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Organisational behaviour; Leadership; Organisational development; Public–Private partnership; Health care management; Public health.

Masters students in Business Administration, Post Graduate Diploma, Clinical Training of Medical Professionals, Health Leadership Programme.

Prof Jannie Hugo, the protagonist in the case, was considering his dilemma of aligning the multiple partners involved in public health care. A high level of collaboration was required of a multitude of stakeholders in developing the Daspoort clinic into a pilot site for the Tshwane district’s implementation of the National Health Insurance system. In addition, the re-engineering of primary health care with the focus on the patient and community orientated approach were launched on this site.

Gaining insight into international and national landscapes and principles of health care systems. Critically analyse the role of technology in delivering innovative health and social services. Present judgment of Prof Jannie Hugo’s contextual leadership effectiveness in enhancing collaboration between the multiple stakeholders and recommend next steps.

2 × DVDs on Vimeo, Slides and teaching plan with discussion or exam questions with model answers.

CSS 7: Management Science.

The learning outcomes are to understand the definition of public value and the strategic drivers behind public value creation, understand the nature of social innovation in the public sector, identify the critical opportunities and challenges involved in sustaining innovation in the public sector and identify the role that non-profit organizations can play in supporting and sustaining social innovation.

This case puts participants in the shoes of a global health innovator’s leadership team as the organization approaches a funding crisis. The organization, VillageReach, is on a quest to expand across the public health system of Mozambique and experiences a funding dilemma. The case reveals the challenges of working with governments to achieve large-scale, systemic change. It explores the conundrum of using international donor funding to embed new practices in government service delivery. Ultimately, it asks participants to choose between the pursuit of new, small-scale innovative projects and the large-scale rollout of a national programme.

This teaching case is written for courses focused on social entrepreneurship, social innovation and social change. It can also be used in courses focused on non-profit management and public sector innovation. Specifically, the teaching case is suitable for two audiences: social enterprise and non-profit managers focused on strategy, development and operations (the case focuses on an enterprise that relies primarily on donor funding) and health-care managers and administrators. Generally, the case is suitable for undergraduates in their final year of study as well as graduate-level business and public administration courses, including MBA, MPH, MPA, EMBA and Executive Education courses.

Teaching Notes are available for educators only.

CSS 3: Entrepreneurship.

The subject areas are strategy, general management, health-care management, change management and inclusive growth model and application of technology to manage health care.

The case can be used to teach challenges in managing change in a health-care facility.

Tata Memorial Centre (TMC) is dedicated to provide best health-care services in the field of cancer cure. TMC established its credentials for service, education and research, which contributed to it being rated among the ten best hospitals year on year. Starting from humble moorings, TMC has grown to an institution of high repute from an 80-bed hospital to a 700-bed hospital. TMC held a number of pioneering efforts, which included bone marrow transplantation, external beam radiotherapy (linear accelerator), tumor tissue bank and bio-imaging to name a few. The management team of TMC had ensured that the growth had been orderly and appropriate to the changing needs of the community. Managing a hospital with disparate skill sets in the face of ever-increasing demand for services had always been a challenge in itself. As a government-run facility and well funded by the trust, TMC offered excellent services and post-operative care to the patients. So, it became imperative for the hospital to adopt technology to improve its hospital services and maintain transparency. Patients came to the hospital from different states in India and across the globe. TMC registered international and national patients online. Online medical reports were checked before the patients visited the hospital. TMC has developed an e-system that will allow patients around the world to send their tissue samples that are suspected to be cancerous for medical advice to the hospital. This case study is developed to provide insights into the transformation of TMC into an e-health-care service and explains the process of change management.

They are to provide insights into the challenges in health-care management, to illustrate the challenges faced by organization in implementing information and communication technology- managing change and to bring about best practices in the case organization and find solutions to the following questions: What are challenges faced by health-care officials in providing health care using new technological innovations? How can hospitals equip themselves with new technology? With the advent of improved and modern communication methods, medical practices and cases are more easily shared. Cases are discussed, recorded and, in many cases, put up for general public viewing through the electronic media. How can hospitals manage change? How can hospital administrators manage speed of delivery, quality healthcare, innovation and brand image?

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:11 Strategy.

Key State Blue Cross and Blue Shield Plan (a disguised case of an actual BCBS Plan) is the merged product of three state plans. Initially burdened with a reputation of poor customer service, Key State's executives decided to invest heavily in service improvement, eventually achieving superior levels. Key State's high-quality customer service emerged as a true competitive advantage for its customers, who were primarily businesses and health benefits consultants who influenced corporate purchasers of health insurance. The Key State brand came to be synonymous with personal service, security, choice, and dependability. But the health care insurance market was changing under Key State's feet. Spiraling costs meant that high-quality service became less of a competitive advantage as employers were lured by low-cost, low-service providers. Many employers cut or dropped health care benefits entirely, swelling the ranks of the under- and uninsured, who in turn were extremely price-sensitive when shopping for health insurance on their own. Finally, the health care insurance market was being revolutionized by financial institutions willing to hold health benefit accounts and pay providers directly, thereby eliminating the need for Key State as a mediator. Key State executives were aware of these changes but were challenged by the mindset, culture, and organizational design custom-fit to their business accounts. The case asks the reader to consider whether Key State has the right number of target markets, whether it should have one brand or several for its different target markets, what it should do for the uninsured, and how it should improve its brand experience in light of the industry's changing landscape. All of these decisions will have significant implications for the organizational design of Key State.

To better understand the challenges involved in a successful health insurance company to cope with a rapidly changing and unpredictable environment; to formulate a new strategy and a new organizational design to accomplish this adaptation.

Public Health; Leadership; Organisational Development; Organisational Behaviour; Public Administration Management.

Postgraduate level for honours or masters programmes in courses on public health; executive leadership and management programmes; MBA level.

The case unpacks decentralisation as a means to promote and improve local decision-making and accountability through community participation and engagements. Ayanda Nkele was a programme manager in a health district in South Africa. He was faced with many challenges when trying to implement his programme, most of which were related to local authority, responsibilities and decision-making abilities at his level. This case describes briefly the South African health system. and how it functions. It describes the proposed changes to the health system and its transformation towards Universal Health Coverage. The decision space analysis as discussed in the case illustrates the types of decentralisation in the country and how this also applies to Nkele’s level.

Understanding the concepts and principles of decentralisation within the context of strengthening district health services, the re-engineering of primary health care (PHC) and rolling out a National Health Insurance in South Africa. Applying the “decision space” approach to analyse the extent of decentralisation. Grasping the requirement of leaders to be “contextually intelligent” and identify the important contextual variables to take into account when analysing public health care.

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 7: Management Science.

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.

After studying this case, the students should be able to: explain the importance of employee engagement; illustrate the role of the participatory management style in an organizational context; discuss why managers may use engagement practices to operate effectively in businesses to lead change and innovation; identify the critical success factors, barriers and outcomes of employee involvement in driving high performance; and discuss the dilemma faced by the managers in the emerging economies while driving the momentum of excellence in the long run.

This is a real case about a leading health-care service company located in the Middle East. The health-care organization’s name is changed to NOVA for reasons of confidentiality. The NOVA is an independent, public joint stock company created to meet the curative needs of the public health-care system in Middle East. The company introduced the Employee Suggestion Scheme named Minara in 2011 in a Federal Government decree, introducing innovation as a major pillar of management in 2013 with intent to encourage organizations build innovative solutions and pioneer initiatives and apply it effectively in services, processes and programmes. Making the Minara programme work in line with the national health agenda, Ms. Fatima who headed the Excellence and Innovation Department took the initiative of accelerating the innovative Programme (Minara). The case data were collected based on both primary and secondary sources. Although the case is based on the real data, it has been ammonised. The case describes the transformation of the innovation process at NOVA through the employee engagement programme (Minara) in meeting the disruptive challenges. This case addresses the challenges faced by the Excellence and Innovation manager who used effective employee engagement practices through the Employee Suggestion Programme in a creative way to bring about innovation in the health-care sector. The case outlines the dilemma faced by the Excellence and Innovation manager in bringing about innovation through the Employee involvement programme in the emerging economic scenario. The case will focus on the analysis of the different aspects of the issues pertaining to employee engagement, employee motivation and the framing of empowerment strategies to bring about innovation and continuous improvement through an effective employee suggestion programme. The case is intended to give budding managers an insight into innovation and employee engagement practices that impact performance in the organization.

This case will be suitable to be used in Human Resource Management and Management of Change and Innovation course at undergraduate and Master’s level.

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 1: Accounting and Finance

The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and Woerner, 2015) and is referred to as the W & W framework. This approach provides a useful structure for thinking through the strategic options facing environments ripe for digital transformation.

Research for this case was conducted through face-to-face interviews with the protagonist, as well as through a review of their business planning documents and other data and documentation provided by the founder. Some of the market and industry data were obtained using secondary research and industry reports. Interviews were digitally recorded and transcribed to ensure accuracy.

The case follows the story of Kurt Waltenbaugh, a Minnesota entrepreneur who shared the dream of using data analytics to reduce costs within the US health-care system. In early 2014, Waltenbaugh and a physician colleague founded Carrot Health to bring together their personal experience and expertise in both consumer data analytics and health care. From the beginning, they focused on how to use data analytics to help identify high-risk/high-cost patients who had not yet sought medical treatment. They believed that they could use these insights to encourage early medical interventions and, as a result, lower the long-term cost of care.

Carrot’s initial success found them in a consultative role, working on behalf of insurance companies. Through this work, they honed their capabilities by helping their clients combine existing claims data with external consumer behavioral data to identify new potential customers. These initial consulting contracts gave Carrot the opportunity to develop its analytic tools, business model and, importantly, to earn some much-needed cash flow during the start-up phase. However, they also learned that, while insurance companies were willing to purchase data insights for one-off market expansion projects, it was much more difficult to motivate them to use data proactively to eliminate costs on an ongoing basis. Waltenbaugh believed that Carrot’s greatest potential lay in their ability to develop predictive models of health outcomes, and this case explores Carrot’s journey through strategic decisions and company transformation.

This case is intended for either an undergraduate or graduate course on entrepreneurial strategy. It provides an effective introduction to the unique structure and constraints which apply to an innovative start-up within the health-care industry. The case also serves as a platform to explore the critical criteria to be considered when developing a digital transformation strategy and exposing students to the digital business model developed by Weill and Woerner (2015) at MIT (referred to in this instructor’s manual as the W&W framework). The case was written to be used in an advanced strategy Master of Business Administration (MBA) class, an undergraduate specialty health-care course or as part of a health-care concentration in a regular MBA, Master of Health Care Administration (MHA) or Master of Public Health (MPH). It may be taught toward the end of a course on business strategy when students are building on generic strategy frameworks and adapting their strategic thinking to the characteristics of specific industries or sectors. However, the case can also be taught as part of a course on health-care innovation in which case it also serves well as an introduction to the health-care payments and insurance system in the USA. Finally, the case can be used in a specialized course on digital transformation strategy in which case it serves as an introduction to the MIT W&W framework.

The case is particularly well-suited to students who are familiar with traditional frameworks for business strategy and business models. The analysis builds on this knowledge and introduces students interested in learning about the opportunities and challenges of digital strategy. Equally, the case works well for students with clinical backgrounds, who are interested in how business strategy can influence changes within the health-care sphere. Finally, an important aspect of the case design was to develop students’ analytical confidence by encouraging them to “get their hands dirty” and to carry out some basic exploratory data analytics themselves. As such, the case requires students to combine and correlate data and to experience the potentially powerful combination of clinical and consumer data. Instructors should find that the insights from these activities give students unique insights into the potential for of data analytics to move health care from a reactive/treatment ethos to a proactive/intervention ethos. This experience can be particularly revealing for students with clinical backgrounds who may initially be resistant to the use of clinical data by commercial organizations.

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.

The learning outcomes are as follows: to understand the cultural and ethical dimensions revolving around the issue of female feticide; to apply the lens of institutional theory with respective change management measures; and to analyze and evaluate the impact of such intervention programs such as Beti Bachao Beti Padhao in the context of emerging economies such as India.

This case attempts to highlight the innovative and effective governance approach by the Government of Rajasthan (India) and, in particular, the State Health Assurance Agency to curb the menace of female feticide and the rising cases of abortion and sex determination in an attempt to favor a male child. The case concentrates on mainly three dimensions of Indian societal ecosystem, namely, the grave concern of preference of male child over female child leading to widespread cases of female feticide in different states in India with specific focus on the state of Rajasthan; the role of cultural dimension which primarily drives such preferential treatment in rural and urban areas in India; and the importance of using effective policy measures in monitoring various activities, introduction of incentive schemes to patients for preventing sex determination and promoting the birth of female child.

This case can be used as a teaching material in the Public Policy course – Social Welfare and Health Policy, Policy interventions, organization theory and change management at the Graduate/MBA level.

Teaching notes are available for educators only.

CSS 10: Public Sector Management.