Jun 27 / Staff

Understanding the Health Care Landscape for Underserved Communities

Using ecosystem analysis to guide strategic innovation in a post-reform environment.

Client Context

A regional trade association representing health care providers and allied organizations sought to position itself—and its members—for leadership in a rapidly shifting health policy landscape. Following major federal health care reform, the association recognized that its members serving low-income communities would need new insights, strategies, and collaborative models to respond effectively.

Rather than defaulting to internal policy reviews or fragmented member updates, the association aimed to take a systemic, future-facing view of the entire health care ecosystem—focusing especially on how it impacts underserved populations. Leadership was committed to not only understanding the implications of reform, but also generating momentum for innovation in service delivery models across the region.

The Challenge

The policy reform introduced by federal legislation presented both an opportunity and a threat. For organizations accustomed to traditional reimbursement structures and siloed service delivery, the new environment demanded different thinking: integrated care, client-centered design, data-informed practice, and inter-organizational collaboration.

The challenge was two-fold:
  1. Sensemaking: How do we help members understand the emerging health care landscape with clarity and strategic focus?
  2. Mobilization: How do we turn that understanding into collective action that prioritizes innovation and service equity?

The association needed a structured, analytical process that could inform strategic planning while also catalyzing energy for change.

The Symphonic Approach

Symphonic Strategies was engaged to design and lead a three-month strategic planning initiative anchored in our ecosystem analysis methodology. This approach moves beyond traditional stakeholder engagement to explore how systems operate—and how they must evolve—within shifting policy and economic contexts.

Our engagement unfolded in five key phases:
1. Stakeholder Interviews and Data Collection
We conducted in-depth interviews with a cross-section of system actors—executives, frontline providers, and community health advocates—alongside a review of key policy and research documents.

2. Environmental and Sectoral Analysis
Using SWOT and PESTEL frameworks, we examined the political, economic, social, and technological forces shaping the health care ecosystem. These insights informed the strategic framing of future opportunities and threats.

3. Logic Model and Theory of Change Development
We collaborated with the client to articulate a theory of change that clarified the pathway from current realities to future aspirations—defining key levers, assumptions, and outcomes.

4. Visual Ecosystem Mapping
A pivotal deliverable was a graphic representation of the current and future health care ecosystem, visualizing the experience of low-income communities navigating care. This map served as a catalyst for reflection and alignment at the leadership level.

5. Board Retreat and Strategic Planning Facilitation
We facilitated a half-day strategy session with leaders from Federally Qualified Health Centers and association staff to interpret findings, pressure-test assumptions, and co-develop a responsive strategic plan.

The Impact

The process yielded a comprehensive strategy document and a renewed sense of purpose within the association.

Notable outcomes included:

A Unified Vision for the Future
The ecosystem map helped leadership visualize the systemic shifts required for innovation. This shared mental model created a stronger foundation for collective action.

Strategic Prioritization
The plan identified clear strategic initiatives to position the association as a thought leader in customer-driven care for underserved populations.

Accelerated Momentum and Buy-In
By involving members directly in the diagnostic and planning process, the engagement generated internal energy and urgency for transformation.

Enhanced Role as a Regional Convener
The association emerged with increased capacity to coordinate cross-sector collaboration and advocate for the needs of vulnerable populations in policymaking and implementation spaces.

Reflections

This case illustrates the power of ecosystem analysis as a tool for systems change. Rather than relying on siloed metrics or narrow organizational plans, the client embraced a method that surfaced complexity, clarified opportunity, and equipped leaders to move from insight to action.

The client continues to use the visual tools and logic model from this engagement to guide implementation and foster strategic alignment across its member base.

Feedback

“This wasn’t just a report. Tt was a lens. It helped us see how to lead in a time of change, with and for our communities.”
— CEO, Regional Trade Association (anonymous)