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With uncertainty about tariffs and other government policies growing, companies need more flexibility in their operations. That is, they need the ability to surge production quickly, as they also need the capability to cut costs quickly. President Trump’s tariffs and likely retaliation provide extreme cases where this may be necessary. Companies without access to inexpensive raw materials may have to hunker down. But other businesses may see opportunity as foreign competitors become uncompetitive.

Most business leaders understand cost-cutting well, but ramping up production—especially quickly and without damaging quality—is more a black art. Thus the benefit of looking deeper into the topic.

Fred Turner, the founder and CEO of Curative, has ramped up quickly and ramped up slowly, as well as pivoted to different lines of business. His methods are not so much a roadmap for other business leaders as an idea map. That is, his experience highlights a way of thinking that can help others determine their own solutions to their particular challenges.

Before trying to gain flexibility, though, business leaders should consult my guide for how to know when increased supply flexibility is important. The need for quickly changing production capacity comes from the economic concept of demand elasticity. Sometimes, the demand for a particular good or service changes quickly. When that happens, producers that can quickly meet the demand will profit. But when demand falls, those who cannot cut costs quickly will face severe problems.

Turner faced the challenge of rapidly rising demand in the middle of the pandemic. His business was testing for sepsis, a serious condition in which the body reacts improperly to an infection. The Covid pandemic hit in the company’s first year of business, and Turner realized that they had the capability to provide Covid testing. That pivot meant a huge increase in demand.

Looking at constraints was one key element of the game plan, Turner explained to me on a video call. Laboratory capacity was much lower than swabbing capacity. If they administered as many tests as possible, they would create a backup in the laboratory, delaying test results by days. But test results that take a week to get back from the lab were not very useful. So, the company throttled back on swabbing. They matched the throughput available at the bottleneck: the lab. Turner cites the classic book, The Goal, by Eliyahu Goldratt. (My own copy was close at hand, and Turner grinned when I held it up to the camera.) Goldratt’s theory of constraints led to a focus on different parts of the process that held up throughput.

Later, times swabs were in short supply. Turner argues for “orthogonal supply chains.” He describes this concept as not trying to compete for the same materials that everyone else is trying to buy. His team found an alternative product that would work, got it certified, and satisfied demand.

This approach works best, Turner says, with end-to-end control of the software. Leadership needs to understand the bottlenecks in the overall process. If data at various stages of production are not up-to-date and accessible simultaneously, then the management team cannot diagnose problems.

Predicting demand surges is not always possible, but Turner’s company developed a great solution. The lab test for Covid is usually presented as a positive or negative, but the lab knows the level of infection, called viral load. Those results are usually not useful for an individual, Turner said. In the aggregate, however, the average viral load at a testing location predicts future demand for tests. Viral load probably predicted infection rates, which in turn predicted test demand.

The Covid testing was a great example of rapid ramp-up, but our conversation shifted to a planned ramp-up. Curative is currently offering group health care insurance with no deductible and no co-pays. That presented the company with two potential bottlenecks: finding staff for the member on-boarding process and finding healthcare providers for the group members. The resolution was controlled growth. The company asks every member to join a video call about how their unique system works. That causes a need for many people in January, the most common time for health plan changes. Normal hiring of employees by their client companies is spread more evenly through the year, but adding a large number of employees from a single company causes a surge of demand for onboarding appointments. Curative’s solution is to carefully control their pace of growth.

Controlling growth comes through pricing, Turner says. They look for the sweet spot, whereby the pricing leads to profitability with growth, but not so much growth that service suffers.

Another tool for growing rapidly with less stress on production capacity is allowing no customization of plans. Large employers may ask for a plan with some details changed from the usual offering. That raises the difficulty level for health procedure authorizations, which also leads to more mistakes, leading to more correction work. As Turner explained this, I recalled the headaches of a bank trust department with a large number of special employee benefit plans. Customized plans were the major source of errors at the large bank where I used to work.

Summarizing Fred Turner’s lessons as I understood them, business leaders should begin with viewing the process as a whole. Having good data from start to finish is crucial. If not a single software platform, as Turner suggests, then work to get the different systems to share data seamlessly and in real time.

With data in hand, identifying bottlenecks begins the ramp-up process. Then anticipating subsequent bottlenecks will be necessary. Predicting surges, though difficult, will help tremendously.

At times, throttling back demand will be critical to good service to those you serve. You’ll certainly want to ramp up production, but don’t sell more than you can with good service.

Finally, when a particular product or service that is a necessary input becomes hard to buy, look orthogonally—in a different direction—for another product that might do the job.

And although Turner did not specify it, a can-do attitude seems to permeate his experience, especially when the market asks a CEO to surge production.

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