focused on the changes to their practice which will survive the pandemic and might require a strategic pivot. 

The themes emerging from these conversations fall into categories associated with returning to a sustainable volume, changing core operating processes, redeploying staff and considering the use of physical space to provide care in a safe and timely manner. Federally Qualified Health Centers (FQHCs), primary care and behavioral health providers have rapidly adopted telehealth technologies for many day-to-day care needs and are now shoring up their infrastructure to support increased telehealth volumes with patient scheduling, document collection and validation, check-in and check-out processes, virtual waiting rooms and post-encounter documentation. Further, the dramatic increase in the use of telehealth has leaders considering different roles that care team members and providers will perform on a daily basis in order to support both virtual and face-to-face encounters.

With the potential to continue to work from home on a go-forward basis (providers doing virtual care, care managers doing outreach and coordination activities, or administrators managing billing and coding functions) some organizations are thinking strategically about their physical space, considering the future of their empty waiting rooms or the need to create distance for staff on-site.  Others, particularly in expensive urban settings, recognize this as an opportunity to reduce their physical footprint in the future and hence reduce their overhead costs.

Procedure-based specialties have been hit particularly hard with the postponement of elective procedures, however care teams in these practices have continued to perform pre-procedure preparation and post-surgical follow-up via virtual visits while they await the reopening of their facilities. Leaders in some of these procedure-focused practices have taken this unanticipated downtime to do a deep dive into their managed care contract arrangements with payers; evaluating how to shift away from a productivity incented fee-for-service model and move toward reimbursement that rewards outcomes, value and patient experience.

For many healthcare provider organizations who find themselves in the figurative ‘eye of the storm’, now is not the time to dramatically alter their core strategy; but it may be time to strategically review their operations to identify areas which would benefit from a pivot to ensure a sustainable future. 

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Graham Brown

Graham Brown

Senior Vice President, NextGen Advisors

Graham Brown is a principal and senior vice president with NextGen® Advisors focused on transforming care with provider organizations. His practice centers on accountable and value-based care strategy, population health management programs, and technology solutions for providers enabling new models of care delivery across the United States.

Mr. Brown is a former senior vice president and national practice leader for population health and clinical integration with GE Healthcare Partners (previously The Camden Group) where he led multidisciplinary client teams in strategy creation, program development, implementation, operations, and performance optimization engagements. He is an experienced leader in organizational development, managed care contracting, and change management initiatives.

Mr. Brown has over 25 years’ experience supporting provider groups, health and hospital systems, integrated delivery networks, and managed care payers to assess, design, contract, and implement systems and structures for population health management. He has worked nationally across the United States and Canada.

Graham completed his undergraduate studies at the University of Victoria, the Emily Carr University of Art and Design, and the Instituto Europeo di Design in Florence, Italy. He is certified in conflict resolution and negotiation by the Justice Institute of B.C. and received his Master of Public Health from the University of Rochester Medical Center.