Disaster Discourse: The Hagerty Blog

Top Three Cost Recovery Actions for Healthcare Leaders to Implement Now as COVID-19 Cases Surge

As the COVID-19 pandemic continues to surge across the US, hospitals, local governments, and medical care providers are facing exponential increases in COVID-19 patients. Across the country, surge capacity alternate care sites and Emergency Operations Centers that had been decommissioned earlier in the year are now being reopened. Risks for supply chain shortages are reemerging, and while an increased knowledge of the virus has improved the ability to treat symptoms, lowering the death rate, COVID patient volume and treatment costs continue to increase. Simultaneously, vaccination planning measures introduce additional complexities and costs.

Hagerty continues to work with hospitals, governments, universities, and medical care providers across the country on COVID-19 response and financial recovery. With providers continuing to incur significant costs for COVID-19 treatment and facing revenue losses from the cancellation of non-elective procedures, we continue to work with entities as they seek to maximize available federal and state funding and reimbursement opportunities. In anticipation of the continued heightened response and vaccination efforts over the upcoming weeks and months ahead, Hagerty recommends finding the time now to incorporate lessons learned from initial response to streamline ongoing cost recovery needs.

Typical disaster recovery flows into preparedness planning, documenting an entity’s lessons learned to better prepare for the next disaster. The ongoing pandemic places the healthcare industry as well as state and local governments in the unique situation of continuously responding to the pandemic while simultaneously trying to recover and implement lessons learned in real-time to save lives, improve response outcomes, begin cost recovery, and enhance preparedness efforts. With these competing priorities in mind, preparing now for sustained financial recovery efforts is vitally important. The following actions can help health care providers and state and local governments best position themselves financially during response:

  • Centralize cost and decision-making documentation. During the height of the immediate response last Spring, life-saving decisions were made quickly – likely without significant documentation. Details of the decision-making process may not have been recorded in formalized logs. Multiple parties may have been part of surge site creation without a single party to retain ownership and management of information. Hagerty has seen challenges in pulling this information together to meet federal and state funding requirements. As playbooks are reopened for this second surge, enact documentation and information control measures by assigning individuals to ensure the creation and retention of documentation. As the pandemic response continues, details of actions taken will become harder and harder to recall and accessing federal recovery funding will require full cost documentation (invoices and proofs of payment) as well as reconstruction of the decisions around a response effort (descriptions of who, what, where, when, why, and how).
  • Create a unique and centralized cost center to capture pandemic related expenses including vaccination-related costs. Funding program details for vaccination-related costs are just beginning to emerge. With the CDC releasing its vaccination playbook, as well as State-by-State executive summaries, providers are purchasing supplies and equipment to implement a nationwide vaccination program. As plans unfold, new funding programs and/or policies may be released. For best practices, track these costs uniquely from other COVID-19 testing and treatment costs, so they can be easily identified if distinct funding opportunities become available.
  • Consider a recovery roadmap to avoid duplication of benefits and prepare for future audits. It is likely that the current surge and response measures will linger for the coming weeks and months, so take time to review practices and invest in any modifications now. Creating centralized systems and repositories now, will reduce headaches later.


The complexity of the pandemic response and recovery will continue to increase as the virus continues to spread, the timeline stretches, and funding programs continue to change or be added. Plans and organization enacted now will prevent the need to untangle information after the fact and increase the chances of maximizing reimbursement.

Hagerty Can Help!

Throughout the COVID-19 pandemic, Hagerty has supported over 100 hospitals and healthcare systems nationwide. Over the past several months, our professionals have assisted healthcare facilities as they address immediate treatment needs, medical surge requirements, management of increasing COVID-19 patients, as well as implementation of important community and facility mitigation measures. We are also ensuring healthcare systems have access to immediate resources to facilitate financial recovery, such as federal and state short-term liquidity funding opportunities, as well as long-term cost-recovery to ensure readiness as healthcare systems continue to support critical community needs. Contact us to discuss how we can help you meet your preparedness, response, and recovery needs!

Kara Koirtyohann is a Senior Recovery Manager and Portfolio Manager for Hagerty’s hospital and university clients. This year, Kara has worked with multiple hospitals and universities to plan for and maximize their COVID-19 cost recovery. Prior to the pandemic, she worked with Hagerty as the Lead of the of New York City Hurricane Sandy Recovery Project Program Conformance Team and as Project Manager for wildfire and flooding recoveries in California. Kara is a licensed architect. Prior to working with Hagerty, she managed the design and construction of public and private buildings and spaces.

Jeff Bokser is Hagerty Consulting’s Vice President of Healthcare Programs with strategic expertise in all aspects of healthcare operations, finance, crisis management, and recovery. Jeff currently works with healthcare systems, public health departments and universities across the country focused on COVID-19 financial recovery, preparedness and response. Jeff has over 20 years of experience as a senior leader at NewYork-Presbyterian and Yale New Haven Health. Jeff is nationally recognized in the healthcare sector for his transformational leadership in the areas of emergency and crisis management; security and safety; pandemic and surge planning; and business continuity.