BLOG: Scenario planning - shifts and results from a recent session

Dennis Bolin, Health Plan Alliance



In the beginning of my career, more years ago than I care to share, strategic planning was a very structured process.  We typically took a long-term view developing even the tactical elements of a plan which would be implemented over three to five years.  That plan would then be revisited and revised at the end of the implementation period starting the implantation cycle again.

Today, most organizations are constantly evaluating the environment, the success of implementation, and making adjustments as they move through their planning cycle.  In David La Piana’s book on strategic planning, David makes the case that in today’s rapid-response world, strategic planning is done in real time.  His model is that plans are made within the context of a quickly evolving environment that requires managers to be constantly thinking and acting, thinking and acting, thinking and acting in rapid cycles.

So the question is: how does one “think” when changes occur quickly, events cannot be anticipated and so much is unknown?  How do you “act” when not all information is available to make decisions, risks are high and outcomes uncertain.

For two days in January in Boston – very cold days I might add –25 healthcare executives representing key segments of the health insurance industry, including four Alliance member health plans, spent time thinking about possible scenarios and how we could take into account those scenarios in our planning processes.  Nancy Wise and Ferris Taylor, with Spring Street Exchange, led the discussions.  You may remember Nancy led a session on scenario planning at our Spring 2017 Leadership Forum  (RecapAudio, Part I  |  Audio, Part II).


The group looked at four scenarios in two areas:

1. Healthcare Policy:

a. Market dissolution

b. Single payer healthcare

2. Disruptive Competition:

a. Disruption of distribution chain

b. Disruption of care delivery

After defining these scenarios, considering environmental factors and drivers, looking at the impact from the perspectives of key stakeholders, defining and, if possible, quantifying the impact and possible paths forward, we identified common threads across the scenarios.  

These common threads are the beginning of strategy:

  • Get ready for new competition with lots of money to invest, closer relationships with customers and accustomed to rapid change and driving innovation.
  • Continue the march toward value regardless of the political and competitive environment; the transition is here to stay.
  • Focus like a laser on operational efficiency which requires the involvement of all stakeholders.
  • Expect disruption in the provider care chain especially through alternative delivery channels.
  • Be smart and strategic about data, both its management and use for decision-making.
  • Keep pace with increasingly rapid change by being proactive in strategic and operational planning that is dynamic with the landscape.

One participant commented, “We’ve cried wolf about change so many times in healthcare that some have started to tune it out.  Yet, with so much change on the horizon, especially from out-of-industry players, the change could hit fast, and many in the industry won’t see it coming.”

If you’re interested in scenario planning and strategy development, join your peers April 4 – 6 at the Four Season in Irving, Texas for our annual Spring Leadership Forum where we will have a full line-up of sessions on the topic of “evolving strategy.”  In typical Alliance fashion, Alliance members will share ideas and perspectives that will shape the strategic future, and future success, of your plan.


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