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Six imperatives for chief strategy officers in health care

Leading the charge in health care transformation

Josh Lee
Wendy Gerhardt
Wendell Miranda

As the health care industry moves towards a future dominated by consumer-driven change, emerging technologies and evolving regulation, the strategy leader can play a pivotal role in navigating stormy waters.

Executive summary

IT’S the morning of the monthly board meeting. The strategy leader reviews the latest list of potential technology and community partners to assess opportunities and execute the organisation’s strategies. The strategy team, which is well-connected to important thinkers throughout the organisation, has gathered that list. At the lunch-time board meeting, the strategy leader recommends new businesses and investments to build new capabilities linking to long-term strategic priorities that have a broader impact on their consumers’ health. Over coffee in the afternoon, the strategy leader has a huddle with the CIO to discuss the latest technology investments and ensure strategic alignment. At the end of the day, the strategy leader’s out-of-the-box thinking and strong connection with the CEO, C-Suite and the broader organisation help steer the organisation towards the future.

This may sound like a dream sequence for a typical health care chief strategy officer. But strategy leaders play a critical role in their organisation and days like this should be the goal as health care faces a tsunami of change. While many leaders of incumbent organisations can see coming change, we argue that there is no one better positioned than the strategy leaders at these organisations to lead the charge in addressing these changes. The “bat signal” is on for you, strategy leaders.

Strategy leadership is vital for the future of health care organisations. They help prepare for changing consumer expectations, embrace emerging technologies, stay current amid evolving regulations, understand factors that impact health and compete with both traditional players and new entrants. As this tsunami of change confronts health care organisations, the strategy leader should be interpreting the patterns and trends—both inside and outside the industry. There is now even greater opportunity for the strategy leader to take a lead role in the industry’s transformation.

What role are strategy leaders currently playing to help their organisations navigate towards a changing future? Is there a way to enhance the role’s impact on preparing the organisation to weather change and disruption? To answer these questions and others, the Deloitte Center for Health Solutions surveyed 63 health care strategy leaders (chief strategy officers and EVP/VPs of strategy and planning) from health systems and health plans and interviewed another 10.

Our research finds that health care strategy leaders see transformation coming from multiple players and directions. Surveyed respondents told us that top sources of concern are:

  • Competition from traditional and new entrants (57 per cent)
  • Evolving consumer demands (56 per cent)

Health care chief strategy officers will need new focus, authority and scope to their roles to help their organisations transform to succeed in the future of health. But at the same time, these leaders are juggling many competing priorities. While most surveyed strategy leaders say their highest priority is helping shape their organisation’s long-term strategy, most also say they spend “the least” amount of time actually working on this priority.

Our interviews with strategy leaders found a disparity among organisations in terms of preparing for tomorrow. Some already have a well-defined vision for the future supported by continued investments—including new leadership, technology adoption and investment in edge businesses (those outside of its core). But many others are still struggling to define their path to tomorrow, putting them at a greater risk for disruption.

How can organisations and strategy leaders stay ahead of it all? To prepare for tomorrow, health care organisations should realise the full potential of the strategy leader role. To make their organisations and roles as effective as possible in preparing for the challenges ahead, health care strategy leaders and CEOs should consider the six imperatives shown in figure 1.


As we say in Forces of change: The future of health, the health care system of the future will look very different. By 2040, we expect consumers to be at the centre of the health model; the focus to be on health and wellness; virtual monitoring and care delivery to be the norm; and interoperable, always-on data to be available for insights and collaboration. We also expect new entrants to the industry to help drive this transformation by offering customer-friendly, technology-driven solutions to solve for some of the industry’s biggest challenges.

What does this mean for today’s health care companies? Disrupt or be disrupted. Incumbents will need to change or risk displacement by industry disrupters—large technology companies, startups and retailers included. The entire industry will undergo radical transformation.

Some of these trends are already underway. For example, 20 per cent of consumers have used technology to measure and share their medication data with their providers and 35 per cent are interested in engaging with a virtual assistant to identify symptoms and direct them to a physician.1 Also, 27 per cent of health care organisations say that they have invested in technologies to automate tasks and processes.2

The Deloitte Center for Health Solutions surveyed 63 strategy leaders (chief strategy officers and EVP/VPs of strategy and planning) at health systems and plans and interviewed another 10 to understand how organisations are reacting to these trends, preparing for tomorrow and aligning themselves for future transformation. Nearly three-quarters of surveyed participants were from organisations with annual income greater than US$1 billion. In addition, Deloitte also held a summit with strategy leaders from health systems and health plans in the autumn of 2019 to discuss these topics. Our research findings suggest that many opportunities lie ahead for health care organisations—as well as their strategy leaders.

Research findings

Opportunities exist to evolve the strategy leader role and the organisation to prepare for tomorrow.

A tsunami of change–new technologies, regulations, changing consumer expectations and industry entrants—is fast approaching health care. Our survey and interviews found that strategy leaders at health care organisations must juggle these and other trends.

Industry transformation expected

Strategy leaders agree that the industry will experience major transformation in the next 10 years. Interviewees expect care delivery to change the most across the industry. Consumer demand, new payment models and alternate sites of care (virtual health, urgent care and retail clinics) will likely shift care delivery outside of hospitals. And with multiple modalities to access care (in-person, virtually, or on mobile devices), strategy leaders say that incumbent health care organisations will be required to develop new capabilities to deliver an immersive patient experience. Others also pointed to the imminent evolution of health care financing as consumers, employers and governments are increasingly unable to manage the growing costs of health care.

“As the industry around us evolves, consumers are going to want immediate access to things at their fingertips. If you really want to be successful in this business, you need to tend to what the consumer wants.”
—Health system chief strategy officer

Competition has a new look

More than half (57 per cent) of those surveyed said greater competition from traditional and new entrants will likely compel their organisations to focus on long-term strategy (figure 2). As incumbent organisations consider their market positions and competition, many are also concerned about their ability to react to consumers’ growing demands.

Interviewed leaders discussed how large technology companies, retailers and startups are entering the industry intending to disrupt incumbents. Some said that technology entrants could make data more liquid, analysable and shareable. For now, though, many are adopting a wait-and-watch approach, as they do not perceive these entrants as a major threat to their core business. Many say these entrants are likely to impact only the fringes of health care but not the core—care delivery. Only time can tell what impact they will have on the industry and on incumbents’ businesses.

“I don’t know what to think of their [new entrants to the industry] role yet … We are just sitting around and guessing. We need to have an eye on them and be ready to react.”
—Health system chief strategy officer

A more imminent concern among interviewed leaders is competition from incumbent players stepping outside of their core business or retailers entering the industry. Many of them say these competitors have customer-friendly offerings. Many of the top retailers have already built retail clinics in their stores that are competing directly with health systems by offering convenient access to care. Recently, Walmart opened a stand-alone primary care clinic.3

Strategy leaders’ ability to make an impact—on the organisation and the industry—is often limited

The world of health care strategy leaders can be stressful. Their role is often limited in scope and oversight, which prevents them from significantly impacting strategy execution. Juggling multiple organisational priorities also makes it difficult for them to focus on preparing for tomorrow.

When asked to rank organisational priorities, surveyed strategy leaders rank overall performance (including containing costs and sustaining margins) the top priority today (75 per cent) and in the future (86 per cent). Beyond that, however, strategy leaders appear to be handing over other priorities to their future selves. While transforming clinical and business decision-making capabilities through digital technology adoption and shifting into value-based care is the greater priority for the future, strategy leaders should speed up those efforts today.

Some are walking the walk or talking the talk, others don’t yet have a vision

Through our interviews, we analysed how prepared each organisation is for the future, based on its defined strategies and investments. While not an analysis of the entire industry, it is representative of the reality at most organisations today. Some of the organisations we interviewed are walking the walk—they have a defined vision for the future, supported by investments—including new leadership, technology adoption and edge businesses (those outside of its core). Others are talking the talk—they have a clear vision for the future but are yet to begin execution. Finally, another set of organisations is still determining the future path.

In figure 4, we plotted the interviewed organisations along a spectrum to represent their preparedness for future transformation. Those that fall in the upper right quadrant—walking the walk—have made transformation a high priority and have strong investment strategies to support it. Those in the bottom left quadrant are neither prioritising nor investing in strategies for future transformation.

Organisations gave many reasons for not walking the walk during our interviews—they face competing priorities, scarce resources and a lack of clarity around where to invest. But one thing is clear: Organisations that have yet to define their future strategy or take steps to execute on it may be at risk of disruption. However, they do have the opportunity today to get started.

Our research also revealed a few early movers acting to transform their business (see sidebar, “Early movers transforming today for tomorrow”).

Early movers transforming today for tomorrow

Some leading companies are exploring ways to innovate today and reposition themselves for the future. Building new income streams and “edge businesses” outside the core of care delivery and financing is one common pathway. A few even expect new income streams and/or edge businesses to account for a significant share of overall income in the next decade. Others are hiring talent from other industries to bring in greater consumer-centricity or are developing new technological capabilities. All result in the companies taking action towards the future ahead of their peers and competitors.

Providence St. Joseph Health (PSJH) is positioning itself with new technology capabilities and building new income streams through acquisitions. It recently acquired Bluetree Network to help other health systems optimise their electronic health record (EHR) investments.4 PSJH also acquired a blockchain company with a claims processing platform that simplifies financial transactions between payers and providers and reduces administrative burden.5

Humana has launched “Humana at Home” to provide in-home, behavioural and palliative care for chronically ill patients.6 In 2019, Humana launched Studio H to develop digital health apps and virtual care for care coordination.7 It also joined the Consumer Technology Association (CTA), a diverse group of companies (including Microsoft and Walgreens) aiming to use consumer technology to lower health care costs and drive better outcomes. Humana is the first health plan to join CTA.

Anthem is transforming itself into a digital platform company, hiring talent from technology companies to lead AI and health data efforts.8 It is beginning to rely on AI as the foundation for business transformation and also for AI to power the development of consumer friendly solutions to address whole person health and to simplify healthcare.

Mayo Clinic is testing AI algorithms to detect and diagnose arterial defibrillation from EKG readouts and invested US$30 million in a startup that uses AI to help physicians detect early signs of stroke.9

Cleveland Clinic is investing in a centre for advanced AI to build machine learning algorithms for diagnosis, treatment decision-making and predicting patient outcomes.10

Sanford Health has built a high-margin retail presence with 140 weight-loss storefronts. It plans to open 350 more stores in the next few years.11

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Challenges to a longer-term focus

Surveyed strategy leaders say they spend most of their time on activities that are not their top priorities. While most say their topmost priority is helping shape their organisation’s long-term strategy, most also say they spend the least amount of their time (among all the other activities we asked about) actually working on this priority (figure 5).

How can strategy leaders make a greater impact?

Today the role of the strategy leader is already central to the future of health care organisations. The approaching tsunami of change and disruption presents multiple opportunities for these leaders to further the impact and influence their role has on organisational transformation. Strategy leaders, CEOs and the organisation as a whole should consider the following six imperatives:

1. Enlist the CEO to challenge the organisational status quo.

  • Strategy leaders should have the CEO’s support to push back on organisational orthodoxies on how new ideas are evaluated and backed and the way in which the organisation thinks about itself, its customers and its competitors.

2. Own and incubate “edge” businesses.

  • Strategy leaders should impress upon their executive leadership and board the imperative to own and incubate an “edge” business unit to test hypotheses for new growth and transformative initiatives.
  • These edge businesses should have different financial criteria for decision-making—thinking that is unbiased against innovation. Emphasis should be placed on expected value over discounted cash flow.

3. Get on the frontline.

  • Strategy leaders should align better with frontline staff who have direct contact with new technologies and entrants in the industry and crowdsource transformative ideas. They should create policies and protocols to test the most compelling ideas and invest in them.
  • They should also work closely with frontline managers to anticipate trends and convene with leaders from across divisions to discuss opportunities for innovation.

4. Join forces with the CIO and the CIVO.

  • Strategy leaders and CIOs can work together on the overall technology strategy—from underpinning future strategies with the latest and greatest to the implications of today’s technology investments on future strategies.
  • The CIO should be at the front end of technology efforts and develop deeper relationships with the organisation’s core technology vendors.
  • Strategy leaders should closely align with the CIVO to put innovation at the forefront of all organisational strategies.

5. Rethink the partnership portfolio.

  • Organisations should identify and build relationships with external partners, potentially entities outside of traditional health care boundaries.
  • Build partnerships with large technology companies through consortiums, industry groups to build the capabilities (data, platforms and digital tools) to achieve long-term goals through innovation.
  • Strategy leaders also should partner with community organisations and state and local governments to test new models of care delivery and coordination.
  • Create relationships with community partners to better impact the health of the community and social determinants of health.

6. Get into execution.

  • Strategy leaders should become much more involved in implementing organisational- and business-level strategies. This would include serving as the leader to execute and operationalise certain new business units.
  • Strategy leaders should impress on their leadership and board the necessity of having a pool of resources dedicated to innovation. This could include teams—or funds—to partner with thought leaders who can help with sensing and scanning.
  • Lastly, strategy leaders should encourage all functions to adopt the fundamental priorities of the strategy plan as their own. Doing this can require organisations to shift away from annual planning to future transformation by creating both short- and long-term vision and strategy. Every decision and investment should tie into the organisation’s broader, long-term strategy and overall business goals.

Leading organisations could go a step beyond these strategies to ensure they remain relevant in a changing future. For one, they should identify needed capabilities that require external partners, including technology, retail and other leading health care organisations. In addition, building a team of “out-of-the-box” thinkers—from bringing in experts from non–health care industries to influencing the board membership and composition—could bring new ideas and perspectives to light.

Organisational transformation requires the strategy leader to play the role of the “canary in the coal mine” and identify previously unthought of risks, trends and challenges. By shifting the focus towards a long-term future, strategy leaders can help their organisations innovate.

​The future of health

The health industry is on the cusp of a major transformation that will affect all stakeholders. Incumbent players can either lead this transformation as innovative and well-connected market leaders or they can try to resist this inevitable change. A wide range of companies—from inside and outside of the health care sector—are already making strategic investments that could form the foundation for a future of health that is defined by radically interoperable data, open and secure platforms, and consumer-driven care.

Learn more

Project team: Bill Siren led the Deloitte Chief Strategy Officer Summit and helped with interpretation of the findings and review of the paper. Adam Hewson contributed significantly to the design of the survey, interpretation of the findings, and review of the paper. Claire Cruse contributed significantly to every aspect of this research—survey design, data analysis, interviewing executives, and writing sections of the paper. Madhushree Wagh helped analyse survey results and build charts for the paper.

The authors would like to thank Felix Matthews, Mike Schwartz, Bill Laughlin, Alex Schulte, Noam Schildhaus, Kartika Mittal, Sarah Thomas, Ramani Moses, Lauren Wallace, Samantha Gordon, and the many others who contributed to the success of this project.

Cover image by: Chiara Vercesi

  1. David Betts and Leslie Korenda, Inside the patient journey: Three key touch points for consumer engagement strategies, September 25, 2018.

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  2. Jennifer Radin et al., The future of work: How health systems and health plans prepare and transform their workforce?, Deloitte Insights, March 7, 2019.

    View in Article
  3. Bruce Japsen, “As CVS rolls out health hubs, Walmart prepares clinic expansion,” Forbes, September 3, 2019.

    View in Article
  4. PRNewswire, “Providence St. Joseph Health acquires Bluetree Epic Consulting,” June 27, 2019.

    View in Article
  5. Nathan Eddy, “Providence St. Joseph Health acquires Lumedic for blockchain tech,” Healthcare IT News, February 11, 2019.

    View in Article
  6. Landmark, “Humana and Landmark announce in-home care program for Humana Medicare Advantage members with chronic conditions,” April 24, 2018.

    View in Article
  7. Heather Landi, “Humana first major health plan to join Consumer Technology Association,” Fierce Healthcare, September 3, 2019.

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  8. Christina Farr, “Health insurer Anthem has hired a bunch of Apple employees to help it modernize,” CNBC, July 9, 2019.

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  9. Neil Versel, “Omron, Mayo Clinic invest $30M in AI for stroke prevention,” Forbes, March 16, 2017.

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  10. Morgan Haefner, “Walmart is changing how we pay for healthcare: 5 things to know,” Becker’s Hospital Review, October 3, 2018.

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  11. Interview with CSO from Sanford Health, July 26, 2019.

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