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 preferred, undesired, standard and wildcard futures
- Backcasting fields for decisions, strengths, partnerships and warning signals
Active members may be prompted to sign in before downloading.
Set up a stronger scenario planning discussion
The framework is designed for healthcare strategists and hospital or health system teams that need to examine uncertainty, challenge assumptions and consider how external forces could affect long-term decisions.
Questions the framework helps teams explore
- Which external forces could materially change our operating environment?
- How might several trends interact rather than unfold independently?
- What would preferred, undesired, standard and wildcard futures look like?
- Which decisions, partnerships and warning signals would matter in each future?
Inputs to bring into the discussion
Use evidence from multiple sources to make the environmental scan more useful. The starter tool recommends inputs such as:
- Industry publications and government data
- Community feedback
- HR metrics and workforce information
- Operational trends
- Local news and market developments
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 include characters, or who is affected; context, or the trends shaping the future; and conflict, or the central challenge.
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 healthcare?
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 major drivers of change that could affect strategy.
Why should hospitals and health systems use scenario planning?
Scenario planning helps leaders identify risks and opportunities, explore uncertainty and develop strategies that can remain useful under different future conditions.
How many scenarios should a team develop?
The SHSMD starter tool recommends developing three or four contrasting scenarios, including preferred, undesired, standard and wildcard futures.
What information should teams use for environmental scanning?
Teams can draw from industry publications, government data, community feedback, HR metrics, operational trends and local news to identify relevant drivers of change.
What should a scenario include?
Each scenario should include characters, or who is affected; context, or the trends shaping the future; and conflict, or the central challenge created by those conditions.
What is backcasting?
Backcasting starts with a scenario's endpoint and works backward to identify the decisions, people, strengths, partnerships and signals that could lead to that future.
Continue the planning process
These SHSMD resources can help teams move from examining possible futures to clarifying assumptions, engaging stakeholders and connecting strategy to execution.
Strategic Assumptions Toolkit
Define and prioritize expectations about the forces most likely to shape the organization, then use those assumptions to stress-test strategy.
Stakeholder Analysis and Needs Grid
Map stakeholders by influence and impact, anticipate resistance and plan more targeted engagement strategies.
Strategic Planning Canvas
Connect mission, strategic priorities, near-term actions, performance measures and required capabilities in one planning framework.