To say these are unprecedented times would be an understatement. What the global pandemic has done to economies across the world has never been seen before, and it is far too early in the process to know what the exact long-term impact will be. Added to that, the strain of the health crisis is already beginning to be felt far and wide, demonstrating how inseparable healthcare and the economy have become.

Our healthcare systems are not designed to deal with this crisis, an unpredictable, large-scale health catastrophe that requires urgent mobilization of resources and affects the entire population. The healthcare industry in the United States was already strained before COVID-19 and is now under even greater economic pressure.

In this month’s issue, we focus on the current state of the healthcare industry. We discuss the impact on hospitals and healthcare systems, how we can sustain healthcare providers, methods to continue to maximize value, operate distressed physician practice management companies, and evaluate the use of bankruptcy as a tool.

Kicking us off, Morris Alhale and David Samikkannu of AlixPartners discuss enterprise value and give us an insightful look into the macro threats introduced by COVID-19 and the challenges associated with them. From who is experiencing distress to what initiatives should be undertaken, the authors provide tangible advice for maximizing value.

The crisis in the healthcare system, while not new, has been exacerbated by the pandemic. Aaron Newman and Michael Fixler of FocalPoint Partners dig into how rural hospitals, independent health systems, and large integrated health delivery systems will be reshaped through COVID-19. The article provides thoughtful and innovative restructuring concepts and the development of more sustainable systems after reviewing how the historical and current environments collide.

How do we support providers during this time? While regulators and legislators are consistently vocal about healthcare, the pandemic increased the debate and demands for swift action from policymakers. By looking at the CARES Act and how the healthcare system responded, Charlene MacDonald of FTI Consulting takes us through the viability of healthcare providers during this time and the initiatives legislators and regulators should consider.

Gregory Hagood and Neil Luria of SOLIC Capital Advisors give us strategies for managing distressed physician and dental groups in the post-COVID environment. Primarily noting and examining the industry issues before the pandemic, the article walks us through the key reasons for insolvency and the need to restructure, and then aptly points out that the industry has an opportunity to pivot with this crisis. The authors provide us a future framework to support provider groups and sustain profitability.

As previously noted, the healthcare industry was struggling before the pandemic, and many concerns were already utilizing the Chapter 11 process to find relief. In his article, Stephen Astringer of Polsinelli gives us a case study of the True Health Diagnostics matter and the ultimate reversal of a prepetition Medicare payment suspension and its possible implications.

Finally, we close this issue with an in-depth look by Samuel R. Maizel, Tania M. Moyron, and Nickolas Koffrath of Dentons at the sale of Medicare and Medicaid agreements, and the benefit of transferring these agreements in bankruptcy. The authors look at various recent decisions and provide how important recent arguments are in bringing the government to the bargaining table for a settlement that provides greater value for creditors.