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Harvard Case - Oak Street Health: From Start-up to Strategic Acquisition

"Oak Street Health: From Start-up to Strategic Acquisition" Harvard business case study is written by Leemore S Dafny, Thomas H. Lee. It deals with the challenges in the field of General Management. The case study is 22 page(s) long and it was first published on : Feb 21, 2024

At Fern Fort University, we recommend that Oak Street Health (OSH) continue its strategic expansion while focusing on refining its operating model and leveraging technology to enhance its value proposition for both patients and investors. This includes prioritizing a balanced growth strategy that combines organic expansion with strategic acquisitions, while simultaneously strengthening its core competencies in healthcare delivery, data analytics, and patient engagement.

2. Background

Oak Street Health is a primary care provider focused on serving Medicare Advantage patients, a fast-growing segment of the healthcare market. Founded in 2013, OSH has rapidly expanded its network of clinics across the United States, driven by its mission to provide high-quality, personalized care to underserved populations. The case study examines OSH's journey from a start-up to a strategically acquired company, highlighting its growth strategy, operational challenges, and future prospects.

The main protagonists of the case study are:

  • Mike Pykosz: CEO of Oak Street Health, a visionary leader with a strong track record in healthcare and a clear vision for OSH's future.
  • The Oak Street Health Management Team: A diverse group of professionals responsible for driving OSH's growth, operations, and strategic decisions.
  • Medicare Advantage Members: The primary target market for OSH, representing a growing segment of the healthcare landscape.

3. Analysis of the Case Study

The case study presents a compelling picture of OSH's success and the challenges it faces in a rapidly evolving healthcare landscape. We can analyze the case using the following frameworks:

Strategic Framework:

  • Porter's Five Forces: The case study highlights the competitive landscape in the primary care market, with increasing competition from traditional healthcare providers, new entrants, and alternative care models.
  • SWOT Analysis: OSH possesses several strengths, including its focus on underserved populations, its strong leadership team, and its innovative care model. However, it also faces weaknesses, such as its dependence on Medicare Advantage contracts and the need to scale its operations efficiently.
  • Growth Strategy: OSH has adopted a multi-pronged growth strategy, combining organic expansion with strategic acquisitions. This approach has allowed it to rapidly expand its reach and market share.

Financial Framework:

  • Profitability and Growth: OSH's financial performance has been impressive, with strong revenue growth and profitability. However, it faces challenges in managing costs and achieving sustainable profitability as it scales its operations.
  • Valuation and Investment: The case study highlights the attractiveness of OSH to investors, as evidenced by its successful IPO and subsequent acquisition by CVS Health.

Operational Framework:

  • Healthcare Delivery Model: OSH's care model is centered around personalized care, patient engagement, and data-driven decision-making. This approach has been successful in improving patient outcomes and satisfaction.
  • Technology and Analytics: OSH leverages technology and analytics to optimize its operations, manage patient data, and enhance care coordination. This is a key differentiator in the competitive healthcare landscape.

4. Recommendations

To maintain its competitive advantage and achieve sustainable growth, Oak Street Health should focus on the following recommendations:

  • Refine its operating model: OSH should continue to invest in its care model, focusing on improving efficiency, streamlining processes, and reducing costs. This can be achieved through:

    • Optimizing staffing levels: Employing a data-driven approach to staffing, ensuring appropriate staffing levels based on patient volume and complexity.
    • Leveraging technology: Further integrating technology into clinical workflows to automate tasks, improve data accuracy, and enhance patient communication.
    • Streamlining administrative processes: Implementing Lean management principles to eliminate waste and improve efficiency in administrative tasks.
  • Strengthen its data analytics capabilities: OSH should invest in building a robust data analytics platform to gain deeper insights into patient needs, care patterns, and operational efficiency. This can be achieved through:

    • Investing in data infrastructure: Building a secure and scalable data infrastructure to handle growing data volumes and complex analytics.
    • Developing advanced analytics models: Employing machine learning and AI algorithms to predict patient needs, identify potential health risks, and optimize care pathways.
    • Partnering with data science experts: Collaborating with data science experts to develop and implement innovative analytics solutions.
  • Expand its geographic reach strategically: OSH should continue to expand its footprint, focusing on high-growth markets with significant Medicare Advantage populations. This can be achieved through:

    • Organic expansion: Opening new clinics in strategic locations, leveraging data analytics to identify high-potential markets.
    • Strategic acquisitions: Acquiring existing primary care practices or healthcare providers that align with OSH's mission and care model.
    • Developing a robust acquisition strategy: Establishing clear acquisition criteria, due diligence processes, and integration plans.
  • Enhance its patient engagement strategies: OSH should prioritize building stronger relationships with its patients, focusing on personalized care, communication, and support. This can be achieved through:

    • Improving patient communication: Utilizing various communication channels, including telemedicine, mobile apps, and personalized outreach programs.
    • Empowering patients: Providing patients with access to their medical records, facilitating self-management tools, and encouraging active participation in their care.
    • Building a strong patient-centric culture: Fostering a culture of empathy, compassion, and respect within the organization.

5. Basis of Recommendations

These recommendations are based on the following considerations:

  • Core competencies and consistency with mission: The recommendations align with OSH's mission to provide high-quality, personalized care to underserved populations. They focus on strengthening its core competencies in healthcare delivery, data analytics, and patient engagement.
  • External customers and internal clients: The recommendations prioritize the needs of both external customers (Medicare Advantage members) and internal clients (OSH employees and healthcare providers).
  • Competitors: The recommendations aim to position OSH as a leader in the primary care market by leveraging its strengths, addressing its weaknesses, and differentiating itself from competitors.
  • Attractiveness ' quantitative measures: The recommendations are expected to improve OSH's financial performance by enhancing operational efficiency, increasing patient satisfaction, and expanding its market share.

6. Conclusion

Oak Street Health has established itself as a leading provider of primary care services to Medicare Advantage members. By focusing on its core competencies, refining its operating model, and leveraging technology, OSH can continue to grow and thrive in the evolving healthcare landscape. Its strategic acquisition by CVS Health further strengthens its position and provides access to valuable resources and expertise.

7. Discussion

Alternative strategies include:

  • Focusing solely on organic growth: This would require significant investment in infrastructure, staffing, and marketing, potentially slowing down expansion and increasing operational costs.
  • Pursuing a more aggressive acquisition strategy: This could lead to rapid growth but also increase integration challenges and potential financial risks.

Key assumptions:

  • Continued growth of the Medicare Advantage market: This assumption is supported by demographic trends and the increasing popularity of Medicare Advantage plans.
  • Availability of qualified healthcare professionals: OSH needs to ensure access to skilled and experienced healthcare providers to support its growth.
  • Technological advancements in healthcare: Continued innovation in technology will be crucial for OSH to maintain its competitive edge.

8. Next Steps

To implement these recommendations, OSH should:

  • Develop a detailed strategic plan: This plan should outline specific goals, timelines, and resource allocation for each recommendation.
  • Establish key performance indicators (KPIs): KPIs should be defined to measure the success of each initiative and track progress toward achieving strategic goals.
  • Allocate resources: OSH needs to allocate sufficient financial and human resources to support the implementation of its strategic plan.
  • Build a strong leadership team: A strong leadership team is essential to guide the organization through its growth and transformation.
  • Foster a culture of innovation: OSH should encourage a culture of innovation, experimentation, and continuous improvement.

By taking these steps, Oak Street Health can continue its journey from start-up to a leading provider of primary care services, delivering value to its patients, investors, and the healthcare system as a whole.

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Case Description

Oak Street Health opened its first primary care center for seniors in underserved communities in 2013. By 2022 the company had 169 centers and a market valuation exceeding $10 billion. Oak Street created value by accepting risk-adjusted, capitated payments for Medicare enrollees and reducing the expected spending for these enrollees through high-quality, high-touch primary care. In 2023 CVS Health acquired Oak Street on the thesis of substantial synergies across its various businesses. Which among these synergies was most important to prioritize, and what tradeoffs might be created by pursuing these opportunities?

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