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GE Healthcare Camden Group Insights Blog

Top 10 Considerations for Strategic Planning in Uncertain Times

Posted by Matthew Smith on Jan 3, 2017 2:19:57 PM

By Laura P. Jacobs, MPH, President, GE Healthcare Camden Group

Healthcare has entered a period where confusion and uncertainty will be the overarching context, where the performance challenges and financial pressures on organizations will mount, and where more constant and ever-present change will be the new normal. With healthcare policy, insurance coverage, and economics headed for change with a new administration, coupled with the already turbulent healthcare environment, many healthcare leaders are concerned about how to develop reliable strategies for the future. Is effective strategic and financial planning even possible with so many variables up in the air? Yes, and one could argue it is even more critical to have a clear path forward during unsettled times. Here are 10 considerations for strategic planning in times like these:

  1. Stay true to your mission and vision. When your organization established its mission and vision, they were meant to be statements of the long-term purpose and role of the organization. The mission describes why the organization exists, and the vision establishes the destination. While a changing environment may require adapting strategies or refining tactics and action steps, staying focused on the long-term destination is especially important when approaching headwinds. If a “refresh” of the vision is required, do so with a long-term lens, based on how your organization can best meet the intent of its mission.
  2. Don’t panic. This is not a time to allow inertia to overtake the organization. It could be helpful to re-evaluate the variables that could affect your results – Medicaid coverage, commercial insurance coverage, reimbursement rates, etc. – but many of these things won’t change overnight. Like an airline pilot encountering unexpected weather ahead, it is important to reassess your approach based on current information. But a lack of forward momentum can result in a mid-air “stall” for your organization – from which it could be hard to recover. Another reason to remain calm and adhere to the core principles of your organization and its mission.
  3. Focus on the “knowns.” While there are many things we don’t know about specific federal and state policy changes ahead, we do know many things that are unlikely to change. The imperative to reduce costs and deliver value and reliable outcomes, the aging of the population and the complexity of caring for multiple chronic conditions, rising consumer expectations for access and a better experience, the increasing number of disrupters that are poised to provide alternatives to traditional delivery, and the continued advancement of medical biotechnology and information technology are just a few of the trends that are not abating any time soon. Further, there will still be legacy competitors and new entrants in your market that will be striving to take market share and improve their position at your organization’s expense. Once you take stock of the things that are NOT changing, creating a strategic direction will be less daunting and will create the framework for moving forward.
  4. Engage all stakeholders. Most strategic planning processes include a method for obtaining input from the organization’s key stakeholders:  board members, medical staff, management, community members. In times like these, make sure that you have the pulse of employers, payers, and other healthcare entities with which you may interact such as FQHCs, post-acute providers, or behavioral health providers. Non-healthcare entities such as retail or technology providers may also provide good insight. Understanding the potential direction and actions that all related entities may take will allow you to have a more complete view of the variables for which you may need to be prepared. Furthermore, involving these parties in your planning process will enhance their ownership of the plan and their participation in its implementation.
  5. Refresh your financial plan. This is equivalent to checking your fuel gauge before take-off. With the possible need to divert your route, it is important to know the resources required and capacity to withstand downturns within your financial position. Be sure to take an objective view of your current state, including understanding the ability to withstand lower reimbursement rates, higher interest rates, or changes in payer mix. It may also be helpful to model the likely financial impact of federal and state policy changes on your organization, such as possible reductions in Medicaid coverage, should those come to pass.
  6. Conduct rigorous scenario planning. With an integrated strategic and financial planning process, your organization can “pressure test” various scenarios. The scenario planning will help evaluate the impact of various financial, marketplace, and other variables in your planning assumptions. This will help identify the areas of greatest risk, and prompt the identification of actions to mitigate those potential risks for inclusion in your strategic plan.
  7. Avoid “herd” mentality. Your strategic planning process must reflect yourorganization’s situation and mission. While it is important to learn about how others are responding to the current healthcare environment, it is also important to chart a path that is individualized for your organization. It is even more critical to identify how your organization will be distinctive, based on its culture, capabilities, resources, and current position. A strategic plan that defines how that distinctiveness will be cultivated and nurtured requires setting clear priorities and considering approaches that your competitors or those featured in industry journals may not have considered.
  8. Stay close to your market. Keeping an ear to the ground regarding local market conditions is especially important when so many variables have the potential to change. Are new disrupters – new delivery models, new technologies, new or growing competitors – making an impact in your market?  Are new payers or are local competitors changing the way they develop and pay their provider networks?  How is your state responding to changes that may be made to Medicaid or insurance exchanges?  Having knowledge of national trends is important to learn what could impact your market; being sensitive to local market conditions will allow your organization to apply those learnings in a meaningful way.
  9. Develop an organizational navigation system. While the strategic plan will provide clarity on the goals and priorities for the organization given the assumptions and expectations made at the time, it is also important that the planning process consider how the organization will absorb information and create alerts when a new route may be required. Just as your GPS system can provide alerts when there are traffic situations ahead and suggest alternative routes, your organization must develop its own ability to respond to changing conditions and still get to the desired destination.   Some organizations have found that having a “rolling” strategic planning process, that allows the plan to be refreshed each year, is the best way to keep the roadmap current. Keeping the strategic plan front and center as part of board discussions will also assure that you are continuously testing assumptions and assuring the relevancy of your plans.
  10. Communicate and activate the plan. In uncertain times, it is ever more important to assure that the strategic plan is well understood throughout the organization. Demonstrating that leadership has considered all internal and external factors and developed a clear path forward will go far in building internal confidence and focus. The absence of a well-articulated and communicated plan raises the risk of an explosion of potentially conflicting initiatives, as nervous management or physician leaders react to uncertainty by taking matters into their own hands. The final step in the planning process must assure that the strategic plan is fully activated:  translated into management goals, including accountabilities and timeframes; integrated with the budgeting process; and is a cornerstone of board discussions.

In uncertain times, it is the most resilient and agile organizations that succeed. To create resilience requires having a solid foundation that a well thought and thoroughly constructed integrated strategic and financial plan provides. To optimize its effectiveness requires that the organization use the plan as it would a GPS navigation system:  know your destination, know the resources and capabilities available before you leave, be alert to changes in conditions ahead, make sure the driver and its passengers are aware of the route, and be agile and ready to make course corrections as new information is absorbed.

 Strategic Planning in Uncertain Times


Jacobs.jpgMs. Jacobs is president at GE Healthcare Camden Group and has been with the firm since 1990. She has more than 30 years of experience in the areas of integrated delivery system development, payer strategy, population health management, healthcare strategic and financial planning, transactions, and governance/management systems. She is a noted speaker and industry resource on the impact of healthcare trends, most notably the requirements for success in value-based payment models, clinical integration, and creating successful integrated delivery systems. She may be reached at laura.jacobs@ge.com.

Topics: Hospital Strategy, Laura Jacobs, Strategic Planning, Healthcare Strategy

10 Questions That Are Often Overlooked by Health System Management Teams During a Mid-Year Checkup

Posted by Matthew Smith on May 9, 2016 4:06:42 PM

By Panos Lykidis, MBA, Vice President, GE Healthcare Camden Group

Many health system management teams and boards use dashboards to track their organization’s performance. The purpose is to do a quick view of current trends. But, how often do you dig deeper to evaluate performance against metrics, market trends, and your strategic plan? This list poses 10 questions you may have overlooked or should proactively address as you consider your organization's mid-year checkup.

1. Narrow network strategy

Your organization’s payer mix no longer changes based only on consumer choice or socio-economic status. Are you securing narrow network positioning that benefits your organization while strategically displacing one or more of your top competitors? The opportunity cost of not being on the right side of this equation is compounded by the significant advantage you may be gifting to your competitors.

2. Physician enterprise results

You have aligned with some of your physicians. You listened to the right advice. However, have you evaluated if you are getting the optimal desired results? Keeping your physicians happy is only part of the answer. Recalibrating and tying the performance of your physician enterprise to your organizational targets should be an annual if not mid-year exercise. Is its performance aligned with your population health management strategies? Assuring that physician-hospital strategies are aligned with payer strategies is critical in today’s environment.

3. Mid-year strategy tune-up

Some of your strategies worked, some have not. Have you given enough focus on understanding why some failed? Is it due to timing, market factors, or poor execution? Unless you understand all the contributing variables, you will not improve your success rate and will continue to diminish the value generated from your annual planning efforts. Do you need to eliminate some strategies and reinvigorate others? Re-setting priorities periodically is critical when the market is changing quickly.

4. Risk mitigation analysis

All strategies have varied degrees of associated risks. Some organizations ignore them; others make sure to be aware of them. However, risks are not fixed variables. They can be prospectively mitigated to increase the chance of success. Are you including a risk mitigation analysis in all your strategic planning? It is a vital mid-year step that can help you decide between choices with the same potential return.

5. Department/Service line business process efficiency analysis

There have always been periods where organizations focus on “trimming the fat” and becoming lean. These efforts are often followed by periods of no growth, as the remaining staff struggle to perform the basic duties of the organization. Like a shark that has to keep swimming to survive, an organization must continue to grow. Are your departments and service lines operating efficiently and optimally? A business and clinical operational process assessment can improve your department and service line operational efficiencies, fuel your growth by reducing waste, and be funded through future savings, since most of these engagements are structured wholly or partly at-risk for the vendors providing these services. Further, they are critical to enabling success in new payment models, such as bundled payment or shared savings.

6. Pre- and post-acute continuum services

Historically, what happened inside the walls of the hospital dictated how the organization fared. Then, outpatient became as important. Today, the question is, are you winning the pre- and post-acute care battle? What is your strategy to partner, provide, or acquire these services? Focusing on the whole continuum of care means that you need to be very good at things you did not do or maybe even think about just five years ago.

7. Revenue impact assessment

Changes to worry about used to be related to losing one payer contract or seeing one medical group align with a competitor. In today’s competitive environment, the changes are happening in waves, with the impact becoming exponential. Can your organization survive a 15 percent revenue decrease? You must have a revenue-focused growth contingency plan in place to weather such an eventuality for 6 to 12 months, in order to prevent a tough blow from becoming a fatal one.

8. Philanthropy, again

Competition is not a new phenomenon, but it is not only about market share, physician alignment, and service growth. With financial pressures negatively impacting operational margins, philanthropy is becoming all the more important. The haves and have-nots are also distinguished by how much philanthropy they attract. Are your vision, brand, and message attracting the right levels of philanthropy?

9. Care model redesign

You have probably revised your care protocols to achieve best practices across your organization. Have you assessed the effectiveness of your care models for today’s needs? Are they positioning your organization to succeed in value-based payer relationships? Are they responsive to new entrants into your market that are patient and technology-friendly? They should be enhancing your ability to attract, engage, and retain patients. If they are not resulting in behavior change from your providers, with tangible results, then it is time for an adjustment.

10. Competency-guided governance

Lastly, the complicated questions laid out here demonstrate the sophistication needed to navigate the current healthcare landscape and make decisions that could determine if an organization will survive. Do you have the right board composition for this climate? What was appropriate before may no longer be the case. It is essential to determine what competencies the board needs (individually and collectively) to effectively govern the organization through these complex and changing times. The results of a competency needs analysis can help you create a board that is more engaged and more confident in tackling their fiduciary duties.

A mid-year check-up using some or all of these questions will put your organization ahead of the curve in weathering the evolving healthcare environment that persists. Riding the turbulence successfully will be the challenge of the decade for all.


Mr. Lykidis is a vice president with GE Healthcare Camden Group with more than 15 years of healthcare experience specializing in strategic and business planning for a broad range of healthcare provider and payer organizations. His experience includes service line strategic planning, such as developing hospital/physician alignment models, co-management arrangements, facility master planning, conducting medical staff development plans and community impact studies, developing co-management arrangements and performing physician needs and fair market value compensation studies. He has extensive experience guiding healthcare organizations in developing actionable strategic plans, including facilitating planning retreats utilizing a dynamic approach that ensures active participation by all participants and resulting in maximum buy-in. He may be reached at panos.lykidis@ge.com.

Topics: Panos Lykidis, Healthcare Planning, Strategic Planning, Healthcare Strategy, Narrow Network Strategy

Top 10 Strategic Questions You May Be Too Busy to Ask (But Should Make Time for Anyway)

Posted by Matthew Smith on Sep 1, 2015 2:29:19 PM

By Panos Lykidis, MBA, Vice President, GE Healthcare Camden Group

A lot of health system management teams and boards use dashboards to track their organization’s performance. The purpose is to do a quick view of current trends. But, how often do you dig deeper to evaluate performance against metrics, market trends, and your strategic plan? This list poses 10 questions you may have overlooked or should proactively address as a mid-year checkup.

1. Narrow network strategy

Your organization’s payer mix no longer changes based only on consumer choice or socio-economic status. Are you securing narrow network positioning that benefits your organization while strategically displacing one or more of your top competitors? The opportunity cost of not being on the right side of this equation is compounded by the significant advantage you may be gifting to your competitors.

2. Physician enterprise results

You have aligned with some of your physicians. You listened to the right advice. However, have you evaluated if you are getting the optimal desired results? Keeping your physicians happy is only part of the answer. Recalibrating and tying the performance of your physician enterprise to your organizational targets should be an annual if not mid-year exercise. Is its performance aligned with your population health management strategies? Assuring that physician-hospital strategies are aligned with payer strategies is critical in today’s environment.

3. Mid-year strategy tune-up

Some of your strategies worked, some have not. Have you given enough focus on understanding why some failed? Is it due to timing, market factors, or poor execution? Unless you understand all the contributing variables, you will not improve your success rate and will continue to diminish the value generated from your annual planning efforts. Do you need to eliminate some strategies and reinvigorate others? Re-setting priorities periodically is critical when the market is changing quickly.

4. Risk mitigation analysis

All strategies have varied degrees of associated risks. Some organizations ignore them; others make sure to be aware of them. However, risks are not fixed variables. They can be prospectively mitigated to increase the chance of success. Are you including a risk mitigation analysis in all your strategic planning? It is a vital mid-year step that can help you decide between choices with the same potential return.

5. Department/Service line business process efficiency analysis

There have always been periods where organizations focus on “trimming the fat” and becoming lean. These efforts are often followed by periods of no growth, as the remaining staff struggle to perform the basic duties of the organization. Like a shark that has to keep swimming to survive, an organization must continue to grow. Are your departments and service lines operating efficiently and optimally? A business and clinical operational process assessment can improve your department and service line operational efficiencies, fuel your growth by reducing waste, and be funded through future savings, since most of these engagements are structured wholly or partly at-risk for the vendors providing these services. Further, they are critical to enabling success in new payment models, such as bundled payment or shared savings.

6. Pre- and post-acute continuum services

Historically, what happened inside the walls of the hospital dictated how the organization fared. Then, outpatient became as important. Today, the question is, are you winning the pre- and post-acute care battle? What is your strategy to partner, provide, or acquire these services? Focusing on the whole continuum of care means that you need to be very good at things you did not do or maybe even think about just five years ago.

7. Revenue impact assessment

Changes to worry about used to be related to losing one payer contract or seeing one medical group align with a competitor. In today’s competitive environment, the changes are happening in waves, with the impact becoming exponential. Can your organization survive a 15 percent revenue decrease? You must have a revenue-focused growth contingency plan in place to weather such an eventuality for 6 to 12 months, in order to prevent a tough blow from becoming a fatal one.

8. Philanthropy, again

Competition is not a new phenomenon, but it is not only about market share, physician alignment, and service growth. With financial pressures negatively impacting operational margins, philanthropy is becoming all the more important. The haves and have-nots are also distinguished by how much philanthropy they attract. Are your vision, brand, and message attracting the right levels of philanthropy?

9. Care model redesign

You have probably revised your care protocols to achieve best practices across your organization. Have you assessed the effectiveness of your care models for today’s needs? Are they positioning your organization to succeed in value-based payer relationships? Are they responsive to new entrants into your market that are patient and technology-friendly? They should be enhancing your ability to attract, engage, and retain patients. If they are not resulting in behavior change from your providers, with tangible results, then it is time for an adjustment.

10. Competency-guided governance

Lastly, the complicated questions laid out here demonstrate the sophistication needed to navigate the current healthcare landscape and make decisions that could determine if an organization will survive. Do you have the right board composition for this climate? What was appropriate before may no longer be the case. It is essential to determine what competencies the board needs (individually and collectively) to effectively govern the organization through these complex and changing times. The results of a competency needs analysis can help you create a board that is more engaged and more confident in tackling their fiduciary duties.

A mid-year check-up using some or all of these questions will put your organization ahead of the curve in weathering the evolving healthcare environment that persists. Riding the turbulence successfully will be the challenge of the decade for all.


Mr. Lykidis is a vice president with GE Healthcare Camden Group with more than 15 years of healthcare experience specializing in strategic and business planning for a broad range of healthcare provider and payer organizations. His experience includes service line strategic planning, such as developing hospital/physician alignment models, co-management arrangements, facility master planning, conducting medical staff development plans and community impact studies, developing co-management arrangements and performing physician needs and fair market value compensation studies. He has extensive experience guiding healthcare organizations in developing actionable strategic plans, including facilitating planning retreats utilizing a dynamic approach that ensures active participation by all participants and resulting in maximum buy-in.He may be reached at panos.lykidis@ge.com

Topics: Panos Lykidis, Healthcare Planning, Strategic Planning, Healthcare Strategy, Narrow Network Strategy

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