1. Stratis Health Leadership Strategy
Developing Future Scenarios to
Describe Health and Health Care
MAPS Board of Directors
January 25, 2018

2. Leadership Strategy: Lead With Vision
Goals:
Be bold about Stratis Health’s vision for the future of health care
Inspire commitment and lead with accountability
Outcome Measure:
By September 2018, a concrete and actionable set of critical next steps and investments that will enable Stratis Health to realize our future vision of health and health care and Stratis Health’s role in it.

3. Why?
To assure that Stratis Health is well positioned as a leader into the future
Explain or articulate a future world to leaders, especially in an uncertain policy and program environment
Demonstrate thought leadership to our partners, collaborators, funders, policymakers

4. How do we get there?
Create alternate plausible “futures of health care”
To envision dramatically different health and health care in 2025 and beyond, and to signal to community leaders that Stratis Health is a thought leader about the future.
Use scenario planning as a tool to create the plausible futures, and how we envision quality in each future scenario and prepare for our role in it

5. What is Scenario Planning?
Method to define possible and plausible future scenarios, identify the conditions in each scenario and then plan around those conditions
Start by identifying “pre-determineds” (what we know will exist) and “critical uncertainties” (what could happen that would have big impact)

6. Scenario Planning – Impact and Uncertainty
Impact – to what degree will the factor impact the future
Uncertainty
“Low” means we are reasonably certain that it will play out or continue in ways that are fairly well understood
“High” means that we have no clear idea which of a number of plausible ways it might go

7. Building Blocks
Gathered information and insight on health and health care in 10+ years:
Board breakout groups (October 2016) and ongoing board input
Coral Initiative CEO focus group (December 2016)
Key informant interviews (April – July 2017)
Medical sociologist interview (December 2017)
Various articles and resources

8. Themes from Building Blocks
Pre-determineds: High impact and low uncertainty
Increase in number of both older adults and Millennials
New technologies to collect data and access care (real time)
Proactive mining and use of ‘big data’
Sharing economy (e.g., Lyft, Airbnb)
Changes in access points for health services

9. Critical Uncertainties Identified from Building Blocks
Critical Uncertainties: high impact and high uncertainty
1. Health services value system
2. Source of decision making and accountability

10. Critical Uncertainty #1 – Health Services Value System
How will we as a country view our health system and services in 2027?
Basis for and ability to access to coverage, care, services
Payment for healthcare and role of the employer
Impact of globalization and immigration
Balance of investment between medical and social services

11. Critical Uncertainty #2 – Source of Decision Making and Accountability
Who will be responsible for health care decisions in 2027?
Level of economic power by consumers
Shifts in control for decision making
How “quality” or “health” is defined
Patient defined or technology calculated
Illness focus or wellness focus

12. Critical Uncertainties Scale
Access to care and services is a public good
Need to qualify or achieve access to care and services
Health services value system
Individual personal responsibility, individual initiates interactions with healthcare system
Population based, individuals are community investments, health system or public health initiates interactions with individual
Source of decision making and accountability
Keep in mind that critical uncertainties must have two distinct endpoints.

13. Four Future Worlds Public Good Health services value system
A: “Free for all” or “Come and get it”
B: “ Community investment” or “U.S. healthcare starts to look like the rest of the world”
C: “Figure it our for yourself” or “The have’s and the have not's”
D: “If you have a ticket” or “If you’re not in a group, you don’t count”
Health services value system
Population Based
Individual
Source of decision making and accountability
Need to qualify or achieve

14. Elements of Each World Pre-determineds help build out descriptions.
Quality and safety
Technology
Workforce
Money transactions
Relationships between patients and healthcare team members
Politics
Access points
Influencers of health
Pre-determineds help build out descriptions.

15. How will we use the scenarios?
To clearly articulate and define Stratis Health’s role in the scenario, what gaps exist currently, and the business considerations relevant to moving toward these futures.

16. Strategic Planning Next Steps
Use the four worlds to identify and plan for Stratis Health actions today to prepare for tomorrow’s scenarios
Staff input sessions (3) in Feb and March 2018
Synthesis and implications
Action recommendations
Continued board and staff engagement

17. Questions for MAPS Board
Will safety still be a primary core value, or will it be supplanted by other values like privacy, autonomy or convenience?
What are the emerging challenges for safety given the changing environments (e.g., will more fragmented access result in increased opportunity for diagnostic error?)?
How will safety improvement work be funded under the various scenarios?