Case Study: Strategic Planning

Veterans Health Administration


In 2008 Congress passed legislation authorizing the creation of seven regional Consolidated Patient Accounting Centers (CPACs), and directed the Veterans Administration (VA) to transition the billing of commercial insurance for non-service connected healthcare services from its 153 Medical Centers to the CPACs. Establishing the CPACs and transitioning services was a 5 year process requiring the creation of automated and administrative infrastructures, and the hiring of approximately 3400 new staff members with varying degrees of VA, revenue cycle and management experience.

As evidenced by a material increase in collections, the creation of the CPACs was a tremendous success. However, like all newly-established entities, the need for a strategic process outlining the way forward emerged. To build on their success, this strategic process would enhance their effectiveness in generating non-appropriated revenue for the Veterans Administration. A Strategy Committee consisting of the organizations’ Executive Leadership was created. After creating a strategic vision and destination the Committee established two goals and six strategic objectives with a defined purpose and expected outcome to meet these goals. 


ITG worked with the Veterans Administration Chief Business Officer Strategy Committee to review, evaluate and score the initiatives developed during the strategic planning retreat. The Strategy Committee then selected integrated initiatives that enhance the VA’s ability to increase revenues or reduce costs. For each initiative, ITG worked with the VA to identify the scope, the specific issue being addressed, intended outcomes, and performance metrics required to ensure achievement of intended outcomes. These elements were then documented in the organization’s strategic plan.

In order to provide Executive Leadership with ongoing visibility on all strategic initiatives, ITG developed a project catalog. This index allows leadership to review the status, risk factors and any other outstanding issues of all strategic initiatives across the enter enterprise.


 Allowing leadership to know when a project will be completed prior to beginning another allows for the efficient and effective use of resources. The ability to house and review completed initiatives allows leadership to retrospectively evaluate the effectiveness of their efforts. The Strategy Committee adopted a Communications Plan designed to engage staff in current strategic developments, and build consensus of the long term vision of the organization. The Communications plan also provides for external stakeholder engagement and calls for regularly scheduled executive updates.