The 2022 Global BAHM Case Competition was held April 7-8, 2022 at Baylor University. The event offered students the unique opportunity to work collaboratively and compete for cash prizes as they envisioned the “Hospital of the Future.”
BAHM programs fielded teams from North America, Costa Rica, India, Kenya, and or Spain who presented their business models in person or online, synchronously. Thank you to the Baylor University Hankamer School of Business Robbins Institute of Health Policy and Leadership for hosting the competition. And thank you to Bill and Mary Jo Robbins and the Robbins Foundation for their generous sponsorship of this year’s event.
- Baylor University (First place): Stephanie Dodgen, Cholan Wijekumar, Joseph Spear: A rural health alliance serving the East Oklahoma Native American population by linking six rural hospitals, centralizing contracting, partnering with specialists, and providing home health, mobile health, and telehealth services.
- University of Minnesota (Second place): Ikram Khan, Yu-Hsiang Hung, Erin Green, Dan Muggee: An integrated health system for Jharkhand, India, focused on community health workers who provide basic health services and education and the referral of more acute cases to specialty practitioners.
- Boston University (Third place): Leah Levine, Lucia Ryll, Christina Young, Evan Piccirillo: A critical access hospital in Downeast Maine financed through an accountable care organization, allowing for the redistribution of funds toward preventive care and creating the financial flexibility for innovative system integration.
- Baylor University / Indian School of Business (Fourth place): Riley Griffin, Katherine Griffith, Dr. Vijay Karan Reddy: Community-based health resource guides and councils, provider partnerships and transportation solutions integrated to support the rural American Indians of Oklahoma.
- Indian School of Business (International Judges Award): Jyotiprava Pattanaik, Bikash Sahu, Sriram Chavali, Praveen Gopan: A “hub and spoke” model involving private, public, philanthropic and community stakeholders to deliver holistic population health services in a remote, resource-constrained area in Odisha, India.
Thank you to all students participating in the competition for their excellent ideas, collaboration, and commitment to an important topic. The additional participating schools included: CU Denver Business School; Georgia State University J. Mack Robinson College of Business; Harvard Business School; IESE Business School, INCAE Business School; Johns Hopkins Carey Business School; Strathmore Business School; University of Miami Herbert Business School; UNC Kenan-Flagler Business School; University of Toronto Rotman School of Management, and Yale School of Management.
SEE INTERVIEWS WITH STUDENTS, JUDGES AND HOSTS
Slides – Case Competition Mixer_2021_12_9
Recording – Case Q&A 2022 01 03 (Passcode: 61v6X%@B)
There are two team formats:
- Program team. Programs are invited to field their own team of 3 – 4 students. Program teams may include students from other graduate school programs within the BAHM-member school – including but not limited to MPP, MPA, MPH, MS – as long as at least one student represents an MBA program with a focus on healthcare management.
- Joint International Team. In addition to a Program Team, programs may select 1 or 2 students to compete in a Joint International Team (JIT).
- JITs must have 4 students with a minimum of one international student, and a maximum of two students from the same program
- JIT students will participate in a virtual mixer and will have the option of self-selecting or being assigned to a JIT (self-selection or assignment will take place after the JIT mixer)
- January 21, 2022 Detailed Competition Schedule and Instructions distributed
- February 3, 2022 Case Question and Answer Session (virtual meeting)
- March 25, 2022 Case submission deadline (presentation slides, one-page executive summary, video recording (used as back-up)
- April 7 & 8, 2022 2022 BAHM Case Competition (in-person and synchronous virtual presentations)
Questions about the prompt? Listen to a recording of the Feb. 3 Q&A with the professors who wrote the case here. Passcode: 61v6X%@B
BAHM 2022 Case Prompt_2021_12_7
2022 BAHM Case Competition Prompt: Can the Hospital of the Future Solve the Growing Challenges of Rural Hospital Care?
As of 2013, the world crossed over from being predominantly rural to predominantly urban. This trend has since accelerated in both the developed and developing worlds. In many ways, the provision of healthcare in less-densely populated locales is on a path to being hollowed-out without a critical mass and economy of scale to foster sustainable health services, especially for secondary and tertiary care.
Health care in the US provides a strong example of this evolving trend. For example, in a national longitudinal study of US rural hospitals from 2011-2017, Bai et al (2020) cite their research that found urban hospitals (5.6%) incur over twice the margin of rural hospitals (2.6%) (https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2019.01545) (Bai et al., 2020). Except for non-profit critical access hospitals, all other categories (based on profit status and critical access) experienced declines over the study period. The same study found rural hospitals incur a -3.2% margin the year before closing vs 2.7%, presenting a strong indication how important margin is to rural hospital viability. One hundred thirty-eight rural hospitals have closed in the past decade (https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/) (Sheps Center, 2021). Nineteen rural hospitals closed in 2020 (https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2021/03/24/pandemic-drains-hospital-finances) (Vestal, 2021). Only 43 rural hospitals had closed in the prior five years: 2005-2010.
The definition of closure was based on the Office of the Inspector General: “We follow the convention of the Office of Inspector General of the Department of Health and Human Services that a closed hospital is “A facility that stopped providing general, short-term, acute inpatient care [….]” Closures occurred out of a total of 1,805 rural community hospitals at the beginning of 2020, according to the AHA (https://www.aha.org/statistics/fast-facts-us-hospitals).
The financial picture for rural hospitals in the developed world is dire, as many barely had positive operating margins before Covid-19, according to an AHA commissioned study conducted by Kauffman-Hall (A national median of 3.5% margin pre-pandemic; with almost half incurring negative margins after one-year of COVID with expectation of little improvement) (https://www.kaufmanhall.com/insights/research-report/covid-19-2021-pressure-continues-hospital-margins) ( Kauffman-Hall, 2021). Their optimistic scenario based on data from an overall national survey of hospitals projects a return of rural hospital margins to only negative 38% of pre-pandemic levels by 2021-year end. Their pessimistic scenario anticipates no improvement in margins during 2021.
Similarly, in the developing world, health care services and the availability of sustainable hospital models are in short supply. In many instances, insufficient resources exist to create a hospital, or when they exist, they are not adequately staffed or equipped to provide quality or sustainable care. Data vary tremendously in these situations, but pictures can be painted in Latin American countries, African countries and Asian locales that share many of these challenges. The necessity of a vision of the hospital of the future is universal, albeit relative to local circumstances.
YOUR VISION FOR THE HOSPITAL OF THE FUTURE IN RURAL OR REMOTE LOCALES
Context: The world at large needs to address longer-term health care needs and that assessment includes re-visioning of hospitals. The urgency of applying this reasoning to hospitals in rural parts of the developed world or remote locales in the developing world is particularly acute. The challenge of this Competition is for participants to deploy creativity, innovation, and entrepreneurial thinking to re-designing or conceiving of hospitals for new realities going forward over a longer time horizon.
The Prompt: Most of us when envisioning a hospital think of urban or suburban contexts where there is suitable infrastructure, human resources and sufficient financial or payment resources for the facilities to be sustainable. In rural US, Canada, and Europe, and in the out-lying regions of developing countries, these factors are usually not in evidence. Given the increasing challenges confronting rural hospitals or hospitals in less densely populated, resource-challenged locales, how would you conceive, design, and equip the hospitals of the future to provide adequate services in terms of breadth and quality, and ensure their viability?
Teams in this competition should prepare a business plan that addresses each of the following topics comprehensively. Each is important for business model development and evaluation:
1. Identify rural or remote areas meeting the above criteria and choose one that is currently facing these challenges. Carefully consider the social determinants of health at work in that locale. Justify your selection and describe the context demographically and clinically and describe the particular challenges. How is care currently being provided? By whom?
2. Based on the starting points in the locale selected, what features would you include? Focus on the macro-, infrastructure circumstances and build on services to be provided. As you develop the services, carefully consider the needs, such as diagnostic and interventional, and the operational and process constraints in delivering quality and safe care that is accessible and cost efficient while providing good clinical outcomes. Efficiencies and sustainability are key considerations. In this regard, address:
a. What type of patient mix with related services mix will be projected?
b. Specifically, address critical care, medical care, surgical care (planned and unplanned surgeries), and emergency services.
c. What type of reimbursement (with consideration of payer mix: fee-for-service, case rates, capitation, value-based payments/bonus models, mixed models within the locale’s context) and revenue stream(s) will be projected in countries that have well-developed payer systems, or alternatives for payment and support in countries where there is a less-developed system? What is the NPV of your proposal over a five-year horizon?
3. Take into account the locale’s primary and specialty care physicians and describe how you would engage them in your proposed vision of the hospital of the future. Your model should anticipate how performance will be defined and measured and how you would evaluate the performance of the characteristics of your vision? How would you build those measurements and feedback to drive performance in the spirit of continuous improvement?
4. Would your approach improve the general health of the rural or remote community? By which specific measure(s) would you determine that?
5. What innovation(s) would you incorporate and deploy in your hospital of the future? Describe your innovation(s). Is (are) it (they) technological, service, process? In addition, students should address the Six Factors Alignment (https://hmpi.org/2016/10/17/diffusion-of-global-innovations-in-health-care-how-to-make-it-happen/) (Herzlinger & Schulman, 2016) when describing their innovation(s). In other words, students should describe how well the innovation(s) align(s) with the Six Factors in the environment that can make it or break it. Where the alignment is poor, please address remedies, if any. The six factors are:
a. Structure: Is the status quo health care system a friend or a foe?
b. Financing: What are the primary sources of reimbursement and capital?
c. Accountability: What are the credible demonstrations of impact on cost, quality, and access?
d. Public Policy: How well is the innovation aligned with public policy and why?
e. Consumers: How well is the innovation aligned with consumers and why?
f. Technology: Is the technology likely to be obviated by competing technologies?
6. What are the needed characteristics of the top management? How will you recruit and retain the talent needed?
7. How does your vision of the hospital of the future address ESG (Environmental, Social, and Governance) considerations?
8. Specify implementation milestones and marketing plan for your hospital of the future.
References:
American Hospital Association. (n.d.). Fast facts on U.S. hospitals, 2021. Retrieved
from https://www.aha.org/statistics/fast-facts-us-hospitals
Bai, G., Yehia, F., Chen, W., & Anderson, G. F. (2020). Varying trends in the financial
viability of US rural hospitals, 2011–17. Health Affairs, 39(6), 942-948.
Herzlinger, R. E. & Schulman, K. A. (2017). Diffusion of global innovations in health
care: How to make it happen. Health Management Policy and Innovation, Volume 2, Issue 1.
KaufmanHall. (2021). COVID-19 in 2021: Pressure continues on hospital margins.
Retrieved from https://www.kaufmanhall.com/insights/research-report/covid-19-2021-pressure-continues-hospital-margins
Sheps Center. (n.d.). Rural hospital closures. Retrieved from
https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/
Vestal, C. (2021). Pandemic drains hospital finances. Pew. Retrieved from
https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2021/03/24/pandemic-drains-hospital-finances
- Site selection – describe location and reasons for selection; current health services offered
- Features of your hospital of the future – patients served, services provided, reimbursement, financial analysis (e.g., NPV)
- Description of providers – recruitment strategy, performance evaluation
- Community/population health – strategies included, evaluation measures
- Innovations employed – describe innovation and alignment using Six Factors model
- Top management – description, recruitment and retainment strategy
- Environmental, social, and governance (ESG) considerations
- Implementation milestones and marketing plan
Additional factors to consider:
- Environmental: Waste & Pollution, Resource Depletion, Greenhouse Gas Emission, Deforestation, Climate Change
- Social: Employee Relations & Diversity, Working Conditions, Local Communities, Health & Safety, Conflict
- Governance: Tax Strategy, Executive Remuneration, Donations & Political Lobbying, Corruption & Bribery, Board Diversity & Structure
Diffusion of Global Innovations in Health Care: How to Make It Happen
Regina E. Herzlinger, Harvard Business School, and Kevin A. Schulman, MD, Duke University School of Medicine
- The event will be held in a hybrid-format. All teams are encouraged to participate in person, and a faculty advisor from each program is invited to accompany the team. Students participating virtually will do so synchronously. More instructions will be provided as we near the event date.
- The registration deadline was December 2, 2021.
- An online Student Mixer for proposed international student teams was held at 9 am CST on December 9, 2022. After that, the composition of the international teams will be finalized.
- All teams have access to the case and instructions. A Q&A about the case will be held February 3, 2022. Teams work on the case until Friday, March 25.
- Students and advisors arrive on Thursday, April 7, in Waco, located between Dallas / Fort Worth and Austin airports. The optional evening reception at McLane Stadium, 1001 S M.L.K. Jr Blvd, Waco, TX 76704 will begin at 7:00 p.m. Due to technological constraints at McLane Stadium, students participating virtually will be unable to join.
- Teams present in the preliminary round on the morning of Friday, April 8, in three/four panels, either in person or virtually.
- Teams attend a luncheon on Friday for the announcement of the three/four finalist teams. We will stream the announcement of finalists and the team draw for panels for those participating virtually. The final round will be held Friday afternoon.
- The competition concludes with an awards ceremony and reception on Friday afternoon. We will stream the awards ceremony for those participating virtually.
Details to come
Details to come
Judges from across the global health care industry will review each submission. The top scoring teams will be awarded prizes.
- First Place $10,000 (or $11,000 for an international team) and the opportunity to submit a paper to Health Management, Policy and Innovation (HMPI.org)
- Second Place $5,000 (or $6,000 for an international team)
- Third Place $2,500 (or $3,500 for an international team)
- Fourth Place* $1,000 (or $2,000 for an international team)
- International Judges Award* $1,000 (or $2,000 for an international team)
*Change from last year’s awards
Details to come
- National and international recognition for the participating programs and students who compete
- Opportunity to network with student and faculty peers from other select programs across the globe
- Opportunity to interact with healthcare industry professionals who serve as judges, case developers, and competition sponsors, with the primary goal of benefitting the students and their respective programs
- Opportunity to form academic-industry partnerships, identify internship/residency and future employment opportunities, and transfer knowledge from healthcare professionals to students and faculty
I learned about the [many] opportunities that Digital Health can contribute to improve the lives of the underserved. With today’s technological advancements, we can leverage the capabilities of our own smartphones to help millions of lives around the world and address issues and communities that were easily overlooked in the past.
Roni Steiner
Product Owner for the Point of Care Ultrasound Devices
MBA from IESE Business School (Class of 2021) and 2021 Case Competition participant
Details to come
The internal contacts for each institution:
Baylor University
Forest Kim: Forest_Kim@baylor.edu
Neil Fleming: Neil.Fleming@BSWHealth.org
Boston University, Questrom School of Business
Ned Rimer: nedrimer@bu.edu
Georgia State University
Marie L Cameron: mariecameron@gsu.edu
Harvard Business School
Frank Sutter: fsutter@hbs.edu
IESE Business School
Magda Rosenmöller: magda@iese.edu
Indian School of Business
Vandana Yadav: Vandana_Yadav@isb.edu
Sowmya Shashidhara: sowmya_shashidhara@isb.edu
Sarang Deo: sarang_deo@isb.edu
INCAE Business School
Andrea Prado: andrea.prado@incae.edu
Johns Hopkins University, Carey School of Business
Bonnie Robeson
Miami Business School
Steve Ullmann: sullmann@bus.miami.edu
Karoline Mortensen: kmortensen@bus.miami.edu
Strathmore Business School
Ben Ngoye: bngoye@strathmore.edu
University of Colorado, Denver
Rulon Stacy: RULON.STACEY@UCDENVER.EDU
University of Minnesota, Carlson
Pinar Mandic: pkmandic@umn.edu
Jessica Haupt: jahaupt@umn.edu
University of North Carolina, Kenan-Flagler
Markus Saba: Markus_Saba@kenan-flagler.unc.edu
Erin Leach: Erin_Leach@kenan-flagler.unc.edu
University of Pennsylvania, Wharton
June Kinney: kinneyj@wharton.upenn.edu
Ingrid Nembhard: ingridn@wharton.upenn.edu
University of Toronto
Rosemary Hannam: Rosemary.Hannam@Rotman.Utoronto.Ca
Vanderbilt, Owen Graduate School of Business
Larry VanHorn: larry.vanhorn@owen.vanderbilt.edu
Scarlett Gilfus: Scarlett.Gilfus@owen.vanderbilt.edu
Yale University
Howard Forman: Howard.Forman@Yale.edu
| Adam Willmann | Chief Executive Officer | Goodall Witcher |
| Afsane Jetha | Chief Executive Officer | Alta Semper Capital (sponsor 2022 Case Competition) |
| Alexandre Lourenco | Healthcare Manager & Researcher | Coimbra Hospital |
| Benjamin Anderson | Vice President, Rural Health & Hospitals | Colorado Hospital Association |
| Bill Nielson, ALT | Associate Dean of the Honors College | Baylor University |
| Bill Novakoski, ALT | Cherise is emailing | |
| Blake Barnes | Vice President of Operations | BSW Health System |
| Bruce Stroud | Assistant Vice President of Strategy | Willis- Knighton Health System |
| Carlos Nueno | International President | Teladoc Health |
| Charles Williams | Chief Executive Officer | BSW Health System |
| Erin Harrison Cannon | PhD Director, Clinial Businsess Services | Baylor College of Medicine |
| Hendrick Miles Ramsey | Medical Director | Caja Costarricense de Seguro Social |
| Jeanna Adler | Vice President of Finance | Ascension Health System |
| John Henderson | President/CEO | Torchnet |
| John Sheehan | Colonel, USAF, MSC (retired); Healthcare Chief Executive Officer | |
| Joshua Williams | Business Development Manager | FIGUR8, Inc. |
| Kyllan Cody | Chief Executive Officer | Encompass Health |
| Mark Clayton | Outreach & Relations Affiliate | St. Davids Health System |
| Martin E Doerfler | SVP Clinical Strategy & Development | Northwell Health |
| Michael Jelinske | Associate Director | Leapfrog Investments |
| Nicholas Goodwin | Director | Central Coast Research Institute for Integrated Care |
| Pratap Kumar | Principal Investigator & Senior Lecturer | Strathmore University |
| Tammy Rodriguez | Vice President/CNO | AdventHealth |