All businesses need to create goals, establish priorities, and flesh-in a pathway forward as part of a business plan.

Most organizations engage in a purposeful examination of performance (results), structure, markets served, potential new opportunities, positives, negatives, and anything else germane to strategic planning and positioning.

Who is your organization (not what)? What are your strengths and weaknesses? What do your customers (patients) say about you (your brand)?

Do you have an effective way to measure patient perception of your commitment to excellence, dedication, and patient-centered health care? Are you able to leverage this positive to grow select service line volume and profitability?

How can you ‘think outside of the box’ like an entrepreneurial enterprise in order to re-invent how you do some things while honing others that are already favorable?

How can you embrace the change in our industry to deliver more effective services while growing your financial viability, market share, and effectiveness as a provider?

How can you reconcile the twin needs of generating sufficient profitability now while planting the seeds of success in new ways?

We know short-term planning reflects the need to reconcile goals with reality (empirical data) as well as a need to change direction or modify tactics to stay on target.

Good businesses build-in flexibility to their business plans, knowing that change can be more of a positive than a negative if they are willing to make changes strategically.

Results are facts we cannot change, but we can change what we do next and how we choose to attack our market. After all, it’s a given that continuing to do the same things despite adverse results does not work.

Why ask your team to look at the organization’s business model and plan from the “outside?”

Healthcare is undergoing more change now than at any time in the past 35 years.

CMS is pushing for greater consumerism by forcing hospitals to publish charge data for the most popular inpatient and outpatient services. Some states are doing this as well, and now several payers have joined in the effort by posting actual payments made to providers for certain procedures and services.

The new CMS Five Star patient satisfaction ratings are designed to reward providers that deliver the greatest patient satisfaction, yet the results in many cases say more about CMS than the providers.

The prevailing assumption is that more competition will drive charges (prices) down, reducing the overall cost of health care and encouraging new disruptive players to enter the industry.

This is classical enterprise economics, yet health care is unique in that a third party in most cases is responsible for paying the majority of costs.

Modifying the charge master is complex and fraught with real risk of forfeiting net dollars unless you use the power of statistics to analyze multiple potential scenarios for setting charges.

There is an underlying assumption that more competition also will deliver better patient outcomes, too, yet the marriage of Best Practices to financial analytics is still in its infancy. Patient outcomes (value) will improve as performance metrics are implemented and refined.

It all starts by asking the tough questions of ourselves, staff, and the hospital Board, as well as seeking key input from patients and the community served.

Where do you see your organization now? What must you change to hit existing targets? How can you create a new paradigm for your organization?

In short, who do you want your organization to be?

Most senior executive teams are on this journey already, immersed in strategic planning, weighing alternatives, looking at process, and evaluating new ventures. It is an exciting time to be in health care.

The ACA is several years old and the change continues.

Regardless of whether you believe the law is a success, an abysmal failure, or somewhere in between, asking tough questions is the only proven way to move forward strategically to position your organization for the next 10 to 15 years of success.

Why ask questions? Why indeed!