In a year when the public and political spotlight was already focused squarely on health care, the COVID-19 pandemic has only intensified the level of scrutiny on the industry. While sentiment toward the industry has largely improved, the outbreak has also reinvigorated conversations about the structural shortcomings of the current system. And although the debate continues to focus heavily on issues surrounding coverage and affordability, COVID-19 has introduced a new dimension—resilience—to the discussion as well. Advisory Board’s 2020 State of the Union examines the emerging focus on resilience by breaking down how purchaser motivations are (and aren't) shifting, and how the core structural elements of the delivery system—namely, our approach to developing, manufacturing, and distributing supplies and pharmaceuticals; our approach to educating, compensating, and organizing our clinical workforce; and our approach to designing, configuring, and deploying our fixed cost assets—could and should evolve as a result of the COVID-19 pandemic.