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5 Questions Every Strategist Needs to Ask

Asking five basic questions can help health system strategists stay on course and strengthen their strategy recommendations.


Strategists can build the foundation of a strategic direction by understanding the demographic characteristics and trends of their primary and outlying markets. Demographic realities can translate into knowledge about what the population’s healthcare needs are today and how these needs are expected to change a few years down the road. Strategists can also use demographic realities to identify the population segments that exist in the market and how these segments may differ in their healthcare needs and in their desired relationship with a health system.


Strategists will need to prioritize programmatic and service opportunities in their market; doing this in a disciplined, realistic way is important. Understanding what the current service gaps are in their market, what gaps are likely to arise in the near future, and what the programmatic strengths are for both their system and competing systems can help a strategist prioritize. Of course, competing systems are asking similar questions, so testing of what strategies and tactics can put their system in a position to out serve and outcompete is important. Strategists can begin with current programmatic strengths and capabilities as well as programs that are accretive in the existing cost structure.


We think about “where?” in two ways; geography and care continuum. For geography, strategists can ask where population growth is expected, where service gaps exist, where economic and consumer activity is concentrated, where populations begin gravitating towards another referral market, and where the center of need and opportunity is moving. Populations segments vary not only in their healthcare needs but in their preference for access points, so a strategist should ask where along the care continuum can our services best meet patients where they are in their healthcare journey.


A strategic direction needs to balance immediate and long-term implications of the recommendation, so a strategist should be asking “why” from the start of their development process. Existing or expected service gaps and improving local access in the market may align with their system’s mission and values, so the responsibility exists to provide care to populations. Current gaps that align with their system’s programmatic strengths and/or that are financially accretive are also reasons why their system should pursue a direction. Asking “why not” is just as important and can include hurdles of scale, quality, and duplication of services. Lastly, the ability to foresee the implications of their strategic recommendation regarding relationship dynamics with other systems in the market is important for strategists to keep in mind. One consideration is whether their recommendation better positions their system for alignment down the road, given the hard realities of the industry today.


Timing and execution are critical to the success of a strategic direction, and we think about “when?” in terms of a pilot or a platform. If the direction is materially new to a market or to the system, a strategist may consider a small-scale launch used as a test case for assumptions around ramp-up, quality, implementation, and competitive response. On the other hand, if the direction is a new approach to grow an existing system strength, a strategist may consider a full platform launch especially if service gaps, scale, sustainability and outward population movement exist together.


Health system strategists can better navigate the ambiguous nature of crafting future strategies by asking five basic questions before recommending a direction.


We believe asking “who?”, “what?”, “where?”, “when?”, and “why?” can help guide strategists to identify what their organization is trying to accomplish and thus make it easier to identify the best tactics and strategies to do so.


About HSA:

Health System Advisors advises health systems on their competitive market positioning. Our team of motivated, engaged, and inspired strategists brings analysis, insight, and expertise as we facilitate your teams to new ways of thinking and strategies that advance your organization.

Mitch Traczyk is a senior manager at HSA and can be contacted at

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