Getting it all together. Systems should link their strategic and financial planning

Foreseeing dramatic changes in healthcare delivery, the leaders of the Franciscan Health System (FHS) decided in the early 1990s to more closely link their strategic and financial planning. Though this cooperation was tentative at first, by 1993 both our planners and our chief financial officers shared certain assumptions about the future--above all, that the coming delivery model was managed care provided by integrated delivery systems (IDSs). Having agreed on our assumptions, we translated them into a vision statement, from which we derived four strategic goals: Advance the healing mission of our sponsors; Create a culture of continuous improvement in leadership, quality, innovation, cost-effectiveness, and measurable customer value; Create an environment that values and empowers those with whom we work; Develop, through partnering, an IDS that provides affordable care to our communities; Our goals established, we charted what we call a "crosswalk" between the strategic and financial aspects of our budgeting. We found that we had to think in a new way about capital. For example, we began investing as heavily in "soft" items like research, partnerships, and new services as in the traditional "bricks and mortar." This process is new for us, and developing it has not always been comfortable. But we believe it has helped us to more wisely allocate FHS's resources and thus give our system greater stability.