Who will win the future in health care?

Purpose, focus, antifragile DNA ready to disrupt

The future will not belong to health systems with the most beds, clinics, or capital. It will be won by those with the clearest sense of purpose, the sharpest focus on a few critical competencies, and the DNA to become antifragile—not merely resilient in the face of change but strengthened by it because they are willing to disrupt their own strategic playbooks.

The conventional playbooks run by health systems are increasingly obsolete. Generative AI is changing how we work. Almost two percent of the population ages out of commercial and into Medicare products annually. Critically, success requires teams to excel at managing actuarial risk (forecasting costs for populations) and financial risk (operating efficiently against budget targets).

Yet, many health systems remain tethered to their old strategic plans. Too few have prioritized the agility to adapt overbuilt acute care assets to control costs. Actuarial and financial risk management are underdeveloped. Disjointed service experiences are misaligned with evolving consumer purchase preferences.

While leaders may recognize these performance gaps and hope for a different outcome, too many are unwilling or unable to change.

What follows is my thinking on one way to reframe system strategy development. My goal is to present a new strategic framework to inform decisions, actions, and resource allocation. Four keys to the framework are offered, followed by a set of provocative questions for executive teams to shape their response to a fast-moving, uncertain future.