What This Phase Is For
Healthcare transformation does not fail at the strategy level — it fails at the stakeholder level. Phase 2 is where you work through the tensions that are already present at your table. Each role has different priorities, different risk tolerances, and different pressures. Some of those tensions are visible. Some are hidden.
This phase is not about reaching consensus for its own sake. It is about surfacing real disagreements, understanding what each role actually needs, and finding positions that are both strategically sound and politically sustainable within your team.
What Your Team Should Accomplish
- Surface the competing priorities across your six roles — name them explicitly, not just implicitly.
- Negotiate toward shared commitments: what can every role endorse as part of the strategy?
- Identify the non-negotiables: what does each role need to protect or secure, and why?
- Develop an approach to physician engagement that the CMO can credibly own.
- Address the financial model in enough depth that the Payer representative can commit to it.
- Ensure the Community Health Director's equity agenda is embedded in the strategy, not appended to it.
- Give the Patient Advocate a visible voice in what the model actually promises.
The Most Important Tensions to Resolve
| Tension | The Strategic Challenge |
|---|---|
| Financial margin vs. access investment | Every investment in primary care, community health, and technology costs money the system barely has. How do you design an ambitious strategy on a 2.4% margin? |
| Speed vs. physician buy-in | Moving fast on care model change risks losing key physicians. Moving slow risks losing the board's confidence. How do you sequence this? |
| System priorities vs. equity obligations | The populations most underserved are often the least profitable to serve under fee-for-service. How does equity get funded in a financially constrained system? |
| Technology investment vs. readiness | The Innovation Officer wants to accelerate digital tools. The CMO knows clinical staff are already stretched. What is the right pace? |
| Payer demands vs. system transition timeline | The Payer wants value-based commitment now. The CEO knows the transition takes time. What do you commit to? |
▶ Coach Note
A negotiation that ends without someone having had to give something up is probably not a real negotiation. Productive disagreement at this stage is far better than false consensus that fractures during the press conference.
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Phase 2 Key Output
Shared commitments across all six roles — and explicit acknowledgment of what each role needed to give up to get there