Leader's toolkit: Challenging the anchor
Health system leaders need to see that there is no longer safety in the middle. Strategy must evolve from incremental optimization to intentional provocation. Six steps for learning from the fringe and five tools for leaders.
Learning to scan the fringe to source future competitive advantage
Strategic crossroads: defend today or design tomorrow?
Health system strategic plans are commonly exercises in refinement: tuning operations, rebalancing portfolios, and defending share against traditional competitors. But the playing field has changed.
Technology platforms, retail brands, private equity-backed disruptors—and most critically—consumer preferences are now reshaping how, where, and by whom care is delivered.
I believe that the question for CEOs and boards is no longer “How do we protect what we have?” The better question is “What are we building that the next generation of patients and payers will value most?” This requires a shift not just in plan, but in posture.
We must move from brittle strategies focused on efficiency and stability to adaptive strategies that grow stronger from volatility. As Nassim Taleb argues in Antifragile, systems that are merely robust can survive disruption, but systems that are antifragile—ones that learn, adapt, and gain strength from disorder—can thrive in it.
This mindset is the difference between being best in market today and being first to market with what’s next.
Why strategic plans fail to predict the future
Recently, I had the opportunity to engage with several health systems that are confounded by how badly their planning assumptions and financial forecasts missed the market. As one executive exclaimed, “We’re not even close.”
The reason is often that conventional strategy development in health care tends to be anchored to known constraints: annual budgets, current service lines, and existing reimbursement models. The plans that emerge often stretch the status quo forward, adding minor innovations at the margins. These strategies may be rational, but they are not resilient. They insulate against change rather than mine it for advantage.
The author Amy Webb, in her book The Signals Are Talking, notes that most organizations are not blind to disruption. Rather, they are deaf. They see the storm clouds on the horizon, but they are listening to the wrong signals: peer benchmarks, internal dashboards, legacy KPIs. By the time the disruptions show up on a mainstream metric, the opportunity has already moved.
