In 2024, “business as usual” in health care means planning for everything but the usual: climate‑amplified wildfires, ransomware that paralyzes electronic health records, supply‑chain failures that empty pharmacies, and pandemics that redraw surge‑capacity charts overnight. To thrive in this new reality, hospitals, clinics, EMS agencies, and public‑health partners need a playbook that stretches far beyond day‑to‑day triage.

That playbook is outlined in the U.S. Department of Health & Human Services, Office of the Assistant Secretary for Preparedness and Response (HHS ASPR) Health Care Preparedness and Response Capabilities framework—refreshed most recently for the 2022–2027 Hospital Preparedness Program. The document defines the “ideal state of readiness” for America’s health‑care delivery system and sets the performance bar for Health Care Coalitions (HCCs), hospitals, long‑term‑care facilities, and EMS. Its four cornerstone capabilities are:

1. Foundation for Health Care & Medical Readiness – building resilient coalitions, governance, and risk‑assessment processes that knit disparate providers into a single response force.

2. Health Care & Medical Response Coordination – synchronizing information‑sharing, incident command, and multi‑agency decision‑making when minutes matter.

3. Continuity of Health Care Service Delivery – safeguarding essential functions, supply chains, and cyber‑infrastructure so care continues even when facilities are damaged or staff are stretched thin.

4. Medical Surge – expanding clinical capacity on demand, from pop‑up triage sites to regional patient transfers, while maintaining standards of care.

Mastering these capabilities is no longer aspirational; it is the minimum entry fee for health systems determined to protect patients, staff, and community trust in an age of compound crises.