Rae Woods (00:20):
From Advisory Board, we are bringing you a Radio Advisory, your weekly download on how to untangle healthcare's most pressing challenges. My name is Rachel Woods. You can call me Rae. On the surface, the role of the strategic planner within the health system hasn't changed much in the last decade, but the operating environment has. Planners are managing tighter budgets, more data options, and policy pressures that require strategy leaders to move quickly and sometimes react defensively. But it's not all about playing defense. In fact, it can't be. We know from our conversation last week that health systems are actively pursuing growth, and we ended that conversation with the acknowledgement that to achieve those growth goals, strategy leaders need to understand what level of granularity is required in their analysis and their evaluations.

(01:13):
So in today's conversation, I've invited two Advisory Board experts, Sebastian Beckmann, who leads quantitative research and Ellie Wiles, our resident service line expert. Together, they'll help us understand how the role of the strategic planner is changing and how their relationship to data is both the problem and the solution. Hey, Sebastian. Hey, Ellie. Welcome back to Radio Advisory.

Sebastian Beckmann (01:37):
Hey, thanks for having us.

Ellie Wiles (01:38):
Thank you.

Rae Woods (01:39):
Are you familiar with this social media trend that's happening right now that's all about going back to the year 2016? Have you seen this?

Ellie Wiles (01:47):
I'm extremely not online, so no.

Sebastian Beckmann (01:49):
Yeah. I thought it was 2016.

Rae Woods (01:52):
Perhaps this reveals that I'm extremely too online. So the trend is that style and things like that go in these kind of decade long cycles. So all these folks online are comparing 2026 to 2016. What was the fashion like? What was the makeup like? I'm going to take us to what was the role of strategic planning like in 2016. Because my understanding is that the function of the strategic planner role at hospitals and health systems has remained basically the same for the last decade. Maybe you could even extend that timeline further back. But of course, the world that those planners are operating in is vastly different. My question is, what shifts have had the biggest impact in reshaping the role of the health system strategic planner?

Sebastian Beckmann (02:38):
Yeah, I think there are maybe three big things I would think about. The first is financial pressure. So your budget constraints that are going to affect your whole organization are going to make it harder for you as a health system strategic planner to justify the investments you need in order to make sure your organization is making the best decisions possible. Because if it's between a claims' data set for you versus a clinical investment that's going to save lives, it's hard to justify that investment every time. The second is kind of an opposite effect, which is that data is more available than ever before. So there's more data sources, different kinds of data, often cheaper data than what's available in 2016.

Rae Woods (03:21):
The way that you're describing this, Sebastian, makes me think that I should believe that both of those things are bad. Budget constraints are obviously a challenge and a challenge that frankly, Radio Advisory listeners should be well aware are happening across the healthcare market. But more availability of data, that's a good thing to me.

Sebastian Beckmann (03:43):
More availability kind of turns into data commodification. It means having the best data is not a competitive edge. So having a data set where you can see ambulatory share that used to be a differentiator. Knowing where physician referrals are going, that used to be something that sets you apart from other health systems and meant that you could compete just on the quality of your data alone. And that's no longer possible.

Ellie Wiles (04:06):
Yeah, that's exactly right. These budget constraints and financial pressures are highlighting the need for more precise decision making in service line strategy as well.

Sebastian Beckmann (04:16):
And I think those two together also set up the third thing I was alluding to. So you need visibility into different sites of care because your growth opportunities are no longer limited to the hospital. Most health systems we talk to are trying to grow ambulatory settings. They're trying to grow their physician network and their outpatient capabilities. They're not as focused as they used to be on just inpatient volume as kind of one big success driver.

Rae Woods (04:41):
All of this means the role of the strategic planner needs to evolve. My question is, how?

Ellie Wiles (04:47):
Strategic planning needs to become more nimble, more frequent, and proactive, and more democratized to drive more precise growth for health systems.

Sebastian Beckmann (04:56):
Yeah. And what that means in practice is you can't get away with one annual plan per service line. You have to be responsive to tons of different opportunities. You need to make it possible for more people at your organization beyond the strategic planning shop to be able to identify proactive growth opportunities.

Rae Woods (05:13):
And they're going to do that with this democratized data.

Sebastian Beckmann (05:15):
Yeah. And I'm going to put structure on it. You need to get good at data democratization. And on the flip side, you also need to get good at governance. So you need to give people access and you need to make sure that you have the QA and the share definitions to make sure everyone's using the data right.

Rae Woods (05:30):
Okay. This means that I have a very difficult job as host, which is to talk about two of I'm sure our audience's favorite topics, data and governance, and talk about it in a way that is effective and helpful for the market. Clearly data is really, really essential to this conversation. And I think I'm starting to come around to why. If planners have to be more nimble, they need to be more precise in what the growth opportunities actually are. You can't have that more nimble approach without clear data governance and clear data cascades. Where I'm very unclear is how you actually do that.

Sebastian Beckmann (06:07):
Rae, can I commit a Cardinal podcasting sin, which is to describe a visualization?

Rae Woods (06:13):
Let's try it.

Sebastian Beckmann (06:14):
Okay. So I think about this in two dimensions. So think about data democratization kind of as your Y axis. So at the far bottom, only a handful of people at your organization are even able to touch the data. It's gated behind code. They have to use SQL. They have to join together tables that most people are not familiar with. And at the very top is there is an interactive system that anyone at your health system can access and it's easy for them to just drag drop tables to get the reports they need. And there's a world of options in between those two.

Rae Woods (06:49):
Okay. I'm with you.

Sebastian Beckmann (06:51):
The X axis, I think of as your data quality. So on the far left, the most basic is something like, I see my claims data and nothing else. On the far right is I've got ambulatory visibility. I've got state discharge data for inpatient. I've got consumer data. I've got cell phone data to see people's actual locations and where they come to the hospital. I've got everything I need. My temptation as the quantitative insights person is to say everyone needs to be at the top right.

Rae Woods (07:23):
Yeah. That's your classic consulting two by two is everybody needs the most access to the most sophisticated data.

Sebastian Beckmann (07:29):
Yeah, it's so easy. No, it's not. It's actually really hard. And it's not right for everyone to be at the top right because it's not just about how much can people access the data. It's also about, are you able to make sure that everyone speaks the same language when they talk about investment opportunities? Do you have a system in place to make sure that when you count orthopedics, you're counting in the same way as you are in cardiac, which is actually not always super straightforward? Do you have a system in place to make sure that the people interacting with your data know what they're doing and are able to produce results that are meaningful to identify an opportunity at your health system? So it's a governance question and not everyone should be all the way up at the top at full democratization.

Rae Woods (08:09):
It makes sense to me that not everyone at an organization should have complete unfettered access to all of the data, but I'm less clear on why we all wouldn't want the most sophisticated data, the far right of the X axis as you described.

Sebastian Beckmann (08:24):
Yeah. And I think it would be great if we could all get there, but data costs money and you have to make trade-offs on how much data is our organization realistically going to use versus how much are we willing to spend on this? So I think longitudinal patient data is awesome. It lets you see when patients get a disease, what's all the care they get beforehand? What's all the care they get afterwards? How much of that do we capture versus our competitors? Most organizations I talk to, even the ones who have access to that data, don't actually use it. So is that worth it to invest in that extra capability if it's not something that you're realistically going to be able to adopt, especially in the context of a constraint budget?

Rae Woods (09:04):
Which by the way, the muscle that you need to flex to be able to manage trade-offs should be quite familiar to the strategic planner because they are constantly managing trade-offs.

Sebastian Beckmann (09:13):
And I think it's both budget trade-offs as well as capacity trade-offs. So do I have budget to buy this? Do I have the time to use this? And do I have the organizational capacity to invest in data governance and bring everyone on this journey together to move more to the top, more to the right?

Rae Woods (09:30):
So far in this conversation, we've had a bias towards the planning office. We've been talking about the health system strategic planner, but we also acknowledge the fact that doing one plan for the entire system is a thing of the past. Ellie, you're here to represent our service line research. What is the role of service line leaders in setting that growth agenda, knowing that we need to be more nimble and we need to be more specific to be actually able to capitalize on the growth targets that we have?

Ellie Wiles (10:02):
I mean, historically, service line leaders are told to lead with influence. They're told to bring their qualitative insights and their qualitative perspective into driving system-wide strategy and driving the strategy forward for their service lines. And we see that they're accessing more of the data that in the past was pretty much just within the domain of the strategic planners.

Rae Woods (10:23):
So you're saying that the service line leader is higher on the Y axis that Sebastian was describing. They're using the data that they have access to.

Ellie Wiles (10:31):
They should be, but a lot of times they don't have the time or the training or the expertise on how to leverage the data that they're given. And they also aren't always clued in or don't have the access to the same data that planners use. So as we've been doing this service line growth research, we've talked to a bunch of service line leaders who were really proud of growth initiatives that they'd recently led, but they couldn't measure the impact of those initiatives because they didn't have the data to evaluate them. Another way that we see this manifest is in the level of granularity that we talked about earlier. So a lot of times they'll prioritize entire service lines as areas for investment rather than finding a comparative advantage or a niche in their market where they can invest in a specific subspecialty or service.

Sebastian Beckmann (11:16):
Yeah. I see that manifesting is a reactive planning approach as well. So service line leaders reacting to what physicians are bringing them, not necessarily proactively evaluating in the data, what are the opportunities in their market? It's, "Hey, my doctors say they want to do TAVR. Let's evaluate that opportunity." Rather than looking across cardiac services and all the markets and all the potential services they could be investing in to understand which one has the greatest opportunity for growth for their organization.

Ellie Wiles (11:46):
And this leads to a pretty big gap in data guided strategy where decision making is driven by qualitative inputs and the quantitative pieces they have are sometimes the wrong ones or not the full picture.

Sebastian Beckmann (11:58):
So ideally, you would want it to look like service line leaders have the data they need and they're proactively looking for opportunity. And I kind of trash talk service leaders a little bit implicitly earlier, and to use a counter example, I talked to a health system a little while ago who locked their data down so tight that their service area definitions are a secret. They won't tell anyone within their organization what their service area definitions are.

Rae Woods (12:23):
Including the service line leaders.

Sebastian Beckmann (12:25):
Right. So service line leaders don't know what their hospital's service area definition is. And the reason the planning shop has done this is they don't trust anyone else to bring meaningful analyses, right? You need to be able to bring everyone along to share that responsibility across the organization, which is then a data governance question and an education question.

Rae Woods (13:55):
There's two things I'm taking for this conversation so far. First, this is a really, really hard environment to be planning your growth agenda in, especially when you have to use a combination of qualitative and quantitative data, and every organization is going to do that in a different way, different levels of data democratization based on different levels of sophistication. Ellie, I'm curious if you have an example that goes a bit counter to the one that Sebastian just said. He just shared an example of service line leaders being entirely locked out of the data and therefore the planning. Is there an example where organizations and service line leaders are doing this well when they're actually harnessing the data at the right level?

Ellie Wiles (14:37):
Yeah. There's one that comes to mind. Memorial Health System spent the last couple of years building out basically service line dashboards at the level of even subspecialties. And they have set it up in such a way that not only does the data and strategy team that manages this platform can access it, but also the service line leaders, the physicians, anybody within the organization can request access to the platform. The data polls are automatic, so they can go in there and find the stat that they're looking for, get it immediately with the caveat that they then take it back to the team to make sure that they're interpreting it correctly before they take it to, let's say, the C-suite to make a proposal for some investment.

Rae Woods (15:20):
So Sebastian, where would you put Memorial on your graph?

Sebastian Beckmann (15:23):
Yeah, I'd put them towards the right and towards the top, maybe halfway to the top.

Rae Woods (15:28):
So pretty sophisticated in terms of the data.

Sebastian Beckmann (15:31):
And everyone who needs access can request access. And there's a training and onboarding process for them to make sure they're using the data appropriately.

Rae Woods (15:40):
And what has the accessibility to that sophisticated data gotten Memorial?

Ellie Wiles (15:45):
They have significantly reduced the time needed to gather data for decision-making, literally from weeks to minutes. They have brought in more decision makers and basically fostered this environment where they're pulling in input from across the system rather than just from their isolated strategy team. They've been able to pinpoint specific procedures and subspecialties that have higher contribution margin, so they can make those more precise growth decisions as well.

Rae Woods (16:13):
And that's exactly the level that we're pushing our health system partners to get to when it comes to their growth agenda. We already said gone are the years of the annual strategic plan, but I'm not sure it's even we have to think about service line level growth at the service line level. What you're describing is contribution margin at the procedure level.

Ellie Wiles (16:34):
Yeah, exactly. The population in South Florida is growing anyways, so it's hard to kind of isolate their results from that, but they have seen growth on the magnitude of 20 to 40% in volume growth and in revenue growth across service lines, as well as their ancillary services like imaging and specialty pharmacy.

Rae Woods (16:53):
So Ellie, that example is a really good one of why more granular data is helpful to pursue more niche growth at the service line level and even at a level deeper. But the other thing I heard is really important for the role of strategic planning in 2026 is being nimble, reacting quickly, assessing progress, making any pivots when you need to. Is there an organization that's taking this nimble approach to strategic planning and doing it effectively?

Ellie Wiles (17:21):
Yeah. So we're seeing that operational considerations are a big part, or at least should be a big part of strategic planning, making sure that you have the infrastructure and capacity to support new initiatives. One example that comes to mind is an AMC in the South who built out an analysis they call the Growth Opportunity Index, which assesses service lines and sub-service lines to identify opportunities that have the right combination of volume and positive contribution margin. So not just looking to invest in the highest revenue service lines or sub-service lines, but what has the highest contribution margin that there's also enough demand to support. So one way that they use this, they were able to shift some of their negative margin services to other sites of care rather than growing them indiscriminately to kind of guide a site of care optimization initiative.

Rae Woods (18:14):
And that's really important because as we talked about in our episode last week, we learned that volume doesn't necessarily equal margin. Something that we've been tracking, especially over the last couple of years, is this decoupling of volume and margin. So I like that this granular level allows this particular organization to identify opportunities for growth, but it also allowed them to understand what do we need to deprioritize.

Sebastian Beckmann (18:39):
Can I add on one point there? So something that I love about both of those examples is they're both organizations that have really solid market data. So what is the external market doing? What's our market share? How much opportunity is there to chase and really good internal data. So that's the margin and cost piece, right? And you really do need both in order to make the best decisions.

Rae Woods (19:03):
Here's why I think our listeners are going to find this so hard though, is that even though both of those examples are great examples, it also sounds to me that the data capabilities that best serve your organization are the data capabilities that best serve your organization. Sebastian, thinking back to that matrix that you outlined for us earlier, this combination of sophistication on the X axis, democratization on the Y, how should health systems be thinking about their data needs to best drive their growth moving forward?

Sebastian Beckmann (19:34):
Yeah. I think both those examples, having at least directionally correct margin data on the internal side is really important to make sure that you're identifying growth opportunities that are also going to result in margin growth. On the market data side, I think there's kind of a minimum level that everyone should be hitting now, which is you need full inpatient visibility and you need ambulatory visibility because that's where a lot of these growth opportunities are now.

Rae Woods (20:00):
And how do you get that?

Sebastian Beckmann (20:01):
There's about a half dozen vendors out there that offer roughly equivalent solutions. So they all describe about 80% of claims coverage nationally, and they differentiate on things like longitudinal claims coverage on top of that all payer solution, or maybe even really detailed physician referral data intended for liaison offices. But like I said earlier, I don't think all health system strategic planners actually need all of those capabilities.

Rae Woods (20:25):
Yeah. I was just going to ask if there's a minimum threshold that you need, is there a ceiling that you can kind of ignore above?

Sebastian Beckmann (20:33):
Yeah. I mean, for some people, you probably do want everything, right? For some organizations, if you can use the longitudinal data, you should be chasing after solutions there. But I think the minimum that everyone should be hitting is that ambulatory visibility.

Rae Woods (20:46):
Got it.

Sebastian Beckmann (20:47):
Advisory Board is actually launching an all payer claims solution later this year, which is going to provide both that inpatient visibility, hospital outpatient and visibility crucially across ambulatory sites. And looking at what's out there today, we're kind of anchoring on two core principles. One is that this has to be really good value. So most of the vendors we talk to or hear about are charging 150K plus annually for this kind of service. We plan on coming in well below that for this kind of commodity data offering. And then the second is that most of the offerings out there serve a variety of different use cases, whereas we are anchoring solidly around health system strategy. So we want to do the 80/20 of what you need every day. That's market size, market share, competition, out migration, physician connections, but structured in such a way to help you identify opportunities, not necessarily identify specific physicians for acquisition.

Rae Woods (21:45):
Got it. It's impossible for me to have a conversation about data without acknowledging how artificial intelligence can maybe transform the utility of that data. So those of you with your buzzword bingo card at home, go ahead and cross that box off. Have either of you seen planners or service line leaders effectively use AI to make data more usable, more accessible, more precise so that it can actually drive growth?

Sebastian Beckmann (22:14):
Not yet. I think this is early days for AI in this space.

Rae Woods (22:21):
So if not yet, what would it actually take to get to the point where AI can actually be an unlock here?

Sebastian Beckmann (22:29):
Part of it gets back to how is the data stored? And I don't want to get into a plumbing conversation here, but a lot of this is the way we store data is optimized for the EHR or the billing system, not for humans. And your AI chatbot is really good at pulling out insights from semi-structured data, but if it's locked away in five different tables that you have to merge anytime you want to count something, your AI is probably not the best solution. It's probably going to get a result if you're applying some kind of agentic system here, but you will have no way of QAing that is not just as time intensive as doing the work in the first place. So you get into some of those data engineering problems. I also think that there are a lot of concerns about privacy of the data, governance where maybe you don't want to be giving this to take your pick of whichever vendor you can imagine, right? So I think it is just still a little bit early for those kinds of solutions in this space.

Ellie Wiles (23:28):
We keep asking about AI in our service line leader conversations, but we've just gotten vague. Maybe it would be interesting for this, but nobody is really using it yet in service line strategic planning.

Rae Woods (23:39):
Yeah. I see a disconnect between what vendors or tech companies say is possible and what the leaders on the ground are effectively doing. And the good news that I'm hearing from this conversation is that there is a lot that service line leaders and strategic planners can do with the data that they have, especially as that data becomes more sophisticated and as more people hopefully get access to that data across their organization.

Sebastian Beckmann (24:01):
Yeah. I do think if we play forward a couple years, AI should be a helpful tool here, right? So if you need more analyses, need more nimble, you need more granular, you really need a way to increase your capacity to do these analyses and AI feels like a solution there. That said, I think it compounds all the same data governance issues we've already talked about, right? So how do you ensure quality and consistency with your colleagues while this new colleague often hallucinates and is extremely confident about their work. So yeah, you should probably be exploring options here, but it's not going to obviate the need for the hard work of figuring out your governance and figuring out your education and making sure everyone is thinking about growth in the same way.

Rae Woods (24:47):
Well, when AI does eventually help us here, I am sure that you will be back on Radio Advisory to tell us about it. Sebastian, Ellie, thanks so much for coming on Radio Advisory.

Ellie Wiles (24:56):
Thanks, Rae.

Sebastian Beckmann (24:57):
Thank you.

Rae Woods (25:02):
We got into a lot of detail in this conversation, and I know we shared several examples, so allow me to bring you back to our key takeaway. Strategic planning needs to be more nimble and more granular. Here's what that means for you. Take advantage of the different data sets that are available to you and make sure you're democratizing access to that data, matching it with the qualitative perspective of leaders at the service line level so that you can make better growth decisions for the future. Advisory Board will actually be launching an all payer claims solution later this year to help you with this exact challenge. If you're interested in learning more about that, reach out to your account manager or email us at podcasts@advisory.com because remember, as always, we're here to help.

(26:15):
New episodes drop every Tuesday. If you like Radio Advisory, please share it with your networks. Subscribe wherever you get your podcasts and leave a rating and a review. Radio Advisory is a production of Advisory Board. This episode was produced by me, Rae Woods, as well as Abby Burns, Chloe Bakst, and Atticus Raasch. The episode was edited by Katy Anderson with technical support provided by Dan Tayag, Chris Phelps, and Joe Shrum. Additional support was provided by Leanne Elston and Erin Collins. We'll see you next week.