2015 Strategy Execution Summit Presentation: Susan Hill & Walter Mitton from the Centers ffor Medicare and Medicaid Services (CMS): Strategy Implementation in a Large Public Organization

1. Strategy Implementation in a
Large Public Organization
Challenges,Wins, and the Road Forward
Susan Hill, Director of Strategy
Walt Mitton, Senior StrategyTechnical Advisor
Centers for Medicare and Medicaid Services (CMS)

2. Outline
 Introduction
 Our Strategy – an overview
 Approach
 Implementation
 Leadership
 Governance
 Challenges
 Wins
 Our Road Forward – Next Steps
2

3. Introduction
 About CMS
◦ ~6,000 FTEs working across the Nation
◦ Combined, our programs touch the lives of ~123M
individuals (more than 1 in 3 Americans) and pay
almost one-third of the Nation’s health expenditures
◦ Largest purchaser of health care in the U.S.
 Our Mission
◦ As an effective steward of public funds, CMS is
committed to strengthening and modernizing the
nation’s health care system to provide access to high
quality care and improved health at lower cost.
3

4. The CMS Strategy
4

5. CMS Strategy Logic Pyramid
5

6. Our Approach –
CMS Strategy Framework and Playbook
6

7. Implementation – Putting Strategy
into Action
 Objective Champions
 Objective ImplementationTeams (OITs)
 Defining Outcomes
 Developing Performance Measures
 Identifying and Prioritizing Initiatives
 Establishing ProjectTeams
 Launching Projects
7

8. Leadership – A Critical Component
of Strategy
 Strategy sponsorship is critical
 Sponsor sets the direction
 Sponsor’s message about the
organization’s future state is clear and
shared among leadership and staff
 Public-sector risk – sponsor can change
mid-strategy
8

9. Governance – The Decision-making
Force of Strategy Design and
Implementation
 Leverage or establish a decision-making body
for the strategy
 Determine the strategic management
maturity of the governing body – have they
either created and more importantly,
implemented and managed strategy before?
 Clarify roles and responsibilities of the
strategy’s governing body
9

10. Implementation Challenges and
Potential Solutions
CHALLENGES
 Leadership –Who is the Strategy’s Sponsor and what
is her intent?
 Governance –Who’s leading this effort and making
key decisions?
 Team Membership and Competing Priorities –
You know I have a full-time job…right?
 Taxonomy – Is it a goal, objective or an initiative? I’m
so confused!
 Clarifying Desired Outcomes – Is it an outcome
or a means to an end?
 Establishing a Representative Set of Meaningful
Performance Measures – Does this measure inform
us that we’re achieving success?
 Establishing ProjectTeams – Who’s doing the
work, when, with what resources?
POTENTIAL SOLUTIONS
 Leadership – obtain and clearly communicate the
sponsor’s intent to key stakeholders
 Governance – consider using charters and
determine decision-making bodies
 Team Membership and Competing Priorities –
discuss level of commitment upfront
 Taxonomy – integrate teachable moments in
consultation and/or meetings
 Clarifying Desired Outcomes – take the time to
explain this term and make every attempt to limit the
number of outcomes per objective
 Establishing a Representative Set of
Performance Measures – try to avoid the “use
what we have” mentality. Provide guidance, such as a
toolkit to facilitate the process
 Establishing project teams – Provide teams with
project-oriented resources and a well-defined
reporting structure
10

11. Implementation – Wins!
 Objectives are being Implemented
 Senior leadership is referencing the Strategy
 Objective-level and Outcome-focused
performance measures are being developed
 Strategy Management consultation and facilitation
is being requested and deployed to help
implement new federal statutes and regulations
 Other component-level strategies are being
implemented
11

12. Our Road Forward – Next Steps
 The CMS Division of Strategy Management will
continue:
◦ Advising leadership on the benefits of Strategy
◦ Providing leading practices tools, guidance, and
consultation
◦ Refining framework and guidance
 And start:
◦ Building a Strategy Community of Practice
◦ Providing more opportunities for Strategic Thinking and
Decision-making
12

13. Audience Focus Question
 What are your top 3 Strategy
Implementation?:
◦ Challenges
◦ Wins
13