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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.

This case study aims to expect the following learning outcomes. A better understanding of the nature of a psychological contract being developed by employees in non-profit organizations, especially working in the areas of social development and the impact of this contract on employee commitment. Enhanced understanding of conflict of interest (personal versus public) in social development organizations and its implications. Identification of issues of task conflict versus interpersonal conflict and its impact on organizational functions. Identification of dynamics of exclusion of internal stakeholders from organizational strategic decision-making process along with its impact on organizational performance and sustainability. Devising a mechanism to avoid such conflicts in social development organizations, in particular, and organizations in general.

This case highlights five issues as follows: it identifies and discusses conflict of interest between privileged class possessing decision-making positions in the board of directors and implementers working at the grassroots level at ANMOL (a non-governmental organization working for poor girls education in Baluchistan-hub of China–Pakistan Economic Corridor); it discusses the basis for formulation of psychological contracts and impact of its violation on stakeholder’s commitment and motivation; it discusses the implications of difference of opinion of both stakeholders regarding organizational vision and possible drawbacks of converting task conflict into interpersonal conflict on individuals, organization and end-users; it explores implications of exclusion of key stakeholders from organizational decision-making and its impact on organizational smooth working and sustainability; and it suggests a mechanism to avoid conversion of task conflict into interpersonal conflict and smooth functioning of an organization. Hence, this case discusses theories of conflict of interest between top-leadership and workforce, psychological contract and implications of its breach on employee motivation and organizational sustainability in the context of social development organizations.

This case provides sufficient material to be discussed at master level courses (management sciences – master of business administration (MBA) level) such as human resource management (dynamics of psychological contract and conflict resolution), leadership and change management in social development organizations (social enterprises).

Teaching Notes are available for educators only.

CSS 7: Management Science.

Fundraising, Marketing Strategy.

Undergraduate and Postgraduate.

Professional fundraising plays a key role in the operation and sustainability of various forms of organizations, particularly non-governmental organizations (NGOs). “Fundraising for Life” is the success story of a center that is totally dependent on fundraising to achieve its mission of lifesaving and treatment for children with chronic diseases regardless of their financial situation. This case sheds the light on the primary sources of contributions, the importance of an integrated development program, the mutual benefits of partnering with other entities and the challenges encountered in the fundraising endeavors in this developing and unstable part of the world.

The students will be able to explore the current practices used in fundraising as well as the marketing and communication strategies employed in nurturing and maintaining relations with potential donors and partners. They will also be able to explore the internal and external challenges and opportunities available for fundraisers.

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

Describes Myriad Genetics and its struggle to develop a genetic testing service while facing challenges from competitors and activist organizations. After Myriad's discovery of the BRCA gene, capable of genetic testing for breast cancer in women, Myriad needed to choose a strategy to provide this service to the public. With several major competitors offering similar services, intense media scrutiny, and a charged activist and political climate, a poor Myriad decision could have major repercussions.

Upon completion of the case discussion, students will be able to: identify the enablers of a mental skills coaching process and the broad outcomes as a result of a coaching intervention; understand the contributing factors towards creating greater psychological safety in a team and the impact this has on team performance; and identify positive leadership strategies to create an environment in which meaningful work and goal achievement increase engagement.

Leanne Redding was the mental skills coach for Maccabi, a professional league soccer club in Johannesburg, South Africa. Redding had worked with the club’s players using mental techniques, the ultimate aim being to improve performance. Redding’s work was based on the premise of trust, lived values, self-respect and reflection. She believed that a strengths-based approach grounded in sports psychology and aligned with mental contrasting enabled resilience. Her process of holding individual and team sessions helped with sustaining motivation, overcoming limiting fears and encouraging focus on the greater good of the team. The result was Maccabi’s promotion to the professional league of soccer. However, not all of her broad stakeholder group had bought into the value of sports psychology coaching. The case explores Redding’s process and her belief of the importance and buy-in from all players of the team values which should inform behaviour. The case concludes with Redding contemplating what she should do to gain greater acceptance from the rest of the coaching staff for her work.

This case can be used in graduate and postgraduate level courses such as an MBA, in management development programmes or in short executive education courses focusing on organisational behaviour, leadership and human capital development and sports management.

Teaching notes are available for educators only.

CSS 7: Management Science.

After reading the case study, the students will be able to analyze the impact of post-pandemic “new normal” customer behavioral change on a start-up aggregator operating virtually. Recognize the need for the service marketing strategy to prepare a service provider/aggregator to sustain a dynamic and volatile consumer environment. Understand the importance of competitors’ analysis as a primary step of service marketing strategy in influencing “new normal” consumer behavior. Examine the utility of customer engagement through website blogs, social media posts, videos and continuously updated information on the mobile application in influencing the “new normal” customer behavior, from skinner operant conditioning behavior and Rusbolt’s investment model perspectives.

Rafeeg is a mobile application-based home maintenance service providing company, conceived and founded in 2017 by Khamis Alsheryani – who, as an Emirati entrepreneur, has a prior record of accomplishing successful mobile applications and business ventures since 2004. The unique selling proposition of Rafeeg in the Abu Dhabi market is its functioning as the home maintenance services aggregator bringing its suppliers and consumers under-one-roof alongside maintaining ensuring high quality, punctuality and security at competitive prices. Rafeeg has collaborated with approximately 1,000 licensed suppliers using nearly 5,000 technicians and maintenance workers with a customer base of about 70,000 households. Although it is formally situated in Al Salam St, Abu Dhabi, United Arab Emirates (UAE), the company communicates with its consumers virtually. However, with the outbreak of the COVID-19 pandemic in the UAE in March 2020, Rafeeg witnessed a considerable decrease in service requests. Consumers’ psychological fear of the pandemics spread into their houses through the technicians and maintenance workers and the degree of hygienic practices the latter follows before their service provision acted as the major reason behind the fall in requests. Despite Alsheryani’s assurance on the provision of only those suppliers who are verified of their hygienic practices, negative COVID-19 test reports and their availability to the consumers as proof and regular temperature checks of the technicians, the consumer apprehensions remained stagnant and the loss of new service requests, as well as revenue, continued. The pandemic’s spread and consequent lockdown of services in the UAE affected Rafeeg’s business operations gravely, as projected by its sudden drop-in service requests – from 53,638 average monthly customer requests in January and February to approximately 10,000 in March and April. The sudden drop of 81% in new requests drove Alsheryani to develop a service marketing strategy in May to boost consumer behavior, encouraging them to resume their requests without further apprehensions. However, with the continuous rise in the pandemic and vaccines still under trial and research, Alsheryani contemplates the viability of the new marketing strategy. Alsheryani took measures in supplier training programs, excommunicating with suppliers who fail to comply with his strict safety regulations, developing the app with clearly stated, uniform, safety procedures and bearing the additional safety-related costs small suppliers provide quality work as part of the strategy. Despite so, will there be an increase in new requests? Will the bearing of additional costs on the suppliers’ behalf jeopardize its competitive advantage in UAE? Should he consider an alternate business model to adapt to the new normal environment?

This case is written for undergraduate students majoring in consumer behavior, consumer engagement approaches, digital marketing approaches using websites, mobile applications, social media communities and service marketing strategies. Students, through this case, can relate the importance of virtual space in engaging consumers and the importance of the latter in addressing the dynamicity of consumer behavior, especially affected by sudden environmental change, such as the COVID-19 pandemic. The case study also subtly highlights the importance of collaboration with suppliers in an aggregator business model to capture the essence of changing consumer behavior. This case study is appropriate for students having previous knowledge of Rusbolt’s investment model and skinner’s operant behavioral model of consumer behavior and their application in service marketing. Besides, students must be aware of the online business model and aggregator businesses in the service industry of the UAE. The case study purports to motivate critical analytical thinking among students and build their understanding of the importance of consumer behavior for business sustenance.

Teaching notes are available for educators only.

CCS 8: Marketing.

This case aims to study the growth, evolution, and social innovation of iThrive Games, a socially minded initiative that aims to create meaningful opportunities using technology for teens to enhance the knowledge, mindsets, and skills they need to thrive through development and across the continuum of mental disorder to wellness. iThrive's focus has been on creating “meaningful games”—that is, games that promote health and well-being of teen players. Founded in 2014 by Dorothy Batten, President of DN Batten Foundation, the organization's mission was to collaborate with game developers, partner with teens across the game development cycle (ideation to testing), and provide resources to foster teen thriving through gameplay. To do so, the organization took a unique social entrepreneurial approach. Drawing on a positive psychology framework and building the brand among key stakeholders including game developers, researchers, funders, youth, educators, and parents, the organization orchestrated a community dedicated to advancing the meaningful games field, and in doing so, have widespread impact.

Manufacturing, Western management theories and Japanese management practices.

This case can be used in project management or management-related courses at tertiary institutions at Undergraduate and Postgraduate level.

This case provides students with an opportunity to find out what make Toyota so successful in manufacturing through its famous production system as well as the underlying Toyota Way principles. All students are expected to understand the Toyota Way model with a balanced view that goes beyond a set of lean tools such as just-in-time. This case opens a historical account for the Toyota Way model by connecting with possible Western management theories and Japanese management practices.

It is expected to significantly benefit students with industry experience with the intention of initiating appropriate changes in their own industry and/or organization by applying what they have learnt from the Toyota Way, through bridging with Western management theories.

Teaching notes.

The learning outcomes are as follows: identify and evaluate the impact of risk factors for health-care organizations during crisis; evaluate the role of different organizational factors in building resilient health-care organizations; define organizational resilience in a health-care context; and apply the effect-strategy-impact resilience framework.

September 2022 found Ranjan Thakur, the Hospital Director at Manipal Hospital, Jaipur (MHJ) reflecting on MHJ’s resilience toward future health-care crises. MHJ was established in the capital city Jaipur of the Indian state of Rajasthan in 2014, as a 225-bed multispecialty unit of the nationally renowned Manipal Health Enterprises Ltd. As the Hospital Director, Thakur had been responsible for navigating his team and the hospital through the multiple health-care related challenges exacerbated by the multiple waves of the Covid-19 pandemic in a large Indian state with a sizable rural and semiurban population. Though Thakur and his team of doctors had worked through the vulnerabilities of their health-care ecosystem, mapping the risks and mitigating the same, Thakur asked himself if they had done enough. He wondered how a health-care institution such as theirs could sustain effective health-care delivery during future crises situations to deliver high-quality health care to the vulnerable communities. Had they effectively mapped MHJ’s vulnerabilities and built resilience into the hospital’s functioning? The backdrop of the case is public health in the state of Rajasthan (Jaipur), and the case is rich in detailing social factors such as behavior issues of patients, doctors and nurses; operational factors such as standardization of treatment and standard operating procedures, availability of resources, clinical concerns; leadership and management of the hospital through the pandemic. This case can be used by instructors to teach organizational resilience building in the health-care context.

Graduate- and executive-level courses in managing change during crisis in health-care context; health-care management/leadership.

Teaching notes are available for educators only.

CSS 7: Management Science.

For discussion of social entrepreneurship in middle-income economies, emerging markets generally and Africa, specifically, Quali Health presents interesting questions about entrepreneurial funding, scaling and the interplay between social entrepreneurial activities and the informal sector.

South Africa’s primary health outcomes do not correspond to the country’s spending on public health, with South Africa ranking among the worst globally in the incidence of tuberculosis, HIV prevalence, infant mortality and life expectancy. In part, this poor outcome can be explained by high inequality in access to healthcare, which reflects South Africa’s grossly skewed income and wealth distributions, with the bulk of the country’s population reliant upon an underfunded, inefficient and poorly managed public health system. This substandard service for the working poor in South Africa’s townships with high population densities offered a profitable entrepreneurial opportunity to provide affordable and effective primary care with vast gains in quality and outcomes improved dignity for patients. After receiving her MBA, physician and entrepreneur Dr Nthabiseng Legoete self-funded the launch of Quali Health in 2017. The business model set out to disrupt healthcare delivery for South Africa’s poorest citizens. Drawing patients from the working poor in Diepsloot, Quali Health’s inaugural site was cash flow positive within five months when the facility hit only 30% of installed service capacity. With quick success, Dr Legoete faced the strategic question of how fast to scale and finance the expansion. She also considered a new micro-insurance product for her clientele.

For discussion of social entrepreneurship in middle-income economies, emerging markets generally and Africa, specifically, Quali Health presents interesting questions about entrepreneurial funding, scaling and the interplay between social entrepreneurial activities and the informal sector.

Teaching notes are available for educators only.

CSS: 3 Entrepreneurship.