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The case is based on data collected from in-depth interviews, and from company, third-party and regulatory–agency documents. In addition to prior conversations over several years between the company founders and the lead case writer, there were several rounds of interviews in 2023 with the surviving founder and in-depth interviews with eight of the company’s key managers. Company documents reviewed included bylaws, organization charts, profit and loss statements and staffing statistics, all from founding to sale. Also reviewed were documents and evaluations of company operations and performance produced by the merger & acquisition firm that handled the company’s eventual sale. The company owner insisted on complete disguise of the company and all its members and prohibited disclosure of detailed proprietary financial data.

At the strategic level, this case is about how the unique, complex and changing healthcare environment created opportunities and threats to which a women-owned and run start-up company, Aloe Health (AH), had to respond to become and remain successful. At the personal level, the case illustrates what it takes for an entrepreneur and leader having clinical but no real business acumen to start, expand and turn around a company and ultimately position it for a successful acquisition, continually learning and adapting along the way.

The case describes how two women who were friends for many years started up a home healthcare company later in their lives and grew it into the largest women-owned business of its kind in the USA. Based in the Southwest USA, an area with many factors conducive to success, they navigated the many complexities of US Medicare regulations to create a fully-integrated home healthcare company providing unskilled personal care, medically skilled homecare and end-of-life hospice services to thousands of clients. The case provides background on the founders and the home healthcare industry context, and details the steps taken to start up and build the company into a fairly successful enterprise; one of the largest of its kind in the region. The (A) case ends with one of the founders facing a crisis brought on by the death of her co-founder and the revelation of some significant organization dysfunctions, leaving her unable to profitably exit the company and unsure of whether she would be able to turn things around. The students are tasked with making recommendations for what she should do next.

The (B) case brings events up to fall 2023, describing the steps the surviving founder took to transform her leadership style and the company’s systems and culture, and to navigate the due diligence process associated with preparing for an (ultimately very successful) acquisition. It also shares the owner’s “lessons learned,” and briefly notes the current state of the acquired company and the many AH employees that it continues to employ.

The case provides ample information for students to appreciate the company’s strategy and the challenges of operating in the highly regulated health care industry. However, it is probably even better suited to illustrating the “soft” issues of new-venture management, such as the tendencies of founders to overload themselves by micro-managing their growing venture and not adapting to expansion, and for those with clinical backgrounds to focus on caring for patients and employees while overlooking business essentials and organization systems. It also illustrates how business partnerships among strong-willed individuals can produce dynamics in the founding team similar to a “marriage,” with affection and complementary talents, yet also tensions. It further illustrates the process of a successful turnaround strategy, and the “due-diligence” challenges of preparing for an acquisition.

This case has a range of course applications at multiple education levels. Although it is probably best suited for graduate and executive-level programs, it can also be selectively used in undergraduate classes, particularly if populated by upperclassman. It is ideally suited to courses on entrepreneurship and on healthcare management. For an entrepreneurship course, it could be positioned mid-way through the semester, after covering topics relating to the entrepreneurial mindset, founding teams and business models. It can be used to get the class focusing on competitive issues and the challenges of starting up a company in a highly regulated environment, on entrepreneurial founding-team characteristics and management tendencies (e.g. micro-management control tendencies), on transition issues from start up to growth stages and on exit strategies.

We believe this case is also well suited as a teaching exercise for students pursuing healthcare management studies in baccalaureate and graduate programs (MBA, MHA, MHS) in which instructors wish to broaden student exposure to a real-world scenario that focuses on entrepreneurial behavior in a healthcare setting (a topic of increasing interest to healthcare practitioners and managers given the current trend toward provider formation and ownership of health facilities). Here, the case may be used to focus on the complexities of the healthcare industry, the key differences between various healthcare service business models and on the challenges that technically (clinically) trained professionals often face when trying to manage a healthcare business. Ideal placement of the case would be in a capstone course, after students have been introduced to their functional coursework in topics such as introduction to management, organizational behavior and leadership, financial management and strategic thinking. The case also challenges students to apply knowledge obtained in specialized coursework in healthcare systems and policy, industry regulation, as well as healthcare reimbursement methods.

The case also may be used in organization behavior courses to focus on team, cultural and leadership issues and in strategic management courses to focus on strategy implementation. In addition, there are enough family business themes in the case (even though Aloe is not actually a family business) to use it in a course on managing family businesses.

The first three years of operation of the West Kendall Baptist Hospital (WKBH) in Miami, Florida provided a “poster child” for efficient and cost effective healthcare delivery to the West Kendall community that it served. The hospital leadership and management team exemplified a quality-oriented staff that moved as a cohesive and dedicated organization. WKBH exceeded every budget prediction and showed a profit in year 3, well before expected. Then came the winds of regulatory change. With the passage of the Affordable Care Act (ACA) and the attendant imposition of new reimbursement metrics, the picture at WKBH changed almost overnight. By the first quarter of 2016, WKBH started to lose money in excess of budget predictions despite its increased patient admissions, careful financial planning, expense reductions, quality service, and excellence in patient care delivery. A serious financial crisis was looming with little relief in sight. The hospital management team began to search for solutions.

The research methodology includes collecting quantitative data: original financial statements and financial data from WKBH, as well as qualitative data: interviews of hospital administrators and historical information.

Graduate capstone course in a finance course; masters in health administration; and/or the MBA program.

While it is clear that the ACA was designed with all good intentions, it has created substantial and perhaps, unanticipated financial burdens for caregivers. These issues are not only faced by WKBH. Most hospitals could relate to one or more of the four questions examined as part of this learning process. Graduate MBA students worked with the hospital to identify, define, focus, and resolve difficult quantitative and qualitative issues faced by the hospital as a result of major changes in the regulatory environment with the passage of the ACA. This case focuses upon the current reimbursement environment that has only recently emerged as a result of the implementation of the ACA.

The learning objectives have been prepared following Bloom’s taxonomy (Bloom et al., 1956). After completing the case study, the students will be able to identify and recall the prerequisites necessary for establishing a pathology laboratory. (knowledge); analyze the micro- and macroenvironmental factors considered by Mr Sabihul Haque in the development of the strategic plan for Healthcare Laboratories (HCL) (knowledge and application); explain the key components of the Porter’s value chain and their significance in the operation of HCL (comprehension and evaluation); use the TOWS analysis to map the internal strengths, weaknesses, opportunities and threats of HCL (application and synthesis); and analyze the challenges faced by protagonist in managing HCL and generate suggestions for addressing the challenges (analysis and synthesis).

HCL, an enterprise established in 2018 in Sahdeo Khap, Gaya, Bihar, India, aims to provide high-quality pathological diagnostic services in semi-urban and rural areas. This health-care initiative is pioneering, offering pathology services to make high-quality, low-cost diagnostic services accessible in rural India. In rural settings, numerous health-care hurdles make it challenging for individuals to access the care they need. Since its inception, HCL has expanded its reach to connect more areas, facilitating diagnostic services for people in remote regions. The establishment of laboratories in semi-urban areas aims to reduce patient travel time, costs and health risks by bringing services directly to their doorstep. Haque, the chief executive officer of the lab, grappled with multiple challenges, including selecting an appropriate location for the lab, recruiting and retaining skilled workforce, managing logistics supply, collaborating with local health-care providers, dispelling the stigma among the population that superior services are only available in cities and enhancing health literacy in rural communities. Following numerous meetings with Ms Ummati Naiyyer, head of operations, they worked collaboratively to address these challenges, developing a blueprint and future plan to operate services in rural areas. This case study provides insights into the obstacles faced by HCL striving for success in rural areas. It elucidates the beneficial application of the Porter’s value chain, along with an analysis of macro- and microenvironmental factors. Unique challenges such as societal stigma and mistrust are specifically emphasized. Students engaging with this case study will enhance their problem-solving skills through brainstorming and providing recommendations, contributing to potential solutions for HCL’s difficulties.

The teaching notes for the HCL case is designed to enhance the learning experience of undergraduate and graduate students within the context of the course. This case study serves as a valuable teaching tool, allowing students to apply theoretical knowledge to real-world scenarios in the health-care industry. The notes provide a framework for instructors to facilitate discussions, encourage critical thinking and promote a deeper understanding of key concepts related to establishing diagnostic laboratories in rural areas.

Teaching notes are available for educators only.

CSS3: Entrepreneurship.

Marketing Management, Product & Brand Management, Entrepreneurship.

This case can be taught effectively to MBA/BBA students as part of Marketing Management, Product & Brand Management, Entrepreneurship.

The case talks about the marketing mix strategy of India’s fastest growing fast moving consumer goods (FMCGs) brand Patanjali, with a tremendous revenue growth rate of 100 per cent for the past five years, leaving major FMCG companies insomniac. Patanjali Ayurved Limited riding on Baba Ramdev’s brand equity positioned itself as an authentic Ayurved brand with ancient Indian roots. Patanjali’s product line ranges from healthcare, personal care, home care, to food and more. Patanjali’s products were priced 10-40 per cent lower than that of its competitors. Run by franchisees, Patanjali had a three-tier distribution system. These included Patanjali Chikitsalayas which were franchise dispensaries and clinics along with doctors, Patanjali Arogya Kendra which were health and wellness centres and Swadeshi Kendra, non-medicine outlets. The company has 15,000 exclusive outlets across India and plans to grow to 1,00,000 exclusive outlets by 2020. Patanjali amazed the world by achieving phenomenal success without spending much on advertising in its nascent stage. Recently Patanjali adopted the multinational corporation (MNC) style of advertising by hiring two top advertising agencies McCann and DDB Mudra to prepare the company for the next phase of growth. Patanjali diversified into various segments of the market, ranging from FMCG products, Ayurvedic medicines, Ayurvedic hospitals and a medical college. Patanjali plans to enter various categories of products including the beauty products segment to compete with major MNCs, the baby care segment to compete with Johnson & Johnson, and the sports segment to compete with Nike and Adidas. Patanjali as a brand has a strong positioning in the minds of consumers as a natural and Ayurvedic brand. Will Patanjali’s foray into so many diversified segments lead to a brand extension trap and confused positioning? Because Patanjali as a brand, solely rides on Baba Ramdev’s image, if Baba Ramdev ever finds himself at the centre of a controversy, will Patanjali’s brand equity take a hit? Will it affect the brand Patanjali? Even if Baba Ramdev does not get into any controversy, what will happen to the brand Patanjali when Baba Ramdev is no more? Who should be the next face of Patanjali? Can the brand survive without a face?

The case is designed to enable students to understand the following key learning points: The concept of marketing mix. Product mix, Promotion mix branding (especially “Person as a Brand”), customer-based brand equity (CBBE) model or brand resonance pyramid.

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 8: Marketing.

Through this case, students will not only learn about the latest development of this emerging industry, IoT, but also gain a systematic understanding of “ecosystem strategy” and get to know a new corporate growth model called “co-creation”.

This case describes why and how Advantech Co., Ltd. (hereinafter referred to as Advantech) has transformed in the age of the Internet of Things. Aware of the ecosystem attributes of the IoT industry and committed to the company’s principle of “altruism”, Advantech strategically positioned itself as an “IoT platform provider” and an “enabler” for IoT applications. After carrying out a reform in terms of internal management, external cooperation, and development model, Advantech has evolved from an industrial computer maker to an IoT solution provider. Since the launch of the “co-creation model” at the end of 2016, Advantech has drawn attention from many excellent companies in traditional industries. With the Internet of Everything close at hand, Chairman KC Liu is well aware there are many challenges to overcome as Advantech strives to build an industrial IoT ecosystem, the “evolution” continues.

MBAs, EMBAs and senior executives.

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

The primary learning objectives/outcome of case discussion is to apply design thinking principles to design innovative and socially responsible strategies that promote financial sustainability for organizations serving unique societal needs. The secondary learning objectives/outcome of case discussion is to gain a deeper appreciation for the potential social impact of their innovative ideas and understand the complexities and ethical considerations in social entrepreneurship, especially when working with individuals with special needs.

The case study describes the challenge facing Anil Kumar Kundra, the founder and trustee of Autism Ashram and Autism Guardian Village in Hyderabad and Gujarat, an organization that provides shelter and care for individuals with autism and residential facilities for their parents. Autistic individuals often lack social skills and may face challenges in reading, writing and communicating. In addition, they may experience behavioral issues, making it difficult for them to obtain employment or run their own ventures, resulting in a lifetime financial dependency on their guardians. In August 2023, Kundra, in pursuit of sustainability, aims to empower autistic individuals in the ashram to attain financial independence. He envisions Autism Ashrama as a self-sustaining entity, no longer dependent on contributions from parents. The dilemma facing Kundra is the need to identify innovative ideas that will enable these autistic individuals to contribute to revenue generation. The challenges faced by autistic individuals in their day-to-day lives make Kundra’s decision-making complex. While he acknowledges the challenge, he firmly believes that a handful of transformative ideas can bring about a revolutionary shift in the ecosystem for autistic individuals, rendering this business model truly sustainable. The case study invites students to help Kundra identify innovative ideas using design idea techniques, such as the Stanford d.school model.

This take-home assignment is suitable for both undergraduate and postgraduate students and is designed to explore the integration of sustainable business practices and design thinking in a real-world context.

Teaching notes are available for educators only.

CSS 7: Management science.

Bryan Preston, CEO of the Back Office Cooperative, leads several large human service providers through the process of building a shared-services platform to leverage scale and efficiencies. This successful collaboration matches the business case for restructuring against the constraints of mission-driven enterprises.

The case seeks to demonstrate how collaboration, scalability, and leadership interact in a nonprofit organization to produce desirable outcomes from which other organizations, leaders, and resource providers might learn.

Teuer Furniture is a privately owned, moderately sized chain of upscale home furnishing showrooms in the United States. By the end of 2012, it had regained its financial footing and a number of long-term investors, including several of Teuer’s original non-management investors, now want to sell their shares. At the request of the board, Jennifer Jerabek, the chief financial officer of the company, and her team put together an extensive valuation of Teuer based on a discounted cash flow analysis. When the model was presented to investors, a number of them disagreed with the results. Some investors considered the value too high; others considered it too low. Not surprisingly, some of the differences of opinion were correlated with whether or not the investors wanted to sell their shares of Teuer. Jerabek was instructed to build a valuation of Teuer using a multiples approach instead.

After reading and analyzing the case, students will be able to:

• Estimate the value of a firm using a multiples approach

• Select an appropriate group of comparable firms and defend the logic behind the selection

• Select a correct set of valuation ratios and defend the logic behind the selection

• Compare the valuations produced by a multiples and DCF approach and if the valuations do not match, explain why the two methods yield different valuations

Estimate the value of a firm using a multiples approach

Select an appropriate group of comparable firms and defend the logic behind the selection

Select a correct set of valuation ratios and defend the logic behind the selection

Compare the valuations produced by a multiples and DCF approach and if the valuations do not match, explain why the two methods yield different valuations

Today's competitive market is very dynamic. New rivals emerge and customer expectations change—sometimes overnight. This case illustrates the following elements of supply chain management: Offshoring, Global Network Design, Country Selection and Facility Location.

The owner of a small financial services firm is evaluating the performance of four funds to determine whether to offer them to his clients. The funds span a variety of objectives and include a recently initiated fund. The case explores issues related to the evaluation of mutual fund performance, including the selection of benchmarks and the effect of fees. The case provides a natural and compelling context in which to discuss market efficiency.