Harvard Case - Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment
"Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment" Harvard business case study is written by Amitabh Chandra, Anjani Datla. It deals with the challenges in the field of Social Enterprise. The case study is 17 page(s) long and it was first published on : May 22, 2014
At Fern Fort University, we recommend a multi-pronged approach to expanding health insurance access, drawing inspiration from the Oregon Health Insurance Experiment. This approach leverages social entrepreneurship, impact investing, and public-private partnerships to create a sustainable and scalable solution.
2. Background
The Oregon Health Insurance Experiment (OHIE) was a groundbreaking randomized controlled trial that evaluated the impact of expanding Medicaid coverage. The study found that expanding access to health insurance led to significant improvements in health outcomes, financial security, and overall well-being. However, the experiment also highlighted the challenges of implementing large-scale healthcare programs, including funding constraints, administrative complexities, and the need for effective outreach and enrollment strategies.
The case study focuses on the lessons learned from the OHIE and explores how these insights can be applied to other contexts, particularly in developing countries. It examines the potential for social entrepreneurship to play a role in expanding healthcare access, considering the role of nonprofit organizations, NGOs, and social enterprises in bridging the gap between healthcare needs and available resources.
3. Analysis of the Case Study
The case study presents a compelling argument for the potential of social entrepreneurship to address the challenges of expanding healthcare access. The OHIE demonstrates the effectiveness of expanding health insurance coverage, but it also highlights the need for innovative solutions to overcome logistical and financial barriers.
Framework: We can analyze the case study through the lens of the Triple Bottom Line (TBL) framework. This framework considers the social, environmental, and economic impacts of any initiative.
- Social Impact: Expanding health insurance coverage directly addresses the social issue of poverty and lack of access to healthcare. It improves health outcomes, reduces financial strain, and promotes overall well-being.
- Environmental Impact: The case study doesn't explicitly address environmental impacts, but expanding healthcare access can indirectly contribute to environmental sustainability by improving public health and reducing the burden on healthcare systems.
- Economic Impact: Expanding health insurance coverage can stimulate economic growth by increasing productivity, reducing healthcare costs, and creating new jobs in the healthcare sector.
Key Insights:
- Targeted Outreach: The OHIE demonstrates the importance of targeted outreach and enrollment strategies to reach those most in need.
- Community Engagement: Engaging local communities and leveraging their expertise is crucial for successful implementation.
- Data-Driven Decision Making: Utilizing data and evidence-based approaches is essential for program evaluation and improvement.
- Collaboration and Partnerships: Building partnerships between government, private sector, and non-profit organizations is key to leveraging resources and expertise.
4. Recommendations
We recommend the following actions to expand health insurance access, drawing inspiration from the OHIE:
- Develop a Hybrid Model: Create a hybrid model that combines public and private resources to fund and deliver healthcare services. This model can leverage the strengths of both sectors, with the government providing essential infrastructure and subsidies, while private organizations contribute innovation and efficiency.
- Foster Social Entrepreneurship: Encourage the development of social enterprises focused on providing affordable and accessible healthcare services. These enterprises can utilize innovative business models, leverage technology, and create sustainable solutions.
- Implement Impact Investing: Utilize impact investing strategies to attract private capital to healthcare initiatives. This can involve investing in social enterprises, providing loans to healthcare providers, or supporting research and development.
- Promote Partnerships: Facilitate partnerships between government, NGOs, and private companies to leverage resources and expertise. These partnerships can focus on developing innovative solutions, improving outreach, and ensuring program sustainability.
- Prioritize Data and Evaluation: Utilize data-driven approaches to monitor program effectiveness, identify areas for improvement, and ensure accountability. This includes tracking health outcomes, financial impact, and program reach.
5. Basis of Recommendations
These recommendations are based on the following considerations:
- Core Competencies and Consistency with Mission: The recommendations align with the mission of expanding healthcare access and promoting social good. They leverage the expertise of various stakeholders and encourage innovation.
- External Customers and Internal Clients: The recommendations aim to serve the needs of both external customers (individuals seeking healthcare) and internal clients (government agencies, NGOs, and private companies).
- Competitors: The recommendations consider the competitive landscape and encourage the development of innovative solutions to address the unmet needs of the population.
- Attractiveness: The recommendations are attractive from a financial perspective, as they leverage impact investing and public-private partnerships to attract capital and ensure sustainability.
6. Conclusion
The Oregon Health Insurance Experiment provides valuable lessons for expanding healthcare access. By embracing social entrepreneurship, impact investing, and public-private partnerships, we can create a sustainable and scalable solution that improves health outcomes, reduces financial burdens, and promotes social good.
7. Discussion
Alternatives: Other alternatives include solely relying on government funding or focusing solely on traditional healthcare providers. However, these approaches may face challenges in terms of funding, scalability, and innovation.
Risks and Key Assumptions:
- Funding: The success of the recommendations depends on securing sufficient funding from both public and private sources.
- Political Will: The implementation of these recommendations requires strong political will and support from policymakers.
- Innovation: The success of social enterprises depends on their ability to develop innovative and sustainable business models.
8. Next Steps
- Develop a comprehensive strategy: Define clear objectives, identify key stakeholders, and establish a roadmap for implementation.
- Pilot programs: Conduct pilot programs to test the effectiveness of proposed solutions and gather data for evaluation.
- Build partnerships: Establish partnerships with relevant organizations to leverage resources and expertise.
- Promote awareness: Raise awareness about the importance of expanding healthcare access and the role of social entrepreneurship.
- Monitor and evaluate: Continuously monitor program performance, collect data, and make necessary adjustments to ensure effectiveness and sustainability.
By taking these steps, we can leverage the lessons from the Oregon Health Insurance Experiment to create a more equitable and accessible healthcare system for all.
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Case Description
In 2008, the state of Oregon had the budget to enroll 10,000 individuals into Medicaid. But officials knew that demand for Medicaid would be far greater. To give all poor, uninsured Oregonians a fair chance at receiving health insurance, the state established a lottery. In this simple lottery, renowned economists Katherine Baicker (at Harvard) and Amy Finkelstein (at MIT) found a rare and promising natural experiment. For decades, evidence on the impacts of health insurance on health was dominated by observational studies, which offered inconclusive answers. Under the Oregon lottery, some individuals were randomly selected from a waiting list to receive insurance while others were not, enabling comparison between the two groups, and in effect creating a randomized experiment. The Oregon health experiment, as it came to be known, would finally give economists and policymakers rigorous evidence on how access to health insurance affected the provision and use of health care, and ultimately, influenced the health and well-being of the population. By 2016, as part of the Patient Protection and Affordable Care Act, an estimated 25 million Americans were set to obtain health insurance, 12 million under Medicaid alone; driving home the need to find conclusive answers to these longstanding questions. Case number 2019.0
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