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Your HCO has an excellence-in-care mission. It began adopting the principles in chapters 1-3 three years ago. Outcomes, patient satisfaction, and associate satisfaction have all risen to the top 20 percent, many measures to the top 10 percent. Market share has risen, and profit has increased. Without plant expansion, the HCO will soon reach capacity. In the meantime, your two competitors have lost market share. One, which invested unwisely in new construction, may be financially challenged. Your senior management team is considering the following list of strategic options for the board retreat.1—Begin discussions to acquire the faltering competitor.2—Begin discussion to merge with the other, healthier competitor. 3—Use your demonstrated superiority to lure away a few of the best physicians still working at the faltering HCO.4—Expand and strengthen your relationship with primary care providers, and plan to start an ACO.5—Develop preliminary plans to expand plant capacity.6—Begin discussions to move to a population health mission.What are the three options that the board should consider most carefully?

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