Can a social purpose and stakeholder capitalism confer a powerful competitive advantage in the age of COVID-19? For PayPal, the answer is yes. After spinning off from eBay in a 2015 IPO, the company declared its purpose as "democratizing financial services" by ensuring that low-income consumers and small businesses can efficiently and inexpensively manage their money. The company fully lives into this purpose, sending employees out into communities to experience firsthand the indignities and high fees imposed on the unbanked, dramatically lowering the cost of international remittances, enabling small businesses to access working capital without credit checks, and facilitating cross-border purchases for small merchants. The company takes the welfare of each stakeholder group seriously: achieving racial and gender pay equity, raising hourly worker pay and benefits to ensure a living wage, and building a diverse and inclusive culture; working closely with regulators and law enforcement to unearth signs of sex trafficking and terrorism; aggressively removing hate-group transactions; providing $4 billion in credit to hundreds of thousands of small businesses that would never have qualified for bank loans, especially those owned by women and people of color. Together these actions have built a high degree of trust that creates a competitive moat in the otherwise commodity business of online payments. During the pandemic, the company was able to get stimulus funds to individuals and small businesses far faster and less expensively than banks or the SBA, and committed $500 million to investments in black-owned businesses. In the 5 years since its IPO, despite intense competition from major banks and credit card companies, Google, Apple, and countless VC-backed fintech players, the company has more than doubled its users, increased profits and boosted the stock price 500%.

Although people tend to think of the American political system as a public institution based on high-minded principles, it's not. Politics behaves according to the same kinds of incentives and forces that shape competition in any private industry. Our elections and our legislative systems are drowning in unhealthy competition: The political-industrial complex wins, and the public interest loses. Business, in pursuing its short-term interests, has become a major participant in the politics industry, exacerbating its dysfunction. We can have healthy competition in politics--results, innovation, and accountability--by redesigning how we vote to connect acting in the public interest with getting reelected. Applying Porter's five forces framework illuminates the root causes of political dysfunction and points to the most powerful levers for transformation.

Since its establishment in 2005, Hamburg's Martini Klinik had single-mindedly focused on prostate cancer care with a commitment to measure long term health outcomes for every patient. A wholly owned subsidiary of the University Hospital Hamburg, Martini Klinik was a "hospital in a hospital" in close proximity to other medical departments and services. By 2019, Martini Klinik had become the largest prostate cancer treatment program in the world with 8,000 outpatient cases and more than 2,500 surgical cases annually. Patients came from all over Germany and from around the world. A new and expanded facility was under construction to have the capacity to manage more patients with prostate cancer.

Widely considered the founder of the modern strategy field, Michael Porter discusses his current work on the Social Progress Imperative and its accompanying Social Progress Index. He explains why social progress must be on the radar of every business executive. He also describes why Denmark (among countries) and America's largest bank, J.P. Morgan Chase (among corporations) lead the world in terms of their commitment to social progress. In the end, he makes it clear that the most powerful way for any company to affect society is through its business model.

Medtronic is adapting its strategy to changes in health care competition and payments. It has decided to develop new relationships with payers, hospitals, and physicians to become more accountable for patient outcomes and total costs. The case describes new forms of partnerships for therapy optimization, management of acute care episodes, and management of chronic care patients.

Children's Hospital of Philadelphia (CHOP) began as a stand-alone hospital in the heart of downtown Philadelphia in 1855. By 2016 the CHOP Care Network stretched across Pennsylvania, New Jersey, and the New York metropolitan area, providing a wide range of services from primary care to complex specialty care. In 2016, U.S. News and World Report had ranked CHOP as the number 2 pediatric hospital in the nation and among the top 10 in 10 pediatric specialties. CHOP's residency program for training pediatricians was also ranked number one in the country. Madeline Bell, who had been President and Chief Operating Officer, was named Chief Executive Officer in 2015. A pediatric nurse who became a hospital administrator, Bell saw the network as a means to serve more patients, improve pediatric care, and address the challenges posed by a rapidly changing health care environment.

As the largest company, by revenue, in the world, Walmart has been a lightning rod for criticism. However, in an attempt to stay ahead of traditional and digital retailers, and keep customers satisfied with evolving demands, the company is strengthening its competitive advantage by creating Shared Value. Current CEO, Doug McMillon outlines his strategy for fending off competition, navigating a challenging retail landscape, and positioning Walmart as a leading retailer for today and the future.

"CVS Health: Redefining the Value Proposition" explores how a company can use shared value as a lens to think about competition and strategy choices in a challenging and evolving industry. The case takes a historical look at the structure of the retail pharmacy industry and the changing nature of rivalry among competitors. The case examines how CVS was able to surpass the long-time industry leader, Walgreens, and highlights CVS Health's shift in strategy starting in the mid-2000s.

The United States stands at a crossroads in how to pay for health care. Fee for service, the dominant payment model in the U.S. and many other countries, is now widely recognized as perhaps the single biggest obstacle to improving health care delivery. A battle is currently raging, outside of the public eye, between the advocates of two radically different payment approaches: capitation and bundled payments. The stakes are high, and the outcome will define the shape of the health care system for many years to come, for better or for worse. In this article, the authors argue that although capitation may deliver modest savings in the short run, it brings significant risks and will fail to fundamentally change the trajectory of a broken system. The bundled payment model, in contrast, triggers competition between providers to create value where it matters--at the individual patient level--and puts health care on the right path. The authors provide robust proof-of-concept examples of bundled payment initiatives in the U.S. and abroad, address the challenges of transitioning to bundled payments, and respond to critics' concerns about obstacles to implementation.

This case considers Nestlé's creating shared value (CSV) strategy, which focused on the three categories of nutrition, water, and rural development. In the packaged food and beverage industry, pressure had mounted since the 1990s to improve supply chain sustainability and provide healthier, more natural foods, leading to consolidation and causing sales to decline in the 2010s. With 150 years' experience in the industry, Nestlé had transformed into a nutrition, health, and wellness company and made its CSV strategy explicit in the early 21st century. By 2014, Nestlé CEO Paul Bulcke considered how best to fully embed the company's CSV strategy and to communicate it to shareholders and external stakeholders.

The evolution of products into intelligent, connected devices is revolutionizing business. In a November 2014 article, "How Smart, Connected Products Are Transforming Competition," Harvard Business School professor Michael Porter and PTC president and CEO James Heppelmann looked at how this shift is changing the structure of industries and forcing firms to rethink their strategies. In this companion article, the authors look at the effects inside firms, examining the impact that smart, connected products have on operations and organizational structure. The new capabilities and vast quantities of data that smart, connected products offer are redefining the activities of the core functions of companies--sometimes radically. As software and cloud-based operating systems become integral to products, new product-development principles emerge, manufacturing components and processes change, and IT security becomes the job of every function. Companies need different skills and expertise, which creates new imperatives for HR. In the marketing function, the ability to track a product's condition and use shifts the focus to maximizing the product's value to the customer over time. Customer relationships become continuous and open-ended, service becomes more efficient and proactive, and new business models are enabled. The rich data on location and environment that products provide take logistics to a whole new level.

Late in 2013, Novartis CEO Joseph Jimenez was considering how and whether to deepen the company's investment in Arogya Parivar, its profitable program that sold Novartis medicines in rural India, while expanding access to medicine and health information to millions of Indian villagers.

Discovery Ltd. is a South-African based insurance company. Started in the early 1990s, Discovery used behavioral economics and data collection to innovate in the health care insurance industry. Its founder Adrian Gore believed that the company's products needed to not only make money but have a positive impact on society. Using its Vitality Wellness program as its strategic lynchpin, Discovery expanded into other insurance areas and financial services products and also entered new markets abroad. In late 2014, Gore and his team had to decide how to further develop the company and prioritize among many growth opportunities.