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In praise of middle-ground strategy discussions

Why we developed the ‘Board Briefing’ series for members and the general public

In our many years of working with healthcare organizations, we have noticed that board strategy discussions tend to be concentrated at one of two conversational levels:

  • Stratosphere level: Typically in a once-per-year retreat context; e.g., “What is the future of health care? What is the future of this organization?”

  • Immediate-turnaround, rubber meets the road level; e.g., “Should we, or should we not, agree to the terms of this JV?”

In our view, by sticking mainly to these two levels, many health care organizations are missing out on something different, and valuable: a middle ground, if you will, of strategic conversation.

Make space for the all-important middle ground of board strategic conversations

What is this middle ground we speak of? It’s a conversation in which management teams and boards come together to consider an important trend in healthcare from two angles. Angle one: Make sure everyone is caught up on the current situation. Angle two: Talk through some potential opportunities/challenges for one’s own organization.

The trend in question could be a new development that has been in the headlines, or, just as important, stopping to take the temperature of a slow-moving, consequential trend that has been gradually morphing in the background while everyone has been preoccupied with day-to-day urgent matters.

Why are frequent middle-ground discussions important? Two reasons:
  1. First, if done at a regular cadence, middle-ground conversations boost and maintain everyone’s total situational awareness of market conditions. This takes pressure off the once-a-year crash course in market trends.

  2. Second, middle-ground strategy conversations help everyone hone the critical, yet non-obvious, skills of eliciting and providing constructive strategic input. A well-executed middle ground conversation series sets up board members, especially new ones, for success in providing high-quality input. It does by keeping the conversation from teetering on either of the two dangerous edges of the board input road—that is, overly existential on the one hand, or overly in-the-weeds on the other.

The challenges of supporting middle-ground board conversations

Of course, facilitating a productive middle-ground strategic conversation is easier said than done. It’s not a work-free proposition for the executive leading the discussion to pick out the important trend, gather and synthesize current information, and then lead a productive discussion about organizational implications and potential actions needed.

Voila: Union’s ‘Board Briefing’ series

We think a useful role for us here at Union is to provide executives with the materials they need to effectively brief their boards on a range of healthcare trends that lend themselves to substantive board discussions. This is why we are excited about the ‘briefing deck’ resource library we are building for members—a subset of which we are sharing with the public through our free Board Briefing webinar series.

In each briefing deck, we are doing the issue curation and the current-trend synthesis—and have embedded a starter set of discussion prompts for you. We always provide the PPT itself, so that you can go in and modify as needed, especially when it comes to customizing the discussion prompts.

Kicking things off with Medicare Advantage trends and implications

Our very first official board briefing deck, on the topic of Medicare Advantage, is available for members now (please be sure to log in to your Union member account in order to access it).

In it, you’ll find the three trends we think are worth calling out in 2023, including mention of the OIG’s recent announcement re: managed care oversight, which is what initially pushed us to create the deck. At the end, you will find five discussion prompts for facilitating an effective board-level discussion about organizational implications of recent developments in the MA space. Soon, we’ll have bootcamp modules on the topic of both the Health Plan sector writ large and MA specifically, which can be shared as pre-work, if appropriate/for new board members ahead of the briefing and discussion.

Non-members are welcome to access a subset of these briefings

Not a member? Allow us to re-emphasize that we’ll be sharing some of these briefing decks as part of our new monthly Board Briefing webinar series. You can peruse all our upcoming topics here, or register for specific sessions at the links below:

These sessions are suitable for any board-level or executive-level attendees for sheer knowledge-building; but we also take with an explicit “teach the teacher” approach in each one. That means, if you’re the executive in charge of leading board or senior leadership discussions, we will arm you with the tools and materials you will need to save time and feel confident leading the discussion. All our live sessions include the opportunity to ask questions. And again, all attendees will receive a copy of the slide materials in followup.

P.S.: Building foundational knowledge is a slightly different ball game

Remember, today we are talking about middle ground discussions of healthcare—which in themselves may not be foundational enough for new-to-healthcare board members or leaders to get up to speed on essential topics for the first time. For that purpose, we highly recommend pairing these conversations with ongoing board education by way of our Strategy Bootcamp—the ongoing/foundational education piece of the puzzle.

Questions? Suggestions for what topics we should cover in the Board Briefing series? Want to learn more about the Strategy Bootcamp? Reach out to us at


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