The current strategy challenge for health and human service executive teams is to figure out how to grow, and whether those investments in growth should be gradual expansions of current services or a giant step outside of current geographies or payers. That issue is fundamental to strategic plans for the next few years (see Scenario-Based Strategic Planning: The OPEN MINDS Management Newsletter, December 2025).

Most executives realize that “diversify or die” is a management adage with resonance in the current market. There are marked changes in federal policy on health and human services, health plans are evolving with current and projected margin challenges, and the impact of technology is a market wild card. New revenue streams are…