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Harvard Case - HOMI Foundation: Expanding a Non-profit Family Hospital for Children

"HOMI Foundation: Expanding a Non-profit Family Hospital for Children" Harvard business case study is written by Luz Elena Orozco Collazos. It deals with the challenges in the field of Strategy. The case study is 16 page(s) long and it was first published on : Jul 8, 2021

At Fern Fort University, we recommend a multi-pronged approach for HOMI Foundation to expand its non-profit family hospital for children. This strategy leverages a combination of strategic alliances, digital transformation, and business model innovation to achieve sustainable growth while maintaining its core values of providing high-quality, compassionate care.

2. Background

The HOMI Foundation operates a successful non-profit family hospital for children in India. Facing increasing demand and limited resources, the organization seeks to expand its reach and impact. This case study explores the challenges and opportunities presented by this growth ambition, focusing on the potential for international expansion, technology adoption, and strategic partnerships.

The main protagonists of the case are:

  • Dr. Mehta: The visionary founder and CEO of HOMI Foundation, driven by a deep commitment to providing quality healthcare for children.
  • The Board of Directors: Responsible for overseeing the organization's strategic direction and financial sustainability.
  • The Hospital Staff: Dedicated professionals committed to delivering exceptional patient care.
  • The Local Community: Beneficiaries of HOMI's services and potential supporters of its expansion efforts.

3. Analysis of the Case Study

To analyze HOMI's situation, we employ a combination of frameworks:

  • Porter's Five Forces:

    • Threat of New Entrants: High, due to the increasing demand for healthcare services in India and the potential for new players entering the market.
    • Bargaining Power of Buyers: Moderate, as patients have limited options for specialized pediatric care but can choose between different hospitals.
    • Bargaining Power of Suppliers: Moderate, with a mix of local and international suppliers for medical equipment and pharmaceuticals.
    • Threat of Substitutes: Low, as there are few substitutes for specialized pediatric care.
    • Rivalry Among Existing Competitors: High, with established private and public hospitals competing for patients and resources.
  • SWOT Analysis:

    • Strengths: Strong reputation for quality care, dedicated staff, strong community support, non-profit status allowing for focus on mission.
    • Weaknesses: Limited resources, dependence on donations, lack of international experience, reliance on traditional healthcare models.
    • Opportunities: Growing demand for specialized pediatric care, potential for international expansion, technology adoption for improved efficiency and patient care, strategic partnerships with other organizations.
    • Threats: Increasing competition, economic instability, regulatory changes, potential for donor fatigue.
  • Value Chain Analysis:

    • HOMI's value chain is characterized by a strong focus on patient care, with dedicated staff, advanced medical technology, and a commitment to providing a family-centered environment. However, the organization faces challenges in areas like fundraising, administrative efficiency, and technology adoption.

4. Recommendations

HOMI should pursue a phased expansion strategy focused on:

Phase 1: Strengthening Core Operations and Expanding Technology Adoption (1-2 years)

  • Digital Transformation: Implement a comprehensive digital strategy to improve operational efficiency, patient experience, and fundraising capabilities. This includes:
    • Electronic Health Records (EHR): Streamline patient data management, improve communication, and enhance clinical decision-making.
    • Telemedicine: Expand access to specialized care through virtual consultations and remote monitoring, particularly in underserved areas.
    • Online Fundraising Platform: Leverage social media and digital marketing to engage donors and increase fundraising efficiency.
  • Strategic Partnerships: Collaborate with leading medical institutions, technology providers, and philanthropic organizations to enhance expertise, access resources, and expand reach.
    • Joint Ventures: Partner with international hospitals to establish specialized pediatric care centers in India.
    • Technology Partnerships: Collaborate with tech companies to develop innovative solutions for patient care and administrative processes.
    • Philanthropic Partnerships: Secure funding from international foundations and corporations committed to healthcare development.

Phase 2: International Expansion and Business Model Innovation (3-5 years)

  • Emerging Markets: Explore strategic expansion into neighboring countries with high demand for pediatric care and a potential for strong community support.
  • Business Model Innovation: Develop a sustainable business model that balances the need for financial stability with the organization's non-profit mission.
    • Fee-for-service Model: Offer a tiered pricing structure based on service complexity and patient income, ensuring access for all.
    • Social Enterprise Model: Establish a social enterprise arm that generates revenue through healthcare-related services, supporting the core hospital operations.
    • Global Partnerships: Collaborate with international organizations to develop training programs and exchange best practices, fostering a global network of pediatric care providers.

5. Basis of Recommendations

These recommendations are based on the following considerations:

  • Core Competencies and Consistency with Mission: The recommendations focus on leveraging HOMI's core competencies in patient care, community engagement, and non-profit operations while expanding its reach through technology and partnerships.
  • External Customers and Internal Clients: The recommendations prioritize the needs of patients and their families, while also empowering staff through technology adoption and professional development opportunities.
  • Competitors: The recommendations address the competitive landscape by focusing on differentiation through specialized care, technology adoption, and strategic partnerships.
  • Attractiveness: The recommendations are expected to generate positive returns through increased patient volume, improved operational efficiency, and enhanced fundraising capabilities.

Assumptions:

  • The Indian healthcare market will continue to grow, providing opportunities for expansion.
  • Technological advancements in healthcare will continue to improve patient care and operational efficiency.
  • International organizations and foundations will continue to support healthcare initiatives in developing countries.

6. Conclusion

By embracing digital transformation, strategic alliances, and business model innovation, HOMI Foundation can achieve sustainable growth while maintaining its commitment to providing high-quality, compassionate care for children. This approach will allow the organization to expand its reach, improve operational efficiency, and secure a sustainable future for its mission.

7. Discussion

Alternatives:

  • Focusing solely on domestic expansion: While this would be less risky, it would limit HOMI's potential for growth and impact.
  • Adopting a purely commercial business model: This would compromise the organization's non-profit mission and potentially alienate donors.

Risks:

  • Technological challenges: Implementing a comprehensive digital strategy requires significant investment and expertise.
  • Regulatory hurdles: Expanding internationally may involve navigating complex regulatory environments.
  • Financial sustainability: Balancing the need for financial stability with the non-profit mission requires careful planning and management.

Key Assumptions:

  • The Indian healthcare market will continue to grow.
  • Technological advancements in healthcare will continue to improve patient care and operational efficiency.
  • International organizations and foundations will continue to support healthcare initiatives in developing countries.

8. Next Steps

  • Form a strategic planning committee: Include representatives from the board, management, and staff to develop a comprehensive implementation plan.
  • Conduct a feasibility study: Assess the financial viability and potential impact of the proposed expansion strategy.
  • Secure funding: Seek grants, donations, and investments to support the implementation of the digital transformation and international expansion initiatives.
  • Develop a communication strategy: Engage stakeholders, including donors, patients, and the community, to build support for the expansion efforts.
  • Monitor progress and adapt: Regularly assess the effectiveness of the implemented strategies and make adjustments as needed.

By taking these steps, HOMI Foundation can successfully expand its operations and continue to make a positive impact on the lives of children in India and beyond.

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Case Description

The Hospital de la Misericordia (HM), today HOMI Foundation, is a children's hospital located in Bogotá (Colombia). It was founded by José Ignacio Barberi, Great Grandfather Barberi, in fulfillment of his wife's last wish: to build a hospital for children. It officially opened its doors in 1906. Great Grandfather Barberi conceived HM as a non-profit organization to be led by the members of the Barberi family. After the founder, three generations of Barberi family members have assumed the direction of HM: Rafael Barberi Cualla (Grandfather Barberi), Rafael Barberi Zamorano (Father Barberi), and Mauricio Barberi Abadía. Mauricio Barberi (appointed Director of HM in 1992) had to face a demand-based health system, under which HM was paid according to the amount of patients treated and there were not more subsidies from the State. Therefore, Mauricio had to begin a process of reengineering in HM, in order to become a competitive organization within the health market. HOMI was later impacted by the health system crisis, which delayed the payments it had to receive for its services. The case is established in April of 2014, in the midst of the health sector crisis. Despite the situation, Mauricio Barberi decided to analyze two options to expand the services: to build a Pedatric Center to expand the facilities outward in the north of Bogotá, or to build a Childhood cancer center in the current location. The risky context that surrounds this decision begs for multiple questions about his persistence on this idea and the suitability of said decision for HOMI Foundation. Even more, although Mauricio does not consider to do nothing, as a third option, the case invites to consider it in the last step in the discussion of the case, because this option is also viable from a perspective that does not consider family issues. The answers to these questions lie in the power of the family firm's legacy and entrepreneurial legacy, which is the focus of the case.

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