Specialist
Former VP at HCA Healthcare Inc
Agenda
- US hospitals update – carrying capacity, and ramifications if they are overrun
- Efficacy of US government programmes to support hospitals
- Short-term impact of COVID-19 coronavirus, and how hospitals will adjust
- Outlook including best- and worst-case outcomes from COVID-19
Questions
1.
Could you outline the impacts of the novel coronavirus pandemic across various aspects of hospital service lines?
2.
What are your thoughts on the pros and cons of the US decentralised system and the ability to respond to the coronavirus?
3.
How closely are hospitals sticking to the guidelines from HHS [Health and Human Services] and CMS [Centres for Medicare & Medicaid Services]? How is this managed on a state-by-state basis?
4.
Elective procedures are now being deferred for at least 6-8 weeks, potentially longer. How many of these elective procedures will be deferred vs completely lost? What percentage of revenues are likely to be lost, in your view, as a result of this?
5.
Are there any elective surgeries still going through? This will probably differ state by state, region by region, depending on the prevalence of the coronavirus. Is there anything that is essentially non-life- threatening being deferred?
6.
Could telehealth be a way to mitigate a lack of uptick in volume, to at least get patients and doctors face-to- face to set up these elective surgeries down the line whenever we do get out of this pandemic? As you alluded to, there may be some trepidation in terms of doing surgeries in the hospital setting, even after all of this. What are your thoughts on telehealth and its ability to mitigate some of that volume issue?
7.
How would you compare the performance of ASCs [Ambulatory surgery centres] compared to hospitals through the novel coronavirus? Where might there be more significant impact?
8.
In a recessionary environment, do you favour ASCs vs hospitals, given the lower cost structure and some of the other factors that you mentioned?
9.
With unemployment potentially rising, how might this impact profitability as more people move off commercial insurance? Do you think we can take the 2008-09 recession as a potential template in that, as you mentioned, 2-3 years down the line, there might be an uptick? How do you think that dynamic might play out, specifically with the commercial insurance component?
10.
What disruption could there be to the healthcare ecosystem as a result of back office and coding disruptions from India that is outsourced often?
11.
Do you have any insight into what hospitals are charging for coronavirus testing, including the cost of the test and the cost of the ED [emergency department] visits? How does that break down between commercial and Medicare?
12.
What can hospitals do to increase ICU [intensive care unit] treatment capacity? Anecdotally, some health systems are asking for a potential 400% increase in that capacity. How significantly can hospitals truly increase capacity? What is a realistic expectation?
13.
Will there be numerous different outpatient options being leveraged as a way to reduce burden on hospitals? What settings lend themselves best to helping to alleviate some of that burden?
14.
How do you view the mid-term impact to margin as hospitals eventually do seek to catch up on some of the procedures? How do you view that margin catch-up dynamic over 6-12 months?
15.
What are the differences in impact between for-profit and non-profit hospitals?
16.
To what extent are hospital budgets being stretched? What effect could this have on CAPEX decisions from these hospitals?
17.
Is there anything we have not discussed that you would like to highlight?
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