The Sequencing Advantage

What Must Happen First?

Healthcare organizations frequently fund multiple strategic initiatives simultaneously.

A new service line.

A digital platform.

Physician recruitment.

A new location.

AI capabilities.

Patient acquisition.

Operational transformation.

Each may look strategically sound on its own.

But there is an overlooked question:

Are they being funded in the right sequence?

The Problem Isn't Always the Strategy. It May Be the Order.

Healthcare leaders often evaluate initiatives independently:

Is this a good investment?

Will it generate growth?

Does it support our strategy?

But some investments depend on capabilities that have not yet been built.

Expanding a specialty service before referral infrastructure exists may create underutilized capacity.

Implementing sophisticated analytics before data governance is reliable may produce faster access to unreliable information.

Opening additional locations before the operating model is standardized may multiply inconsistency rather than scale performance.

Investing in AI before the organization has clean, accessible data may simply automate complexity.

The investment itself isn't necessarily wrong.

The sequence is.

The Hidden Cost of Getting the Sequence Wrong

When initiatives are pursued in the wrong order, leaders often interpret the resulting friction as an execution problem.

The technology isn't delivering.

Physicians aren't adopting the new model.

The new service line isn't reaching volume.

The expansion isn't generating expected returns.

The organization needs "better execution."

But sometimes execution is being asked to overcome a missing prerequisite.

This creates what I call the Sequencing Advantage™:

The strategic value created when an organization builds capabilities in an order that increases the probability and economic value of subsequent investments.

The concept is simple, but its implications are significant.

One investment can increase the value of the next.

And another investment can make the next one premature.

Think in Dependencies, Not Just Initiatives

Consider a healthcare organization preparing for multi-site expansion.

Leadership might simultaneously invest in:

• New locations

• Recruitment

• Technology

• Marketing

• Centralized operations

• Leadership development

All may be legitimate priorities.

But what must happen first?

If operating standards are inconsistent, expansion may replicate inefficiency.

If leadership capacity is insufficient, additional sites may increase management complexity faster than enterprise value.

If data isn't standardized, executives may struggle to identify which locations are actually performing.

The strategic question changes from:

"What should we invest in?"

to:

"What must be true before this investment can actually work?"

That is a fundamentally different leadership conversation.

The Prerequisite Test

Before approving a major initiative, leaders should ask five questions:

1. What are we funding before the prerequisites exist?

2. Which initiative would become dramatically more valuable if another capability came first?

3. Are we building infrastructure for a strategy we have not yet made executable?

4. What investment is currently premature?

5. What must be true before this investment can actually work?

These questions expose dependencies that conventional business cases often miss.

They also prevent a common strategic mistake: confusing simultaneous activity with coordinated progress.

Sequence Creates Leverage

Strategic allocation is not only about putting resources behind the right priorities.

It is about creating conditions in which those resources can produce their intended return.

McKinsey has repeatedly emphasized the importance of linking resource allocation with strategic priorities rather than treating investments as isolated decisions. Research in operations and innovation similarly demonstrates that the order and timing of activities can materially affect outcomes.

For healthcare leaders, this means strategy should be viewed less like a list of projects and more like a system of dependencies.

Build this → enable that → accelerate the next.

When the sequence is right, capabilities compound.

When the sequence is wrong, organizations can spend heavily while remaining strategically stuck.

What Should Come First?

The strongest healthcare organizations will increasingly ask not only:

What deserves investment?

but:

What needs to happen first?

That distinction can determine whether an investment becomes an accelerator—or another expensive initiative competing for attention.

At Phoenix MedStrategy, we help healthcare leaders identify strategic dependencies before they become expensive execution problems—so investments are not only aligned with the strategy, but sequenced to make the strategy executable.

The question isn't whether every initiative matters.

It's whether the organization is building the right capability, in the right order, at the right stage.

Sources

McKinsey & Company, The Power of Strategic Resource Allocation

Harvard Business Review, How to Make Your Strategy Work

Harvard Business Review, The Strategy That Works

Rita Gunther McGrath, Discovery-Driven Planning, Harvard Business Review