Scenario Planning Starter Tool for Health Care Strategists
Scenario planning helps hospitals and health systems explore multiple plausible futures. Rather than predicting one outcome, teams use structured "what if" stories to test assumptions, anticipate disruption and make more resilient strategic decisions.
Resource details
Turn the framework into a working session
SHSMD members can download the complete starter tool, including guided prompts and a worksheet for capturing trends, drafting scenarios and backcasting from possible future states.
- PESTLEH environmental scanning worksheet
- Prompts for four contrasting future scenarios
- Backcasting questions for decisions, partnerships and warning signals
Active members may be prompted to sign in before downloading.
Scenario Planning for Hospitals and Health Systems: A Four-Step Framework
Scenario planning is a strategic foresight method that helps leaders prepare for several plausible futures instead of relying on a single forecast. The process combines environmental scanning, trend analysis, scenario development and backcasting so teams can identify risks, evaluate opportunities and strengthen strategies before conditions change.
Environmental scanning
Use the PESTLEH framework to identify major drivers of change:
- Political: policy priorities and government action
- Economic: market conditions, costs and payment pressures
- Social: demographics, expectations and community needs
- Technological: digital tools, automation and emerging capabilities
- Legal: laws, compliance requirements and liability
- Environmental: climate, infrastructure and local conditions
- Health: population health, disease patterns and care needs
Analyze trends
Determine whether each trend is growing, declining or changing. Consider how multiple trends may interact and where disruption could emerge.
- Workforce changes
- Payment reform
- Telehealth and digital access
- Competition and market consolidation
- Consumer behavior and expectations
- Regulation and public policy
Build scenarios
Develop three or four contrasting futures that challenge assumptions and broaden strategic thinking:
- Preferred future: the most desirable outcome
- Undesired future: the outcome the organization wants to avoid
- Standard future: a continuation with minimal change
- Wildcard future: a low-probability, high-impact disruption
Each scenario should identify who is affected, which trends shape the context and what central challenge creates conflict.
Backcasting
Start with the scenario's endpoint and work backward to identify the decisions, milestones and signals that could lead there.
- What decisions led to this future?
- Who needed to be involved?
- Which strengths or partnerships were leveraged?
- What signals suggested this future was emerging?
What the member-only tool adds
The public framework explains the methodology. The downloadable member resource helps teams apply it during a planning session and document their work.
- Dedicated fields for Political, Economic, Social, Technological, Legal, Environmental and Health trends
- Space to draft preferred, undesired, standard and wildcard futures
- Backcasting fields for required decisions, strengths, partnerships and warning signals
Scenario planning FAQ
What is scenario planning in health care?
Scenario planning is a strategic foresight methodology that helps hospitals and health systems prepare for multiple plausible futures rather than relying on a single forecast.
What is the PESTLEH framework?
PESTLEH stands for Political, Economic, Social, Technological, Legal, Environmental and Health factors. Teams use these categories to identify external drivers of change that could affect strategy.
Why should hospitals and health systems use scenario planning?
Scenario planning helps leaders identify risks, evaluate opportunities and develop strategies that can remain effective under different future conditions.