1、NOWNEXTWhat to do Now, What to do NextCOVID-19: Rapid ResponseRapid Response Navigating the human and business impact of COVID-19 April 2020 Coronavirus is a global pandemic Source: 1World Health Organization, Situation Dashboard This health and humanitarian emergency presents a serious threat to pe

2、ople across the planet. The World Health Organization has now upgraded the global risk to “very high,” confirming that this is a serious challenge for humanity. The priority is to protect the health and safety of people, including in their workplaces. Business leaders must make rapid decisions, and

3、take immediate actions, to protect and support their workers while ensuring that critical business operations continue. Health care industry challenges Providers and Payers need to overcome a spike in demand while facing challenges to their business operations Sources: 1. Modern Healthcare; 2. NPR;

4、3. Fierce Healthcare; 4. FDA; 5. S&P Global INCREASED CARE DEMAND Sudden increased demand for COVID-19 testing1with limited inpatient room capacity2 COORDINATION OF RESPONSE Manage a cohesive organization wide response in conjunction with government and ecosystem partners SURGE IN SERVICE CALLS Upli

5、ft in service call volumes from patients and members seeking guidance BUSINESS CONTINUITY RISKS Supply chain disruptions3,4, infection of workforces, and testing of business continuity protocols MONITORING & REPORTING Need to respond to government mandated reporting and restating financial forecasts

6、 WORKFORCE EFFECTIVENESS Employees working from home while experiencing challenges in securing laptops5while managing disruptions to their own dependent care In the next week, a rapid response is required to proactively manage -and be ready to react -to the ever changing challenges of COVID-19 Whatn

7、ow? COVID-19 response center framework ASSETS, CAPABILITIES, AND TECHNOLOGY ENABLERS COVID-19 RESPONSE CENTER Accentures COVID-19 response center framework includes specific market actions, differentiated assets and capabilities, and innovative technology enablers FINANCIAL STABILIZATION AND SUSTAIN

8、ABILITY BUSINESS CONTINUITY SURGE RESPONSE COMMUNICATION AND COLLABORATION MONITORING AND REPORTING The steps to readinessThe steps to readiness Surge Response Scale virtual care messaging and visits for quarantined and or “concerned well” patients Prepare to triage and prioritize scarce assets asse

9、ss options to create facility and resource capacity Launch and maintain COVID- 19 digital communications and virtual assistants Create COVID-19 hotlines for members and patients Expand contact center virtualization and surge staffing Business Continuity Assess and address potential supply chain disr

10、uption Validate business continuity plans internal and with external partners Prepare to return to normal as efficiently as feasible think long-term Prepare and enable telecommuting and remote resources Explore options to address employee childcare during crisis Assess and report financial impact (i

11、.e., hot reporting) Financial Stabilization and Sustainability Communication and Collaboration Increase community education activities Establish employee relations hotline for COVID-19 Prioritize media and government agency relations activities establish priority channels and cadence Prepare to augm

12、ent clinical capacity and activate community health resources Monitoring and Reporting Continuously assess and monitor potential COVID-19 threats Perform COVID-19 specific social media monitoring Create and utilize predictive models to forecast potential impact Confirm operations census and KPI repo

13、rting is available Anticipate and prepare for mandated reporting (federal, state, and local) Health plans and providers are assessing and quickly mobilizing to respond to emerging threats and impacts of COVID-19 using these steps: Payer Address near-term financial response Model future scenarios and

14、 impacts on financial plans Manage reputational risk with transparent financial reporting and community leadership Provider Focus on immediate cash flow and liquidity Capture charges for new services, assets, and locations Deploy interim labor strategies to balance demand, safety, and expense Accent

15、ures accelerators are available to help support a rapid response Asset summary Surge Backorder RPA Tool Procurement Planning Tools Workforce Management Tools and Capabilities Scaling Elastic Workforce Social media monitoring for Panic Score and Risk Spread Social Media Capabilities (Sprinklr) Key Me

16、trics Monitoring and Reporting Accenture Health BPS Virtual Support Room Virtual Assistant Accelerators (ACE) Contact Center Virtualization AMBG super agent Accenture BPS HR Hotline KEY: KEY: Available, Piloted in COVID-19 Microsoft Teams Collaboration Business Continuity Financial Stabilization and

17、 Sustainability Communication and Collaboration Monitoring and Reporting Accenture provides this information to clients to highlight industry practices based on our background and experience. Recipients should be mindful of their own industry guidelines, laws and applicable policies and seek appropr

18、iate counsel and guidance as they implement any solutions. Your Accenture account team will work with you to structure the delivery of those services based upon account specific, applicable regulations and laws governing the health care industry. Payer Membership Scenario Models Revenue / Case Mix I

19、mpact on Providers SMB COVID19 Navigator Provider Up-to-Date CARES Act Analysis Cashflow and Working Capital Analytics COVID-19 Community Outreach Index Smart Spend Analytics (ZBS) COVID-19 Charge Capture Backlog Alleviation Ramp-up Methodology Detailed actions, assets Detailed actions, assets and e

20、nablers to remain and enablers to remain ready to react, rapidlyready to react, rapidly What next? Surge response Surge response call center operationscall center operations Market actions 1. Launch and maintain COVID-19 digital communications and virtual assistants - prevent calls to the call cente

21、r by informing patients through web, mobile, social, email, and text communications and AI-powered virtual assistant capabilities 2. Create COVID-19 hotlines for members and patients - launch and run a dedicated COVID-19 patient hotline operation with enabling call scripting and tracking capabilitie

22、s 3. Expand contact center virtualization and surge staffing - mobilize surge staffing and fully virtualize the contact center workforce to manage the workforce and performance Other considerations: Partnerships with vendors Regulatory compliance Privacy & security Address the surge of callsAssets a

23、nd capabilities Communications capabilities Tools and resources for the leading platforms with access to robust U.S. household data to rapidly launch and maintain digital communications Contact center virtualization Operating playbooks and infrastructure frameworks to rapidly expand virtualization a

24、nd command center capabilities to manage the workforce Accenture BPS for surge staffing Mobilize a workforce of licensed and non-licensed agents to support chat and phone interactions Virtual assistant accelerators (ACE) COVID-19 assistants and pre-built assets for the leading NLP platforms to rapid

25、ly integrate with channels, configure and train the NLP, and transition to live agents AMBG super agent Built on NHS Triage Protocols, ready for deployment. Built by Avanade on Azure components Technology enablers Natural language processing (NLP) engines NLP Platform used to understand, process, an

26、d respond to patient voice or text input (e.g., Google, Amazon) Agent and clinician desktops Contact management platforms for scripting and tracking inbound calls and/or telehealth visits (e.g., Salesforce, MS Dynamics) Surge response Surge response - -clinicalclinical Market actions 1. Scale virtua

27、l care messaging and or visits for quarantined or “concerned well” patients scale virtual care operations and enable physicians to communicate with patients through asynchronous texts 2. Prepare to triage and prioritize scarce assets assess options to create facility and resource capacity -Identify

28、and forecast capacity needs to secure resources within the community to address different acuity levels- including assessing options to create facility and resource capacity Other considerations: Partnerships with vendors Regulatory compliance Privacy & security Close clinical capacity gapsTechnolog

29、y enablers Virtual support room MS Teams based virtual environments providing patients with specific configured canvas for group communication and support Patient messaging technology HIPAA compliant asynchronous messaging platforms (e.g., Babylon, CirrusMD, 98point6) Agent and clinician desktops Co

30、ntact management platforms for scripting and tracking inbound calls and/or telehealth visits (e.g., Salesforce, MS Dynamics) Business Business continuitycontinuity Market actions 1. Assess and address potential supply chain disruption - Support the planning and implementation of shortage and backord

31、ers of supplies and drugs 2. Validate business continuity plans internal and with external partners - Review business continuity plan and identify any gaps or concerns 3. Prepare to return to normal as efficiently as feasible think long-term Provide tools to structure processes to transition back to

32、 normal business operations 4. Prepare and enable telecommuting and remote resources - Distribute laptops, configure collaboration tools, and set up virtual communication channels 5. Explore options to address employee childcare during crisis Identify alternative in home childcare options and benefi

33、ts 6. Assess and report financial impact (i.e., hot reporting) Enable financial forecasting to model and understand impact to financials Other considerations: Virtual enablement of response center Staff disruptions Decision authority Predict and plan for challenges across the ecosystemAssets and cap

34、abilities Backorder RPA tool Expedite the search for a viable alternative product and supply, leveraging the Symmetric Global Unique Identifier Database and Inventory evaluation tool Workforce management tools and capabilities Tools and resources to deploy, monitor, and manage increased remote work

35、force resources Financial modeling tools Understand how business is being impacted with financial reporting to identify where mitigation is required Procurement planning tools Support planning for determining demand based on key variables Business continuity scenario modeling tools Multi site and co

36、untry business continuity modeling tools Scaling elastic workforce Support segregated delivery teams with virtual environments specifically configured for clinical or administrative functions Technology enablers Telecommuter deployment and monitoring Acquisition and deployment of tools to support re

37、mote employees MS teams collaboration tools Support segregated delivery teams with virtual environments specifically configured for clinical or administrative functions Financial Stabilization & Financial Stabilization & Sustainability Sustainability - -Payer Payer Market actions 1. Anticipate impac

38、ts from near term financial response Stand up a dedicated financial monitoring team to continuously assess and budget for regulatory responses while monitoring internal reporting metrics and the financial support required to maintain operations and external commitments. 2. Model future scenarios and

39、 impacts on financial plans Model near-term cash flow implications and liquidity needs including assessing actuarial risk from projected case-mix shifts and product bids. Re-evaluate discretionary costs and capital expenditures. Model scenarios for segment shifts and the resulting risks to revenue a

40、nd profitability, and update forecasts and future guidance as necessary. 3. Manage reputational risk with transparent financial reporting and community leadership Strengthen credibility and trust with transparent and proactive financial communication with the board and investor community while showi

41、ng community leadership and social impact with customers, providers, and employees. Other considerations: Anticipate near-term financial impacts, model future scenarios, and build trust with key stakeholders Assets and capabilities (in progress) Membership Scenario Models Understand how payer segmen

42、t mixes will shift based on increases to unemployment in the group market Revenue / Case Mix Impact on Providers Forecasts provider case shifts and the resulting claims and provider financial impacts SMB COVID19 Navigator Solution design that enables payers to proactively support and transition SMB

43、stakeholders facing unemployment concerns/challenges due to Covid-19. Smart Spend Analytics (ZBS) Rapidly identify and triage cash outflows to tighten organizational spending Technology enablers Revenue Assurance Stop loss & reinsurance implications Impacts to contracts and arrangements with provide

44、rs in VBC arrangements Provider payment advances Member premium grace periods and benefit design enhancements Financial Stabilization & Financial Stabilization & SustainabilitySustainability ProviderProvider Market actions 1. Focus on immediate cash flow and liquidity Work cross-functionally to maxi

45、mize cash inflows and reduce unnecessary cash outflows: Deploy cashflow modeling capabilities to validate working capital efficiency, optimize project investments, capitalize on vendor flexibility, and review opportunities to factor receivables for rapid cash acceleration. 2. Capture charges for new

46、 services, assets, and locations The health crisis is creating a rapid shift in care delivery channels and opening new avenues for government support. Expand existing telehealth capabilities, deploy resources to capture charges, audit activities to eliminate revenue leakage, and take advantage of fe

47、deral grant opportunities. 3. Deploy interim labor strategies to balance demand, safety, and expense Employ workforce modeling capabilities to identify labor utilization opportunities. Enact furlough and payroll adjustment plans and redeploy idle resources to perform cross-functional roles to optimi

48、ze labor spend. Stabilize cash expenditures, capitalize on charge capture opportunities, and review labor strategies Assets and capabilities (in progress) Up-to-date CARES Act Analysis In-depth information and analysis on CARES Act provisions and optimization strategies by provider archetype COVID-1

49、9 Charge Capture Summary Up-to-date accelerator documenting CPT & ICD-10 code changes Procedure Backlog Ramp-Up Methodology Framework to assist phased procedure scheduling to alleviate the backlog Technology enablers Cashflow and Working Capital Analytics Analytics models to review and maximize sources and uses of cash COVID-19 Community Outreach Index Design your response strategy based on community- specific SDoH factors prevalent in COVID-19 cases Smart Spend Analytics (ZBS) Rapidly identify and triage cash outflows