Harvard Case - Medical Tourism at Mountain Health Insurance Company
"Medical Tourism at Mountain Health Insurance Company" Harvard business case study is written by Nancy M. Kane. It deals with the challenges in the field of General Management. The case study is 4 page(s) long and it was first published on : Sep 1, 2016
At Fern Fort University, we recommend that Mountain Health Insurance Company (MHIC) pursue a strategic expansion into the medical tourism market by establishing a dedicated division focused on facilitating and managing medical travel for its insured members. This division should leverage MHIC's existing network of healthcare providers, strong brand reputation, and deep understanding of its customer base to create a comprehensive and competitive medical tourism offering.
2. Background
Mountain Health Insurance Company (MHIC) is a regional health insurer facing increasing pressure from rising healthcare costs and competition. The case study highlights the potential of medical tourism as a growth strategy, particularly for patients seeking high-quality, affordable healthcare options abroad. The main protagonists are the CEO, who is considering this new venture, and the company's leadership team, who are tasked with evaluating its feasibility and potential impact.
3. Analysis of the Case Study
Strategic Framework: We will use a combination of frameworks to analyze the case, including Porter's Five Forces, SWOT analysis, and the Balanced Scorecard.
Porter's Five Forces:
- Threat of New Entrants: The medical tourism industry is relatively fragmented, with new players entering the market frequently. However, MHIC's established brand, network, and customer base provide a significant competitive advantage.
- Bargaining Power of Buyers: Patients seeking medical tourism options are price-sensitive and have a high degree of bargaining power. MHIC can leverage its scale and network to negotiate favorable rates with providers.
- Bargaining Power of Suppliers: Healthcare providers in emerging markets are eager to attract international patients. MHIC can leverage this demand to secure competitive pricing and high-quality care.
- Threat of Substitutes: Alternative healthcare options, such as telemedicine and virtual consultations, are growing in popularity. MHIC can differentiate its offering by providing a comprehensive package that includes travel, accommodation, and post-treatment care.
- Competitive Rivalry: The medical tourism industry is highly competitive, with established players like Medjet and International SOS. MHIC can differentiate itself by focusing on its existing customer base and leveraging its strong brand reputation.
SWOT Analysis:
Strengths:
- Strong brand reputation and customer loyalty
- Extensive network of healthcare providers
- Deep understanding of its customer base
- Established infrastructure and operational capabilities
Weaknesses:
- Limited experience in international healthcare
- Potential regulatory and legal challenges
- Lack of specialized expertise in medical tourism
Opportunities:
- Growing demand for affordable, high-quality healthcare
- Emerging markets with strong healthcare infrastructure
- Potential for cost savings and improved access to care
Threats:
- Increased competition from existing players
- Currency fluctuations and economic instability
- Political instability and security concerns
Balanced Scorecard:
The Balanced Scorecard can be used to track the performance of the medical tourism division across four key perspectives:
- Financial: Increase revenue, improve profitability, manage costs effectively.
- Customer: Enhance customer satisfaction, improve patient outcomes, build trust and loyalty.
- Internal Processes: Streamline operations, improve efficiency, ensure quality of care, manage risks effectively.
- Learning and Growth: Develop expertise in medical tourism, foster innovation, build strong relationships with international providers.
4. Recommendations
Phase 1: Market Research and Feasibility Study (6 months):
- Conduct comprehensive market research: Analyze the global medical tourism market, identify key target markets, assess competitive landscape, and understand patient preferences.
- Develop a detailed feasibility study: Analyze the financial viability of the venture, including potential costs, revenue projections, and return on investment.
- Identify strategic partnerships: Establish relationships with reputable healthcare providers, travel agencies, and other stakeholders in key target markets.
- Develop a comprehensive marketing strategy: Target existing MHIC members and potential new customers through various channels, including digital marketing, social media, and partnerships with travel agencies.
Phase 2: Pilot Program Launch (12 months):
- Launch a pilot program in a select target market: Focus on a few key procedures with high demand and proven success rates.
- Develop a comprehensive medical tourism package: Include travel arrangements, accommodation, pre- and post-treatment care, and translation services.
- Establish a dedicated team: Hire experienced professionals with expertise in medical tourism, international healthcare, and customer service.
- Develop a robust risk management plan: Address potential risks related to healthcare quality, patient safety, legal liabilities, and cultural differences.
Phase 3: Expansion and Growth (Ongoing):
- Expand the program to new target markets: Gradually introduce new procedures and destinations based on market demand and performance metrics.
- Continuously improve the program: Gather feedback from patients and providers, refine processes, and leverage data analytics to optimize operations and enhance customer experience.
- Develop a strong brand identity: Position MHIC as a trusted and reliable provider of medical tourism services, focusing on quality, affordability, and patient satisfaction.
- Invest in technology and innovation: Leverage technology to streamline operations, enhance communication, and provide a seamless experience for patients.
5. Basis of Recommendations
These recommendations are based on the following considerations:
- Core competencies and consistency with mission: MHIC's core competencies in healthcare insurance and its strong network of providers align well with the medical tourism market. The venture is consistent with MHIC's mission to provide affordable and accessible healthcare solutions.
- External customers and internal clients: The medical tourism offering caters to the needs of MHIC's existing members seeking affordable healthcare options and potential new customers seeking quality care abroad. It also provides internal clients with growth opportunities and new revenue streams.
- Competitors: MHIC's established brand, network, and customer base give it a competitive advantage in the medical tourism market. The company can differentiate itself by focusing on its existing customer base and providing a comprehensive and personalized service.
- Attractiveness ' quantitative measures: The financial viability of the venture is supported by a detailed feasibility study, which includes potential costs, revenue projections, and ROI analysis. The pilot program will provide valuable data to refine the business model and ensure its long-term success.
6. Conclusion
By strategically expanding into the medical tourism market, MHIC can leverage its existing strengths, capitalize on emerging opportunities, and create a new source of revenue and growth. The company should adopt a phased approach, starting with a pilot program to validate the concept and refine its offering. By focusing on quality, affordability, and patient satisfaction, MHIC can establish itself as a leading provider of medical tourism services, enhancing its brand reputation and creating value for its stakeholders.
7. Discussion
Alternatives:
- Focus solely on domestic healthcare: This option would avoid the risks and complexities of international expansion but would limit growth potential.
- Partner with a specialized medical tourism company: This option would provide access to expertise and resources but would require sharing profits and potentially relinquishing control.
Risks and Key Assumptions:
- Political instability and security concerns: The political and economic climate in emerging markets can be volatile, potentially impacting patient safety and healthcare quality.
- Regulatory and legal challenges: Navigating the legal and regulatory landscape in different countries can be complex and challenging.
- Currency fluctuations: Exchange rate fluctuations can impact the cost of medical tourism services and affect profitability.
- Cultural differences: Communication and cultural differences can create challenges for patients and healthcare providers.
Options Grid:
| Option | Pros | Cons |
|---|---|---|
| Medical Tourism Expansion | Growth potential, new revenue streams, leverage existing strengths | Risks related to international expansion, cultural differences, regulatory challenges |
| Focus on Domestic Healthcare | Reduced risk, focus on core competencies | Limited growth potential, missing out on emerging opportunities |
| Partnership with Specialized Company | Access to expertise and resources | Sharing profits, potential loss of control |
8. Next Steps
- Develop a detailed implementation plan: Outline the key milestones, timelines, and resources required for each phase of the project.
- Secure funding and resources: Allocate budget and resources for market research, pilot program, and ongoing operations.
- Build a dedicated team: Recruit and train experienced professionals with expertise in medical tourism, international healthcare, and customer service.
- Establish communication channels: Develop clear communication channels with stakeholders, including patients, providers, and internal teams.
- Monitor and evaluate performance: Track key performance indicators (KPIs) to measure progress, identify areas for improvement, and ensure the long-term success of the venture.
By taking these steps, MHIC can successfully navigate the medical tourism market, create a sustainable business model, and achieve its strategic growth objectives.
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Case Description
In July 2016, Jennifer Brown, a graduate student at Southwest State School of Public Health, had been asked to staff an Ethics Advisory Group (EAG) meeting at Mountain Health Insurance Company, a large, regional nonprofit health insurance company where she was employed as a summer intern. The mission of Mountain Health was "to improve the health of the people we serve and the health of society." Jennifer had been working with the ethics program director, Robert Jones, to review and update the program's ethical guidelines to reflect emerging ethical challenges in the financing and delivery of health care. This meeting was the first time that Jennifer had been given the responsibility of identifying the ethical issues that EAG should consider and what values should be applied in determining how Mountain Health should address them.
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