From Every Angle
Crisis ready
From workplace violence and supply disruptions to system outages and payer instability, healthcare’s biggest risks rarely stay contained. Our experts share how leaders can build resilience before disruption becomes crisis.
Healthcare leaders have always managed risk. But the range of threats they are preparing for—and the potential consequences—continue to grow.
Consider the signals. Healthcare accounts for roughly three-quarters of all nonfatal violence-related occupational injuries and illnesses in the United States. More than 215 drug shortage alerts were published in 2025. And one-third of CFOs now rank health benefit costs among their top three operating expense concerns, up from 19% in 2024.
The risks may look different, but they share an important characteristic: A disruption that begins in one part of a health system rarely stays there.
For leaders, the challenge is not simply anticipating the next crisis. It’s making sure the organization is prepared when one comes, understanding where vulnerabilities exist, establishing clear ownership, building alternatives when critical resources or systems become unavailable, and testing those plans before they are needed.
These perspectives from our experts examine that challenge from workforce safety and supply assurance to financial resilience and a changing payer environment, offering practical strategies for crisis preparation.
- Treat crisis readiness as an enterprise responsibility. Risks that begin in security, supply chain, or another function can quickly ripple across operations, finances, and patient care.
- Build resilience before you need it. Identify vulnerabilities, establish clear ownership, and create alternatives for critical resources, suppliers, and systems before disruption occurs.
- Pressure-test your plans. Scenario-based exercises can expose gaps, clarify responsibilities, and give teams experience making difficult decisions before the stakes are real.
- Watch for risks beyond the obvious. Emerging threats range from workplace violence and supply shortages to operational outages and changing employer approaches to healthcare benefits.
- Make preparedness continuous. Monitor changing conditions, revisit assumptions, and regularly update plans as organizational vulnerabilities and external risks evolve.
Looking left of bang: Preparing for risk before it escalates
Lisa Terry, Senior Consultant, Security
Why it matters: For many healthcare organizations, workplace violence and hospital security are still viewed primarily as issues that belong to the security department. But Lisa Terry, senior consultant, security, believes that mindset is a big misconception—one that limits an organization's ability to manage risk effectively.
That perspective has become important as hospitals navigate a more complex risk landscape. In addition to traditional security concerns, healthcare organizations face rising workplace violence, behavioral health challenges, staffing shortages, and broader societal stressors that often converge within healthcare settings. At the same time hospitals must remain open and welcoming environments for patients, families, visitors, and staff.
For Terry, the most effective organizations focus on preparation rather than waiting for an incident to occur. The approach she subscribes to, developed by the military in 2007, is operating "left of bang"—anticipating potential risks and building the processes, training, and partnerships needed to prevent situations from escalating. In practice, that means identifying vulnerabilities and preparing for a range of scenarios before they disrupt operations, threaten workforce safety, or affect patient care.
That preparation extends well beyond the security team. It requires leaders, clinicians, operational teams, and support departments to share responsibility for creating a culture of safety.
Strategies to consider:
- Create a multidisciplinary workplace violence prevention program. Organizations benefit from establishing a dedicated team that meets regularly, not only after incidents occur. Ongoing collaboration among security, clinical, operational, and administrative leaders helps organizations monitor emerging risks, review concerning behaviors, track community trends, and coordinate responses across departments. "The security department and hospital police should be joined at the hip with your clinicians, so much so that they know with a nod when they need to step in," she said.
- Conduct comprehensive security risk assessments. Regular assessments help organizations understand vulnerabilities before they become problems. Periodically evaluate physical security infrastructure, access control systems, surveillance technology, and environmental design. That includes reviewing camera coverage, indoor and outdoor lighting, duress alarms, weapons detection systems, and other security technologies to ensure they are functioning as intended and aligned with organizational risks. Bringing in an external perspective every few years also can help uncover blind spots and provide a more objective view of risk.
- Strengthen reporting and executive visibility. Staff are more likely to report concerns when systems are easy to use, non-punitive, and supported by leadership. Organizations should regularly analyze incident data, share insights with executives, and ensure workplace violence prevention remains visible at the highest levels of the organization. “Employees notice when leadership is disconnected from day-to-day safety concerns, which can undermine trust and discourage reporting,” Terry said. “Visible executive engagement helps reinforce that workforce safety remains an organizational priority.”
- Improve access control and visitor management. Hospitals cannot eliminate openness, but they can be intentional with how they manage security. Rather than viewing security as an all-or-nothing proposition, organizations should think in layers. Public spaces may remain accessible, while higher-risk areas such as emergency departments, labor and delivery units, pharmacies, and behavioral health spaces should incorporate additional controls and monitoring. Clear visitor expectations, thoughtful point-of-entry design, established vendor management processes, and appropriate access controls, like badging, help organizations understand who is entering their facilities and where they can go.
- Train for realistic scenarios. Training should extend beyond annual compliance exercises. Scenario-based learning, simulations like table-top drills, and digital exercises can help leaders and frontline staff practice responses in realistic situations before they encounter them in real life. “Make sure your leaders, staff, and clinicians are trained and have the tools they need to respond,” Terry said. “Create opportunities to fail in a real, safe way.”
Prepare to operate when systems go down
Mike Signore, Vice President, Treasury and Capital Markets
Why it matters: The business case for preparedness is ultimately about getting ahead of the inevitable. It is not a question of if disaster will happen, but when. Further, the days when cybersecurity and disaster management were considered an IT and facilities management problem have passed. Today, preparedness is a finance and clinical care imperative that affects nearly every function of a hospital or health system. That is why Mike Signore, vice president, treasury and capital markets, believes operational resilience only works when it is enterprise-wide and that treasury is best positioned to lead the charge.
Treasury must sit at the center of an organization’s operational resilience strategy. It is the linchpin of the finance operation of a health system, positioned to coordinate across all functional groups and lead the charge in securing cross-functional alignment on what a resiliency plan looks like. If Treasury has a game plan in place, but Accounts Payable (AP) does not, there are still going to be gaps. Patient care cannot occur if critical vendor payments cannot be made.
This mindset is critical for ensuring that plans and assumptions remain accurate and relevant as the organization evolves. Practice makes perfect. Moving from awareness to action requires intentional strategy across multiple functions.
Strategies to consider:
- Assign clear executive ownership. Designate a senior leader, ideally at the CFO or CEO level with accountability as the point person responsible for identifying critical finance functions, coordinating cross-functional planning, and addressing operational gaps before a disruption occurs.
- Commit organization-wide coverage. Emergency preparedness is not a treasury function alone; it requires accountability across the organization. Add operational resiliency to the executive team or board risk committee agenda framed explicitly as a finance and patient care issue. This ensures the conversation happens at the highest levels and positions resilience as an organizational priority.
- Center treasury as an orchestrator of operational resilience. Treasury can coordinate across all functional groups and develop specific game plans for critical scenarios, especially around payroll continuity, critical supplier payments, and liquidity access.
- Test assumptions and iterate often. Conduct a finance-focused drill that pressure tests how you would operate without core systems. Run a scenario-based 30-day outage tabletop exercise to reveal gaps and force your teams to think through real decisions: Which vendor payments are essential? Where do we access liquidity? How do we communicate with the bank?
- Maintain relevance. Refresh plans annually or twice per year to keep plans relevant and aligned with your current operations.
Explore Mike Signore’s perspective on operational resilience defined from the finance seat, and what finance leaders can do today to better prepare for When systems go dark.
Build redundancy before supplies run short
Katie Korte, Vice President, Supply Assurance
Why it matters: Healthcare organizations continue to face supply chain pressures stemming from manufacturing disruptions, labor shortages, natural disasters, geopolitical events, and cybersecurity incidents. While the causes may differ, the result often is the same: They experience critical disruptions that affect operations, finances, and access to essential products and medications that directly impact patient care.
For Katie Korte, vice president, supply assurance, the organizations best positioned to navigate these uncertainties are those that build resilience before a disruption occurs. Rather than relying on a single strategy, they develop multiple safeguards that help maintain continuity when unexpected events arise.
Strategies to consider:
- Identify critical supplies and alternatives. Organizations should proactively identify essential medications and products, establish clinically appropriate alternatives, and ensure teams know how to access those items during a disruption. Understanding utilization patterns, inventory levels, and available substitutes help organizations respond more effectively when shortages occur.
- Build resilience into supply strategies. Health systems benefit from having multiple safeguards in place before a disruption occurs such as reserve inventory programs, manufacturing redundancy, diversified sourcing strategies, and contingency plans that reduce reliance on any single point of failure.
- Strengthen supplier partnerships and transparency. Communication before, during, and after a disruption improves decision-making and helps organizations respond more effectively. Additionally, long-term supplier relationships provide health systems greater visibility into sourcing, manufacturing capacity, and potential vulnerabilities—while also helping suppliers better anticipate demand and maintain inventory during periods of disruption.
- Test contingency plans before they're needed. Organizations should regularly evaluate how they would respond to disruptions affecting critical products, transportation networks, or key suppliers. Scenario planning exercises can help identify vulnerabilities, clarify responsibilities, and strengthen organizational readiness before patient care is affected.
- Recognize risks before they become disruptions. While complete visibility into every tier of the supply chain is limited, monitoring market conditions, supplier communications, and utilization trends can help identify potential vulnerabilities early. This proactive approach gives health systems more time to activate mitigation strategies such as evaluating alternative products or securing dedicated inventory for critical supplies.
Explore how the Vizient Reserve Program helps participating health systems strengthen supply assurance through dedicated inventory, manufacturing redundancy, and enhanced preparedness planning.
Protect against an employer payer exodus
Joyjit Saha Choudhury, Managing Director, Strategy and Business Transformation
Why it matters: Health systems are already confronting a wave of payer instability, including the potential effects of the One Big Beautiful Bill (OBBB), Medicaid funding reductions, exchange subsidy expirations, and evolving exchange regulations. They also face a less visible but potentially significant challenge: changing employer attitudes toward healthcare spending and benefits.
According to Joyjit Saha Choudhury, managing director of strategy and business transformation, employer behavior could become the most important force reshaping the future payer landscape.
“Employers are the true purchasers of healthcare, with health plans administering the flow of funds,” Choudhury said. “The problem is that many health systems remain disconnected from the employers that drive their commercial revenue.”
Employer-sponsored insurance remains the largest and most financially important source of commercial reimbursement for most health systems. Yet healthcare costs have continued to outpace both inflation and wage growth for years, with employer health benefit costs projected to rise another 7.9% in 2026. As financial pressure mounts, many employers are reevaluating how much of that burden they can continue to absorb.
Some already are responding by shifting costs to employees, narrowing provider networks, adopting reference-based pricing, or exploring defined-contribution models such as individual coverage health reimbursement arrangements (ICHRAs). If these trends accelerate, healthcare financing could become substantially more consumer driven.
For health systems, the implications could be significant. Greater patient cost responsibility would increase price sensitivity, comparison shopping, and bad debt exposure while placing greater pressure on organizations to justify both pricing and network participation.
The organizations best positioned for the next phase of payer disruption, Choudhury argues, will be those that recognize employer frustration early and adapt before purchasing behavior fundamentally changes.
Strategies to consider:
- Conduct ongoing employer market research. Develop a deeper understanding of the employers driving commercial revenue in your market, including workforce demographics, benefit priorities, cost pressures, and purchasing trends. Monitor market developments such as payer consolidation, policy changes, and commercial membership shifts that could accelerate employer dissatisfaction or benefit redesign.
- Develop a compelling employer value proposition. Employers increasingly expect measurable value, not simply broad network participation. Clearly demonstrate how your organization improves affordability, quality, access, workforce health, and productivity compared with competing providers.
- Build solutions that address employer pain points. Expand beyond traditional care delivery by evaluating opportunities such as advanced primary care, direct-to-employer arrangements, centers of excellence, care navigation services, and workforce-focused population health programs.
- Invest in employer-focused capabilities. Strengthen the infrastructure needed to support employer partnerships, including analytics, wellness programs, onsite and near-site clinics, digital engagement tools, and relationships with third-party administrators and benefits consultants that can help scale offerings.
- Strengthen employer relationships. Develop proactive outreach and executive-level engagement strategies that position the health system as a trusted strategic partner rather than simply a contracted provider.
- Elevate communication and brand strategies. As network participation comes under greater scrutiny, health systems will need a stronger and more consistent and credible story around affordability, quality, outcomes, and community impact. Ensure communications reinforce why employers, employees, and consumers should choose your organization in an increasingly price-sensitive market.
“We’re moving from broad network participation to a market where network inclusion must be earned,” Choudhury said. “Health systems will need to clearly demonstrate value through affordability, quality, and outcomes.”
Learn how health systems can move beyond payer-provider friction to build relationships focused on shared value.