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We do a strategic planning process at least annually. 
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This process gathers input from key stakeholders and data about our practice and marketplace. 
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We review our mission and vision for the practice. 
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We assess the size and growth of the market for our services. 
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We compare our own “penetration” to the size of the market. 
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We assess trends in managed care and payments and analyze our contracts. 
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We evaluate competitors’ strengths and weaknesses, and how we can gain an edge. 
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We assess the strengths and weaknesses of our referral network. 
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We evaluate the depth and breadth of our overall service offerings. We assess the strengths and weaknesses of our marketing. 
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We assess our payers, including our payer mix. 
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We evaluate our clinical utilization rates and quality or care outcomes. 
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We evaluate our internal controls. 
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We evaluate our cost structure and financial ratios. 
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We review our technology. 
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We take a hard look at the patient’s experience, and how to improve it. 
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We assess the capabilities of our clinicians and staff and identify any gaps to fill. 
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We review physician and staff compensation. 
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We assess our risks, compliance, and malpractice insurance. 
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We evaluate our relationship with local hospital(s). 
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We analyze our financial strength, including capacity for debt, days receivables, trends in aging of receivables, collection ratios, and profitability by services. 
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We assess our facility and location, including whether we are located in the optimal zip code/area to serve our desired patient base. 
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We do an overall “Strength, Weaknesses, Opportunities, and Threats” or SWOT analysis about our practice. 
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We determine which services and programs to expand, which to defend, and which to exit. 
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We identify the top issues we need to address, and then identify key priorities to address these issues, achieve our vision, and be more competitive and profitable. 
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We set annual performance/financial goals for our practice and develop a plan to achieve those goals. 
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We assign specific accountability to achieve these initiatives, and a communication plan to follow up on them.