Q&A with Sameer Badlani: Lessons in integrating quality and strategy to drive the future of care

Sameer Badlani, chief strategy officer at Fairview Health Services, believes building better healthcare is more about what you shouldn’t do than what you should.

It’s a deceptively simple mindset shift that has guided Fairview’s strategic journey and established the Minnesota-based academic medical center as a leader in quality. The big question is this: What historic approaches should you forgo to ensure your organization evolves alongside the ever-changing healthcare landscape — and how will those choices make you more essential to your community?

“Healthcare is a tough industry. When you’re in nonprofit healthcare, the mission has to be front and center,” Sameer told me recently. “The table stakes of what healthcare needs to be are so all-consuming, how do you think about strategy at the same time?”

Take ambulatory growth, which is anticipated to grow between 9-14% over the next decade. It’s a stunning statistic, Sameer said, and one to keep in mind as healthcare leaders contemplate the choices they should (or shouldn’t) make. The answer might be less brick and mortar and more building out of virtual care or hospital at home. Think about your choices from the patient’s perspective — and use market data to guide your decision making.

Sameer and I delved even deeper into this topic in a recent webinar, where we discussed the ways in which he and the Fairview team have bolstered strategy and quality — in areas ranging from sites of care and health literacy to culture and consumerism — and how other health systems should think about their own strategic roadmap moving forward.

Note: The following conversation has been edited for length and clarity. View the webinar recording to hear the full discussion.

First things first, Sameer: How do you define strategic, or smart, growth?

Not all growth is equal. Strategic growth means growth that supports your mission, aligns with your strengths and is financially sustainable. It’s not just about increasing revenue; if that growth brings negative margins or stretches your organization beyond its capabilities, it’s not smart. Each organization must define what smart growth looks like based on their context, performance capacity and long-term goals.

There's the famous phrase, “No margin, no mission,” which means yes, you must grow, but it’s important to grow in a financially sustainable way that serves your community and your overall mission. At Vizient, when we think about growth, we emphasize quality — by which we mean patient safety, experience and health outcomes. How do you integrate those quality dimensions with strategic growth at Fairview?

I love the “no margin, no mission” statement. I used to work with a cardiovascular surgeon who loved quoting in the Italian language, “Without money, even saints don’t do miracles.” That is so true in the business of nonprofit healthcare delivery, where it's important for us to have a reasonable margin so that our frontline doctors, nurses and caregivers can continue to serve the community — and perform those “miracles” we love to talk about in healthcare.

Within our core performance dimensions we have quality, safety and patient experience. We collaborate with partners like Vizient to identify where we perform well and where we may need improvement. Combining that internal performance insight with market and consumer analytics helps us determine where to grow, especially as our patients have choices and behave more and more like customers. Growth must align with both capability and demand, and patient expectations are central to that. We must understand how we can differentiate ourselves and show up in a way where a consumer wants to access our services.

It’s interesting to think about consumer expectations and competition beyond traditional health systems. How does Fairview view competitive threats, especially with the rise of digital disruptors and retail healthcare?

Healthcare competition is evolving. It's no longer just about hospitals versus hospitals. We're seeing big tech and wellness brands edging into the primary care space. People get health advice from TikTok or YouTube. Our job is to understand why — and respond thoughtfully. That means better patient education in video and digital formats to evolve how we deliver care and build trust. There's been a change in how information is consumed, and we need to react to the consumer in that sense.

Also, your strategy must be data-driven. While you can’t exclusively rely on data, it should help you have the right conversations and make semi-objective choices. We use Sg2 data to understand market trends, such as the consistent shift from inpatient to ambulatory care. That informs where we invest. We also focus heavily on stopping ineffective practices. A good strategy isn’t just what you choose to do, but what you choose not to do.

Strategic planning cycles seem to be shifting post-COVID. What do your strategic planning timeframes look like at Fairview currently?

Pre-COVID, 5- or 10-year plans were the norm. But the pandemic taught us agility. We had to make decisions quarter by quarter to survive and recover — and it worked: We turned around $600 million in two years. Now, we’re focused on 3-year plans. It’s short enough to be actionable, but long enough to guide strategic choices. We still look at 10-year trajectories for capital planning, but our execution is more agile.

Why is it so important to integrate strategy with quality and performance?

Our goal is to become a community health platform, something people depend on because we deliver value that no one else can. And value isn’t just about care quality. It’s about seamless experiences, trustworthy relationships and being part of the fabric of community health.

That platform concept is powerful. What’s an example of how you’re becoming a community health platform?

We turned a closing hospital into a community hub. It now houses food initiatives, adult education and vaccine access, in partnership with local organizations like the Sanneh Foundation and Hmong American Farmers Association. It’s not just healthcare — it’s health and wellness. We see value in these cross-sector collaborations. The result is a platform that benefits everyone, not just the patients.

You’ve done a great job outlining the strategy behind the strategy. I’d also like to talk about tactics. At Fairview, how have you functionally organized to accomplish your strategic goals and what advice do you have for others looking to do the same?

We built a Transformation Office, which evolved from our enterprise project management function. It combines continuous improvement with a transformation-focused team that helps us drive long-term change. It's not about who reports to whom: It's about shared accountability for performance, including quality, safety, patient experience and engagement. That’s how you make transformation stick.

To drive true transformation, focus on team dynamics — not just skills. You can teach someone analytics or project management, but collaboration and psychological safety are harder to build. Also, remember to embrace failure. We learn more from what doesn’t work than what does. And be flexible with tactics — but stay committed to the goal.

Final question, Sameer: How do you take this strategy and culture and bring it to the front lines — to your care teams and staff?

We’re working on defining our culture from the ground up. When our staff talk about why they love working at Fairview, two themes emerge: advocacy for patients and a family atmosphere. Our brand is the external expression of our internal culture. So, we celebrate stories, like the nurse who bought toys at Costco for a patient’s sibling so that the mother could focus more on the sick child. That’s who we are. And we build on that to shape a culture and brand that resonate.

Questions from the field: Healthcare leaders ask Badlani about patient access, AI deployment and more