DAYTON—In December, the Columbia County Health System commissioners adopted a five-year strategic business plan, representing a 12-month effort for CEO Shane McGuire.

“A $1.5 billion Medicaid Waiver received by the State of Washington to reform the healthcare delivery system, and change payment models creates new opportunities, and with strategic planning, these can be leveraged to position the district for better reimbursement rates, and also to deliver better integrated and higher quality care,” McGuire said.

The plan, called Healthcare 360, identifies major challenges facing the ho...