Search results

A midsize community hospital must choose a strategy to compete with an expanding regional rival. The strategy, focused on acquiring patient volume, includes expanding investment into integrated care, setting the reimbursement structure for revenue collection, and moving to a capitation-based payment system. The case presents an evaluation of revenue models to select that which best supports a given business strategy.

This case is designed to introduce a health care audience to financial analysis. It provides a straightforward introduction to hospital financial-statement ratio analysis and hospital operating statistics, so it can also serve to introduce any audience with a business or medical background to hospital finance.

Fingerhut, based in Minnetonka, Minnesota, is a direct-marketing company that sells a smorgasbord of consumer goods through an array of specially targeted catalogs. In November 1996, an article in the Star Tribune, a major Minneapolis newspaper, drew attention to a class-action lawsuit pending against Fingerhut that suggests the firm made its profits by exploiting the poor. Several civil rights groups rallied around the suit and submitted amicus curiae in favor of the litigation. The case illustrates issues in ethics and management communication. Discussions focus on the constituencies. Is Fingerhut exploiting its customers or providing them with an affordable method of obtaining valued consumer goods on credit? Do retailers have a duty to offer products at reasonable prices? Are the high interest rates reasonable given the risk? What are the options: pawn shops, rent-to-own? What is the profile of the typical Fingerhut customer? Discussions also focus on the issues communicating to the constituencies. How much damage will the lawsuit do to Fingerhut's image as an ethical, socially conscious company? What communication strategies can the firm employ? Should it react to the lawsuit? What should it tell its employees?

The central lesson to be learned from studying the case is to understand the challenges and constraints posed by contextual conditions in designing contracts in public–private partnerships (PPP) for financing and delivering health care in emerging economies such as India.

Perverse incentives, along with contextual conditions, led to extensive opportunistic behaviors among involved agencies, limiting the effectiveness of otherwise highly regarded innovative design of the program.

India’s “Rashtriya Swasthya Bima Yojana” or National Health Insurance Program, launched in 2007 provided free health insurance coverage to protect millions of low-income families from getting pushed into poverty due to catastrophic health-care expenditure. The program was implemented through a PPP using standardized contracts between multiple stakeholders from the public and private sector – insurance companies, hospitals, intermediaries, the provincial and federal government.

Teaching Notes are available for educators only.

CSS: 10 Public Sector Management.

This case features Stripe, a startup that enables merchants to accept payments from customers on the web, on mobile devices, and at the point of sale (POS). Stripe was launched in 2011 by the Collison brothers and quickly gained traction with e-commerce startups, particularly software and platform developers who needed help building their payment processing infrastructures. Stripe incurred high fixed costs in developing its platform and had low margins per transaction, so the company needed to reach high processing volumes (i.e., scale) to survive. This was challenging, as Stripe competed with large payment processors and traditional banks that had high processing volumes and were able to offer merchants significantly lower rates than Stripe. Still, merchants valued Stripe#x0027;s solution because it was simple and versatile. Students assume the role of the Collisons to think about possible strategies Stripe could pursue to process higher volumes of transactions. Students are challenged to think about the potential response of the incumbents to Stripe's different growth alternatives. The teaching note presents the Value Net framework and discusses the importance of considering complementors and their effect on a firm's strategy. Finally, a discussion about Stripe's potential entry into the Indian market allows students to apply the concepts they learned in the discussion of a new market.

The subject area is entrepreneurship.

Graduate and executive education level in leadership, entrepreneurship and strategic management are used to discuss leadership, entrepreneurship and strategy in health services.

This case talks about the passionate journey of a pediatrician practicing in the Mumbai city of India, who as an individual private practitioner is contributing to the fulfilment of the global health agenda and the fourth Millennium Development Goal (MDG) – “reduce child mortality”. His vision is to make quality and affordable expert pediatric care accessible to all the individuals, right from pre-birth to adulthood. Surya Mother and Child Care Hospital (SMCH) is being strengthened as a nation-wide network of mother and child hospital offering patient/consumer-centric integrated collaborative quality care, and it needs to be seen how this model can be made sustainable as it enlarges in scale for the future.

The case is structured to achieve the following learning outcomes: to understand about effectuation as a logic for entrepreneurial success through the lens of Dr Avasthi and his venture SMCH; To understand and apply Porter’s Principles of value transformation that essentially focus on outcome-driven cost-efficient work practices in a collaborative integrative fashion, where transformation must come from within (some practices suggested can be applied to the Indian Healthcare Services Delivery systems); to critically analyze the overall strategic position of SMCH as an organization and its competitive environment; to discuss the factors influencing health-care delivery capacity build up, given the MDGs 2015, Every Newborn Action Plan and Indian Newborn Action Plan framework, as applicable to India; and to discuss and analyze mechanisms for future sustainable service delivery options for SMCH. Although each of these principles is important, possibly, the instructor could emphasize and encourage more discussions on potential models of shared partnerships that can help quality health-care services reach the unreached and the incorporation of technology in achieving this. The learning process can also facilitate discussions about leadership qualities in the creation of health-care entrepreneurs, for the “Change That They Would Want To See”.

Teaching notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS:3 Entrepreneurship.

In the wake of the December 2015 Paris COP21 (Conference of Parties), and India's announced renewable energy commitments, Reliance Power is reviewing its renewable energy investments to arrive at a long term strategy for the role of renewable energy in its power generation portfolio and the financing of renewable projects. The case reviews the Indian government's policies to promote renewable energy; the evolution of the renewable energy sector; and Reliance Power's financing of renewable energy investments. The case requires identification of alternative long term strategies and their financing implications. This case serves as an introduction to renewable energy from the perspective of Reliance Power, a large private power generator of the country. These projects also provide a learning opportunity for Reliance Power to deal with fast evolving renewable technologies.

Discussion of the case will enable students to identify the cornerstones of industry development using simple frameworks like PESTLE and five forces that shape strategy. They will be able to identify critical success factors and evaluate how a firm gets competitive advantage. They will also be able to assess whether the advantage is sustainable for the firms and along which dimensions they have only competitive parity. The issues of contemporary firms growing through the use of network strategies is also highlighted and students will learn to appreciate the role of platforms and connectivity for gaining sustainable advantage.

This case describes the growth strategy of NoPaperForms, a start-up in the domain of enrolment automation for higher education in India. Naveen Goyal, the founder CEO sensed an opportunity in this growing industry segment and acquired it from the founder, Vishal Shah in 2017. The ultimate objective of an educational institute was to attract talent, Goyal evolved a comprehensive enrolment solution starting with the time a prospective student made an inquiry for enrolment till the time he/she paid for enrolment. It was a complete panel, bundled and packaged in a single system taking care of lead management, lead nurturing, application management, fee payment, post-application management and enrolment. He developed it into a unique blend of a customer relationship management (CRM), which was unique in the country. At this juncture, Goyal was exploring growth avenues. On the client side, he had the alternatives of focusing on the B2C segment or diversifying from B2B to B2C. Geographically, he had the options of expanding to tier II and tier III cities, which were the next growth hubs. The option of growing internationally was also on the cards. The purpose of the case is to analyse the opportunities in the education technology sector, specific to student enrolment and leverage the competencies of the firm to detail the future strategy of the firm.

The case can be used in a MBA program for a course in Strategic Management in the module of strategy formulation after fundamental concepts and theories of Strategic Management have been discussed.

Teaching notes are available for educators only.

CSS 11: Strategy.

In early 2017, after launching its successful “Greenhouse-in-a-Box” pilot project in India with fifteen smallholder farmers, Kheyti, a non-profit agricultural technology (AgTech) social enterprise, was struggling with several decisions in developing and growing its business. Kheyti was launched in 2015 to help smallholder farmers battle poverty and income variability by providing affordable technologies bundled with services. Over eighteen months, the team had developed a low-cost and modular greenhouse product to which it added financing, inputs, training, and market linkages to create a comprehensive “full-stack” solution for small farmers. The pilot project was a success in many ways, but Saumya, Kheyti's co-founder and head of product, was concerned that it revealed shortcomings that could severely affect the viability and scalability of Kheyti's solution.

Saumya had some important decisions to make. Should Kheyti redesign the product from scratch, or find other ways to reduce the cost for early adopters? Should it rely on upfront revenues from sales of the greenhouse, or consider developing an innovative financing or contract farming model? Kheyti's dwindling cash reserves meant that these decisions were urgent and critical. The path chosen now would determine whether the startup would move beyond the pilot stage and achieve its vision of serving 1 million farmers by 2025.

The assignment is to design a plan that aligns patient satisfaction scores with quality care metrics. The instructor’s manual (IM) introduces models for designing and implementing a strategic plan to approach the quality improvement process.

This is a field research case. The author(s) had access to the Chief Operating Officer (COO) and other members of the management team, meeting with them on numerous occasions. Cleveland Clinic Florida (CCF) provided the data included in the appendices. Additionally, relevant hospital data, also included in the appendices, is required to be made public on Centers for Medicare and Medicaid Services (CMS) databases. Accordingly, all data and information are provided by original sources.

Osmel “Ozzie” Delgado, MBA and COO of CCF was faced with a dilemma. Under the new CMS reimbursement formula, patient satisfaction survey scores directly impacted hospital reimbursement. However, the CCF patient satisfaction surveys revealed some very unhappy patients. Delgado pondered these results that really made no sense to him because CCF received the highest national and state rankings for its clinical quality at the same time. Clearly, patients were receiving the best medical care, but they were still unhappy. Leaning back in his chair, Delgado shook his head and wondered incredulously how one of the most famous hospitals in the world could deliver such great care but receive negative patient feedback on CMS surveys. What was going wrong and how was the hospital going to fix it?

This case is designed for graduate Master’s in Business Administration (MBA), Master’s in Health Sciences Administration (MHSA) and/or Public Health (PA) audiences. While a healthcare concentration is useful, the case raises the generic business problems of satisfying the customer to increase brand recognition in the marketplace and displacing competition to increase annual revenues. Indeed, the same analysis can be applied in other heavily regulated industries also suffering from a change in liquidity and growth occasioned by regulatory change.

Topics covered by the case include: strategic management processes; and strategies, especially of a platform business.

The case is suitable for use in final-year undergraduate business/management degree programs and MBA or MSc in Management programs. The case can be utilized in courses such as strategic management and management of innovation. For MBA and MSc in management programs, the case can also be utilized in organization theory and design and organizational management, or any courses that cover topics of strategic management and management of innovation.

By December 2010, the e-Pay terminal system was one of the most successful payment platforms in Malaysia. This business, which was launched in 1999, was an electronic prepaid mobile phone reload value distribution system known as e-Pay; it contributed about 80 per cent of the company's annual revenue. Over the past 10 years, e-Pay's terminal system had evolved into a comprehensive payment platform serving many providers on one side and end customers on the other side. However, since the past two years, the company has been facing pressures from their biggest customers on the provider side of its platform, the three giant telecommunication companies (telcos), which had moved to directly deliver reload values to their prepaid subscribers, bypassing e-Pay as the payment intermediary. On the customer side, the number of prepaid subscribers switching to postpaid services was increasing, and this threatened e-Pay's main source of revenue in the prepaid market. In response to this, the company added new service providers to its platform and launched multi-functional cashier machines with reload credits facility. By December 2010, as the market sunk into subscription saturation, the two founders of the company became deeply concerned about the company's future. They wondered if the problems would hinder their company from becoming a dominant payment player in Asia. This case presents an opportunity to discuss strategic posturing of a payment platform company operating in a mobile phone market which was mainly controlled by the telecommunication companies.

Understanding of strategic management process and related analysis enable case analysts to apply these concepts in many business situations involving strategy formulation and implementation.

Teaching Notes are available for educators only. Please contact your library to gain login details or email: support@emeraldinsight.com to request teaching notes.