By Barry S. Bader
Note: “No battle plan survives the first contact with the enemy,” goes a military saying, expressed in recent years by Colin Powell.
The expression is worth remembering as hospitals and health systems embrace bold strategies to participate in the industry-wide economic shift from rewarding volume to holding providers accountable for the value they deliver. Boards must balance confidence in their vision of an integrated, accountable care delivery system with the reality of turbulence and unexpected events in a competitive and highly regulated marketplace. Governance cannot go on automatic pilot in turbulent times. Boards can manage and minimize strategic risks by adopting practices that recognize the inevitable uncertainty ahead. This commentary offers several such practices: recruiting new strategic competencies; learning from the past; developing new metrics; and maintaining strategic focus.