How to strategize when the strategic goal is unknown

Elena WhiteOne of the contradictions of value-based care is that we know we need to plan, yet we’re not always sure what we’re planning for. The old adage that “when you fail to plan, you plan to fail” applies here, but planning without seeing the entire picture means you may be taking your organization into dangerous territory.

How are health care leaders supposed to plan their organization’s journey to value-based care if they don’t know the destination? Let’s start with a few things you shouldn’t do:

Don’t create a five-year plan, then doggedly pursue that plan: Think of how things have changed over the last five years. In 2010, value-based care was a gleam in the eyes of relatively few thought leaders. Today, it’s likely on the mind of every health care leader in America. You should make a plan — even a five-year plan — but don’t stop the planning process. Strategic planning in health care now means constantly evaluating the environment and organizational results, and adjusting as the industry landscape and your local market shifts.

Don’t plan in silos: It used to be that one part of a health care organization — hospital service lines, for instance — could plan for growth and change without much upstream, downstream or parallel effects. Those days are limited. One way or another, all health care providers are affected by regulatory changes and market shifts. Great care must be made to include leaders representing a broad swath of your organization in your planning processes.

Don’t rely solely on your own expertise: The health care industry has never been down the road it is currently on. Hiring outside partners who can apply the experience of other organizations to yours is a smart move. And don’t limit yourself to getting advice from other organizations whose experience matches your particular niche. You’ll benefit from knowledge about value-based care from every segment of the market.

While some principles of strategy have changed, don’t assume that you need to throw out everything you know about planning. You still need to assess the environment in which you’re operating, taking into account external entities, internal culture and in-house resources. In addition, consider three new elements that you may not have strategically considered in the past:

  • Your roots: It’s important that you take into account your mission and vision, your role in the community, and even the personal motivations of your organization’s leaders.
  • Your assumptions: Understand what your organization believes about itself, its community and the market in which it operates, and correct any false assumptions.
  • Your loops: Identify all potential feedback loops that your strategy could affect, as well as how large their effects could be.

Maybe the most important aspect of this new mode of strategy is the way an organization’s leaders think. Relying on old assumptions and biases is discouraged, but letting your experience guide new decisions is encouraged. Thinking more about possibilities and less about restrictions, while allowing space to be analytical and critical, is necessary. Does this all sound contradictory? It’s more complex than it is contradictory, and it takes an uncommon vision to really make it work.

Although we don’t yet know what value-based care will ultimately look like for providers, we have a pretty good idea of the principles under which it will operate. Christopher Columbus was surprised by what ended up being his destination in the Caribbean islands, but the principles of astronomy and the trade winds of which he was familiar made him confident and led him to make a great discovery.

The same is true for us. The principles of value-based care are sound, and we can be confident that fee-for-value, in some form or another, will be worth the strategic effort.

Take a deeper look at strategy in the article written by Joe Flowers, speaker, consultant and health care futurist, reprinted from H&HN Daily, by permission, in the Fall 2015 edition of RISKMATTERS.

About the author

Elena White currently serves as Vice President of the Risk Quality & Network Solutions division for Optum. She has over 18 years experience leading network optimization initiatives, network development and expansion, business planning, provider reimbursement development, transformation to risk based arrangements and medical cost management strategies for both health plan and provider organizations.

Elena holds a Bachelor’s Degree from University of California at Riverside and Master’s Degree in Business Administration from Loyola Marymount University.

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