Organizations invest significant resources in crafting strategies to differentiate and drive change. However, many strategies never materialize and fail to generate meaningful action with tangible results. In our observation, this isn’t due to flawed ideas or a lack of ambition. Rather, there is often a chasm between strategic intent and the organization’s commitment to action against the strategy.
We argue that broad alignment is fundamental during strategy development. When strategies are created in isolation, without involving the stakeholders responsible for putting them into practice, they lack the necessary buy-in to succeed. Without meaningful engagement, debate, and alignment, even the most compelling strategies risk becoming documents that sit on a shelf rather than catalysts for progress.
A dialogue-based approach that focuses on alignment
Our methodology aims to align organizations around a clear and actionable strategy. By structuring strategy development as a process of active discourse rather than passive agreement, a final strategy is selected that has built-in ownership from key stakeholders. This is achieved by facilitating dialogue and debate around underlying assumptions rather than personal preferences, leading to a more productive discussion that drives toward a central aiming point. It also prevents organizations from jumping to conclusions too quickly, removing bias and reflexive decision-making. This methodology moves beyond traditional strategic planning, which often assumes alignment will follow naturally, and instead establishes alignment as an explicit, structured outcome of the strategy process.
Foundational phases of an execution-ready strategy
Our approach is grounded in three key design phases that foster both clarity and organizational engagement:
- Identify Givens and Areas of Choice – Execution failure can arise from misalignment between perceived constraints and real areas of opportunity. We differentiate between non-negotiable constraints (“givens”) and areas where there are open strategic choices, forming a “bounding box” around a potential aiming point. The areas of choice are informed by extensive discovery work, encompassing market research, stakeholder interviews, and competitor analyses, among other topic-specific deep dives. This paints a broad view of the landscape and generates a wide array of possibilities.
- Build Distinct but Plausible Alternatives – Strong strategy development involves outlining viable options for consideration (“alternatives”) rather than marching toward a single, predetermined outcome. Alternative development is intended to span the spectrum of possibilities identified during the discovery phase and translate abstract concepts into tangible options. This is done by clearly detailing assumptions to emphasize “what must be true.” Alternative descriptions can include other considerations such as cost, time to impact, and capability gaps.
- Facilitate Debate and Discussion – Leadership debate and discussion serve as a catalyst for strategy selection. The well-crafted set of alternatives helps fuel leadership convergence over a few sessions. Leaders reduce bias by shifting the debate from personal preferences to underlying assumptions and further exploring foundational attributes. This process drives a shared vision of the future state, enabling the final strategy to emerge organically.
An illustrative example: Behavioral health strategy
Consider the following example to demonstrate the effectiveness of this approach. A multi-state health plan sought to develop a focused and actionable behavioral health strategy. They were under pressure from employers increasingly concerned about workforce productivity and timely access to care. Their current situation lacked clear direction, leaving many critical choices undefined.
We implemented the dialogue-based approach anchored in leadership alignment. Our objective was to align the organization (vertically and horizontally) around a clear, actionable multi-year behavioral health strategy. To accomplish this, we engaged with multiple levels of the organization and formed groups with varying objectives.
- Steering Committee – (composed of executive leadership) aimed to make strategic decisions and select an aiming point for the behavioral health strategy
- Strategy Oversight Committee – (included functional leaders) monitored content progress and shaped material for leadership discussion
- Working Group – (involved middle management and subject matter experts) developed content, provided updates, and escalated risks or issues
We facilitated multiple sessions over 14 weeks, ultimately aligning on a strategy encompassing attributes from three distinct alternatives. The key drivers of success included:
- Active involvement of all executive team members in developing the strategy and future state
- Development of shared beliefs about internal and external capabilities
- Openness to engage in content and grapple with downstream implications
- Desire to achieve near-term wins while pursuing activities with a longer time horizon
A versatile approach for alignment
This approach can be applied to several strategic contexts at varying scales, showcasing flexibility and breadth.
- Enterprise Strategy – Driving alignment across an organization’s full leadership structure, ensuring all divisions move cohesively toward a shared future state.
- Topical Strategy – Addressing complex strategic initiatives or products where stakeholder engagement is critical.
- Functional Strategy – Ensuring that departments within an organization are operating within a defined focus.
By embedding structured dialogue into the strategy development process, organizations don’t just articulate strategy, they build the alignment and momentum necessary for its execution.
Impact Advisors’ seasoned team brings a unique mix of healthcare industry leadership and consulting experience to some of the largest payer and health-tech clients across the country. We offer expertise in product design, value-based care, cost-of-care improvement, digital health, operational efficiency, sales and channel optimization, Rx transformation, and core systems modernization.
