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The Rise of the Chief Strategy Officer

Philip Betbeze, for HealthLeaders Media, November 13, 2013
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This article appears in the November issue of HealthLeaders magazine.

As healthcare undergoes seismic shifts in its business model, many healthcare CEOs have realized they need help on the executive team. Increasingly, that help is coming in the form of leaders who can focus exclusively on something that in many organizations has been the CEO's exclusive responsibility: long-term strategy.

While the CEO is still ultimately responsible for strategic direction and follow-through, increasingly, health systems are creating the position of chief strategy officer, a person who guides strategic planning and is responsible for executing, communicating, and sustaining that strategy. Think of them as business development gurus who are generalists; their projects are long-term in nature. That's one reason a good CSO is hard to find and often will come from within the organization: The right person will need to possess well-rounded knowledge of how the organization functions now in order to envision a higher-functioning future state.

Despite the benefits of the inside candidate, many experts suggest that the chief strategy officer role may be a good fit for executives who are making the transition to healthcare from other industries, given the importance of fresh thinking, strategy, business development, and marketing that is central to the CSO's role. Many systems, however, are reluctant to take that risk.

Significantly more challenging

Greg Poulsen got involved with strategy work at Salt Lake City's Intermountain Healthcare 18 years ago—already 12 years into his career at the 22-hospital system. Then, he was the senior vice president of planning. In part due to his longevity with the organization, he was uniquely qualified because of a reasonably broad understanding of what works and what doesn't, he says. Now, as the CSO for the past five years, he's been elevated to the C-suite—a tight circle of advisors close to the CEO. He attributes that not to his own expertise necessarily, but to the dramatic shifts in the way healthcare business is conducted and the need for health systems to adapt to that change.

"The thing that's changed the most over the past five years that has elevated strategy work is the rapidity with which the world around us is changing," he says, adding that not all of the changes are positive. "Some of it is purposeful change in a consistent direction, but much is turbulent in that it goes one way one day and another the next, and figuring out the correct path is significantly more challenging than when I started."

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