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Students are asked to consider several issues in the case. First, students are asked to explain how Liberator Medical makes money, to evaluate its business strategy for accomplishing this objective, and to evaluate how successful execution of this strategy is likely to be observable from the company's financial performance. Second, students are asked to analyze the company's cash flow situation, and recent financial performance, including its profitability, asset management, and leverage. Third, students are asked to consider the quantitative impact on the company's financial statements of capitalizing and amortizing direct response advertising outlays. Students are also asked to evaluate whether Liberator Medical used accounting methods that were consistent with generally accepted accounting principles (GAAP). Finally, students are asked to consider the communication and disclosure issues the company faced in responding to analyst criticism of its method of accounting for direct response advertising.

"Alameda Health System" (AHS) describes a county-owned safety net health system adapting to the implementation of the Affordable Care Act and an increasingly competitive health delivery environment. It takes the perspective of senior management, specifically the Chief Medical Officer for the system, who has been in his job for just over one year. The case begins in late 2014, when the CEO of 9 years announced that he was leaving AHS to become CEO of a Detroit health system. He was leaving behind a senior management team that had been in place for 1-2 years, and had turned over several times throughout his tenure. At the same time, the system was experiencing a financial downturn, brought on in part by the loss of many low-income, formerly county indigent patients who selected subsidized private health insurance plans on the new state health exchange that contracted primarily with AHS's two largest competitors. AHS also had yet to integrate clinically or administratively with two community hospitals, both of which were in poor financial health, recently acquired as part of a strategy to diversify the AHS payer mix. The system faced operating challenges common to many publicly-owned safety net hospitals, including: a unionized workforce; an independent, mission-driven medical staff that had grown weary of administrative turnover; a poorly functioning revenue collection system; unprofitable contracts with managed care plans; relatively few commercially insured patients or contracts; long wait times for care; lack of telephone and transportation access to providers; and a low-income population with multiple poorly managed chronic diseases, including mental illness and substance abuse, as well as a high rate of violent crime. The case requires that students understand key aspects of the ACA and can synthesize other relevant environmental and organizational trends in order to recommend and evaluate the actions that senior management should take.

How might health insurance exchanges make health insurance more accessible and affordable for employers in the small group market (with 2-50 workers)? While the Massachusetts Health Connector-the state's first-in-the-nation health insurance exchange-successfully enrolled nearly a quarter of a million individuals in subsidized and non-subsidized individual coverage, small businesses remained elusive as customers. The Health Connector needed to increase its scale in the small group market to be able to improve the affordability and quality of health insurance products for this sector, but finding ways to create value had been challenging indeed. In 2017, the small group market would expand, when the ACA would permit SHOPs (Small Business Health Options Programs) to sell to employers with up to 100 employees. But deciding whether, and how, to enter this market, or even whether to stay in the existing small group market, was a major strategic question for the Connector and other SHOPs across the country. SHOPs everywhere could also soon face more competition in the small employer market, as brokers and consultants nationally began to create private exchanges to target small businesses. A state waiver request from the ACA could include deciding to eliminate its SHOP altogether. The Health Connector's leadership had long grappled with how to crack the small employer market, and now other states are facing the same challenge. What should they do next?

Southcoast Health System consists of three hospitals in southeastern Massachusetts: St. Luke's in New Bedford, Charlton Memorial in Fall River, and Tobey in Wareham, as well as numerous affiliated entities. But how did the merger that created the Southcoast system came about? "Basically, we merged because we wanted to, not because we needed to," said John Day, President and CEO of Southcoast Health System (formerly the CEO of St. Luke's Hospital). "We wanted to avoid a divide and conquer situation. As community hospitals, we needed to be able to serve the long-term interests of our communities." "We decided it was ridiculous to be competing with each other," added Ron Goodspeed, MD, President of Southcoast Hospitals Group and Executive Vice President of Southcoast Health System (formerly the CEO of Charlton Memorial). A mix of events and environmental conditions set the stage for the three hospitals to consider merging. One of the most critical of these was a turnover in Charlton's CEO position. Meanwhile, the health care environment was becoming increasingly volatile and competitive, and the focus in the business community was shifting away from city-specific planning and toward developing the larger southeastern area of the state. The predominant goal of the management and boards at all three hospitals was to find a way to best serve the interests of their communities. They decided on a full asset merger: building a single executive management team and board of trustees to oversee the organization.

In early 1996, Charlton Memorial, St. Luke's, and Tobey Hospitals were contemplating a full asset merger, something that had never been done before in Massachusetts. The logistics of the merger and its impact on the finances of the hospitals were among the many unknowns that the boards of trustees and management were facing. But, as Ron Goodspeed, MD, CEO of Charlton at the time, explained, "We had a fundamental desire to make it work. We expected hurdles - we knew there would be difficulties - but that is not a reason to back away...We took one step at time, taking care of hurdles as they appeared."

Dr. George Annan was hired as an assistant professor at Northern Plains University (NPU) in August of 2003. He was born in Kenya, Africa, and was of African descent. NPU was a predominantly white institution, and he joined a small department with faculty consisting of three additional men and one woman - all white, and with varying ranks from instructor to associate professor. Although initially evaluated as having achieved the level of performance "reasonably expected in an Assistant Professor," subsequent evaluations were increasingly negative, and he was informed that his performance did not meet the expectations required of faculty at NPU. His contract was terminated at the end of his second year. Department Head Mary Reed believed that she had provided adequate feedback and support so that this outcome could have been avoided - if he had listened to her. Annan contended that he was treated unfairly by being assigned introductory level classes that wasted his talents as a Ph.D., and because he was an African man surrounded by a predominantly white faculty and student body. He was threatening to sue NPU for discrimination. Although Department Head Reed felt that Annan had largely ignored her advice on how to improve his performance, she knew that she needed to prepare evidence to defend NPU in case Annan decided to pursue legal action. Her primary concern was that Annan would allege discrimination under Title VII of the Civil Rights Act of 1964, claiming he was discriminated against on the basis of race.

Michael Geranen and Joe Roberts forged a business relationship around a disruptive drug delivery technology that was developed by Dr. Cherng-ju Kim, a researcher and Professor at the University of Arkansas for Medical Sciences, College of Pharmacy. After an exclusive licensing agreement was negotiated with the University, EZRA Innovations, LLC began the long and arduous process of capitalizing on a flexible and low cost series of technologies that enabled EZRA to compete in the international pharmaceutical industry. EZRA reformulated drugs that were currently available in the marketplace that faced little or no competition, using drug delivery patents that EZRA had licensed. The aim was to become one of the first generic drug competitors to enter the market, and though competitive market entry put downward pressure on drug prices, maintaining what was referred to as premium-priced generics. While many drugs cost upwards of $100 million to develop and take 10 years or more, EZRA's business model offered an accelerated FDA pathway to market and the potential for exponential investor returns within 4-5 years. EZRA first needed to decide how much money to raise and then, how to craft an impactful message to acquire those funds. The challenge was to adequately allay investor fears around a complex business model while still knowing each drug they developed had to negotiate the complex world of FDA filing and approvals. Should their pro forma come to fruition, huge returns for the investors, and EZRA, were possible.

In late spring 2013, Nakedwines.com (NWC) founder and CEO Rowan Gormley brought his team together to prioritize initiatives and formulate a strategy. Five years earlier, Gormley and other Virgin Wines' veterans founded NWC in the United Kingdom, with significant backing from a German family wine company. Naked Wines' business model involved raising money directly from subscribers via the Internet, using these revenues to fund winemakers around the world, who in turn created new brands, which were consigned to NWC and then sold directly via the Internet to subscribers ("Angels") at a discount and to non-subscribers at a premium. Some industry observers considered NWC's business model "disruptive" with respect to how wine was traditionally marketed and sold, i.e. via distributors and retailers. Others opined that NWC was little more than a traditional wine club that used crowdfunding and social media technologies. NWC expanded to Australia and the United States in 2012, at which time NWC leased a Napa office and a Kenwood (Sonoma), California winery for wine production, storage, shipment, and wine tastings. NWC's Angels, who represented 95 percent of NWC's customers, had exclusive access to a mobile application to rate and purchase wines. By spring 2013, NWC had reached breakeven, signed up over 100,000 Angels, and forecasted reaching 200,000 Angels and $96 million in sales by year's end. While NWC's management was pondering which of the initiatives deserved the highest priority (acquiring new customers, retaining customers, or rethinking the mobile app strategy), the most pressing issues involved capacity and capital to grow. The case is intended as a lead-off case for a strategic management course, but also works well in information technology courses.

After significant growth in 2013 when Hostess Baking, a major competitor, declared bankruptcy, Carolina Foods, Inc.'s CEO, Paul Scarborough, wanted to develop a strategy to maintain that level of growth for his family's 80-year-old commercial bakery and its Duchess brand. Hostess brands were purchased by various other commercial bakeries, and the Twinkie, an iconic American snack cake, was back on the market. CFI's Duchess family brand of baked sweet goods included honey buns, donuts and pies manufactured in the original factory in Charlotte, NC, and distributed to markets across the USA, Canada, Mexico and Puerto Rico. Consumer tastes were changing: Snacking in general was increasing and consumers were increasingly focused on healthy, or at least healthier, snacks. Social media was changing the marketing landscape: Could honey buns, donuts and pies be sold on line? Baked sweet goods firms were steadily consolidating across the nation. At CFI, no new products had been introduced over the past twenty years, the company did not have any dedicated marketing personnel, and no marketing budget was allocated (a sales budget did exist). Students can apply numerous basic marketing principles and tools to analyze and choose a viable marketing strategy for CFI. What strategy should CFI pursue for growth? Students may consider new product development, branding, market penetration, and market development, including changes in distribution strategies.

Ned Larsen, the CEO of Ferris Valley Foods Company (FVF), located in westernMichigan, was focusing on the issue of hiring ex-felons. He planned to ask his management team to consider if (and how) FVF could use information obtained from the Michigan Department of Corrections (and the Michigan Prisoner Reentry Initiative) and West Michigan Therapy, Inc. to benefit people like Lori Mitten, a middle-aged ex-offender who recently earned a Bachelor of Business Administration degree and was seeking employment. In a deeper sense, Ferris Valley Foods Company also needed to consider the meaning of corporate social responsibility, with respect to the human, financial, and time-related resources that would be required in order to reach out to ex-offenders. One option might be to adopt a hands-off approach and either do nothing at all or simply make a financial donation to a non-profit organization that provides support for ex-offenders; another could be to become actively involved in partnering with the aforementioned entities. Finally, it could begin to hire ex-offenders. Additional (ethical) complications arise because the CEO's nephew is one of the ex-offenders portrayed in the case.

Tania Kay, Marketing Manager at Consumer & Food Products Corporation of Canada (ConFood), had just returned from a marketing department team-building retreat that had been a miserable experience. The retreat had involved a surprise scavenger hunt through the woods of cottage country in central Ontario, complete with tree climbing, rock climbing, canoeing, and a five-kilometer (three mile) hike. Given her physical limitations she had been unable to participate in most of the retreat's activities. The facilitator-led debriefing session had also been humiliating and demoralizing since her exclusion either went unnoticed by her peers and session leaders or, worse, was blamed on her. Tania debated whether or not to bring up her experience at the marketing retreat with her boss, Marianne Renfrew. Tania worried that making an issue of it would expose a previously hidden disability and therefore result in people stereotyping her, thereby perceiving her as incapable, negative, incompetent, or a whiner.

Event producer Dan Nelson is faced with a crisis involving a punctured sprinkler water line and a 1.5-ton forklift stuck in the resulting mud during set up for an event for 350 attendees taking place that evening. The event is to be held outdoors on the driving range of a Las Vegas resort's golf course on the famous Las Vegas Strip. Dealing with the resort's catering staff and various contractors, Nelson must now create alternatives on-the-fly for dealing with the crisis during the implementation phase of this event, make a quick decision, and implement an alternative under time pressure. The case provides opportunities for: (1) assessing potential risk and crisis management issues pertaining to a particular event and compiling suggestions for closing gaps; (2) using various decision tools (GANTT chart, project management software, EMBOK model) to aid in crisis management, and ultimately, decision making; (3) identifying event stakeholders and managing the relationship between the stakeholders and the event producer; and (4) reflecting on the crisis that happened and learning from it so as to avoid or prepare for it in the future.

Crossing the Thin Blue Line examines a pressing decision faced by the City Council of Moncton, New Brunswick, Canada, regarding the future of policing services in the municipality and challenges the reader to consider diverse perspectives and recognize that - in the political realm - not all choices are as straightforward as they may seem. The narrative examines the history behind this decision, and considers variables (e.g. cost, stakeholder salience, local government issues, etc.) relevant to the decision. The case opens as Moncton City Councilor Brian Hicks weighs this imminent decision faced by the Council.

PepsiCo's CEO Indra Nooyi believes that each PepsiCo product must engage customers so directly and personally that they fall in love with it. So in 2012 she hired renowned designer Mauro Porcini as PepsiCo's first chief design officer. What Nooyi calls "design thinking" now informs nearly everything the company does, from product creation, to the look on the shelf, to how consumers interact with a product after they buy it. HBR Editor in Chief Adi Ignatius interviews Nooyi about how she transformed the company's strategy, its products, and its organizational culture by placing design at the center. The article also includes a sidebar, written by Mauro Porcini, called "How Design Can Thrive."

With cyberattacks soaring, corporations must step up efforts to protect their IT networks. Most firms could learn from the U.S. military, which has been tightening its cyberdefenses for the past six years. In the past year alone, it adroitly repelled more than 30 million intrusions. A focus on reducing human error is core to the military's heightened security. As is true in the private sector, mistakes by administrators and users open the door to the vast majority of successful attacks. To address this, the Defense Department has been borrowing from the "high reliability" practices of the U.S. Navy's nuclear program, which hasn't had a single accident in its six decades of existence. In this article the former vice chairman of the Joint Chiefs of Staff, a special assistant to the Joint Chiefs' chairman, and a management professor describe the military's approach and how business leaders can apply it in their firms. It involves six cultural principles: integrity, which leads people to adhere fully to protocol and own up immediately to mistakes; depth of knowledge, which is ensured by rigorous and continual training and testing; procedural compliance, which is enforced by extensive inspections; forceful backup, to prevent problems that could be introduced by workers acting alone; a questioning attitude, which induces people to investigate anomalies quickly; and formality, which prevents miscommunication. By taking charge, making everyone accountable, and instituting tough standards for IT training and operation, CEOs can embed these principles in their organizations and close critical gaps in security.

Certainty profoundly shapes our behavior. The more certain we are of a belief--regardless of its objective correctness--the greater its influence will be on what we do. People who are certain of their opinions are more likely to buy, buy sooner, and spend more; more willing to recommend products; and more apt to resist challenges to their beliefs. Certainty is the catalyst that turns attitudes into action. Imagine that two customers flying Virgin America give the carrier the same high rating--a 9 out of 10--on a satisfaction survey. Most marketers, seeing that the customers are both highly satisfied, assume they'll behave similarly--that they're equally likely to fly Virgin America again, recommend it to friends, and so on. But their behavior depends less on their stated opinion than on how firmly they hold it. Suppose that one of the Virgin customers is a frequent flier and has had reliably good experiences. She is likely to be very certain of her favorable attitude and to remain a loyal customer. The other may have flown just once on the carrier. She's probably less certain of her opinion--wondering whether future experiences would be different--and therefore less likely than the frequent flier to choose Virgin again. They may hold the same view, but if one of them is more certain of that view than the other, she'll be the better customer. Despite the voluminous body of research on the influence of certainty on behavior, it is poorly understood in business and rarely measured or put to use.

For ambitious executives working in dynamic global businesses, big career transitions--to new roles, organizations, industries, or geographic locations--are a fact of life. So is the need to constantly adapt to new technologies, work groups, strategies, and ways of thinking and behaving. And yet even seasoned professionals find this sort of change difficult. Management researchers have a lot to say about the best way to approach organizational change, but when it comes to personal transitions, there is no blueprint for success. Over years working with MBA students and executives, the author has developed a framework to help in thinking about change. It involves navigating through the Seven C's: Complexity (considering all the issues in a particular change effort); Clarity (understanding and prioritizing those issues); Confidence (believing that one can be successful in making the change); Creativity (brainstorming innovative solutions to problems that arise); Commitment (beginning to implement the change); Consolidation (leaving behind the previous identity to adopt the new one); and Change (living into the change and its consequences).

Benjy's, an electronics and appliance retailer, is losing business because of "showrooming": Customers come into the chain's stores to see, touch, and compare products but then buy at a lower cost from online competitors. Does the company's answer lie in matching online prices, trying to thwart price comparisons, improving customer service, offering exclusive products, charging manufacturers a fee for showcasing their products, or something else? Expert commentary comes from Roberto Leao, a finance executive for a global retail organization, and Steve Conine, chief technology officer of Wayfair, on online retailer.

The acclaimed novelist discusses his creative process, the appeal of social media, and the unique truths found in fiction.

Benjy's, an electronics and appliance retailer, is losing business because of "showrooming": Customers come into the chain's stores to see, touch, and compare products but then buy at a lower cost from online competitors. Does the company's answer lie in matching online prices, trying to thwart price comparisons, improving customer service, offering exclusive products, charging manufacturers a fee for showcasing their products, or something else? Expert commentary comes from Roberto Leao, a finance executive for a global retail organization, and Steve Conine, chief technology officer of Wayfair, on online retailer.