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Leading fertilizer producer Yara International demonstrates the concept of creating shared value through the Southern Agricultural Corridor of Tanzania (SAGCOT) initiative, which brought together multiple organizations to enhance agricultural development in rural regions.

Dow had adopted the "Breakthroughs to World Challenges" (BWC) program as part of its ten-year 2015 Sustainability Goals. BWC was an internal award recognizing products that effectively addressed one of five world challenges: energy and climate change, sustainable water supply, decent affordable housing, personal health, and food supply. By late summer 2014, two products had been designated as BWCs and two others were set to be announced in the fall. Dow senior executives believed that Dow was creating shared value through its BWC products. As management began drafting the company's sustainability plan for 2015 and beyond, CEO Andrew Liveris confronted the question of whether to maintain, modify or terminate the BWC program.

This case provides a sample of Walmart's social engagement activities and asks students to categorize each as philanthropy, corporate social responsibility, or creating shared value.

Information technology is revolutionizing products, from appliances to cars to mining equipment. Products once composed solely of mechanical and electrical parts have become complex systems combining hardware, sensors, electronics, and software that connect through the internet in myriad ways. These "smart, connected products" offer exponentially expanding opportunities for new functionality, far greater reliability, and capabilities that cut across and transcend traditional product boundaries. The changing nature of products is disrupting value chains, argue Michael Porter and PTC CEO James Heppelmann, and forcing companies to rethink nearly everything they do, from how they conceive, design, and source their products; to how they manufacture, operate, and service them; to how they build and secure the necessary IT infrastructure. Smart, connected products raise a broad set of new strategic choices for companies about how value is created and captured, how to work with traditional partners and what new partnerships will be required, and how to secure competitive advantage as the new capabilities reshape industry boundaries. For many firms, smart, connected products will force the fundamental question: "What business am I in?" This article provides a framework for developing strategy and achieving competitive advantage in a smart, connected world.

It was the waiting that drew the attention of the Stockholm County Council. In 2008, patients seeking a hip or knee replacement in Stockholm County faced wait times of up to two years of sometimes debilitating pain, intermittent missed work and income, and the trials of disability. Seeking a new model to lower wait times, but also improve patient choice of care, County Council Senior Medical Adviser, Dr. Holger Stalberg, set out to create a bundled payment system for hip and knee replacements in the County. The new model, called OrthoChoice, was set to go into operation on January 1, 2009.

By the end of 2008, all major hospitals (one of which was private) and three private specialized orthopedic centers signed OrthoChoice contracts. In 2009, hip and knee replacements in the County of Stockholm for relatively healthy patients began being reimbursed. By 2013, OrthoChoice had covered 12,531 hip and knee replacements, accounting for 59% of such operations for county residents. Total payments were SEK 704.5 million ($109.4 million). Dr. Holger Stalberg and his team at the Stockholm County Council (SLL) were reviewing the results of the new payment approach and considering how to improve the model.

In 2014, Dr. Charles D. Fraser Jr., Surgeon-in-Chief of Texas Children's Hospital in Houston, was contemplating the future direction of the congenital heart disease program. The nation's largest pediatric hospital, Texas Children's was ranked by U.S. News & World Report as #4 in the nation in 2012-2013. It was ranked #3 in pediatric heart care and heart surgery, following Boston Children's and Children's Hospital of Philadelphia (CHOP). Texas Children's had some of the highest volumes in the nation, seeing more than 20,000 congenital heart disease patients and performing over 800 cardiac surgeries annually. Fraser led the reorganization of Texas Children's care for congenital heart disease conditions beginning in 1995, and had initiated universal outcome measurement. In 2014, the challenge was to continue to improve care in a complicated patient population, and take outcome measurement to a new level. Also, Texas Children's had recently formed partnerships with pediatric hospitals in Temple, San Antonio and Mexico City, and how to structure these partnerships was under active discussion.

In health care, the days of business as usual are over. Around the world, every health care system is struggling with rising costs and uneven quality, despite the hard work of well-intentioned, well-trained clinicians. Health care leaders and policy makers have tried countless incremental fixes--attacking fraud, reducing errors, enforcing practice guidelines, making patients better "consumers," implementing electronic medical records--but none have had much impact. It's time for a fundamentally new strategy. At its core is maximizing value for patients: that is, achieving the best outcomes at the lowest cost. We must move away from a supply-driven health care system organized around what physicians do and toward a patient-centered system organized around what patients need. We must shift the focus from the volume and profitability of services provided--physician visits, hospitalizations, procedures, and tests--to the patient outcomes achieved. And we must replace today's fragmented system, in which every local provider offers a full range of services, with a system in which services for particular medical conditions are concentrated in health-delivery organizations and in the right locations to deliver high-value care. The strategy for moving to a high-value health care delivery system comprises six interdependent components: organizing around patients' medical conditions rather than physicians' medical specialties, measuring costs and outcomes for each patient, developing bundled prices for the full care cycle, integrating care across separate facilities, expanding geographic reach, and building an enabling IT platform. The transformation to value-based health care is well under way. Some organizations, such as the Cleveland Clinic and Germany's Schon Klinik, have undertaken large-scale changes involving multiple components of the value agenda. The result has been striking improvements in outcomes and efficiency, and growth in market share.

The case discusses the origins and development of the European Integration process from the post-war period up to 2007, focusing particularly on the efforts of the Lisbon-agenda under way since 2000 to enhance Europe's competitiveness. It discusses the different policy areas that have been approached at the European level over time, and provides background on the architecture of European institutions. The case enables students to understand how European integration has affected competitiveness across the continent. It provides a platform to discuss the impact of collaboration across countries in large geographies on competitiveness, and the lessons that the European integration experience might hold for other world regions.

Traces the economic development of New York City from its founding in the 17th century through 2012. Focuses on the decisions made by New York City officials, past and present, highlighting the challenges of economic development at the city level. Enables deep examination of the interdependence and interrelation of economic policies at the city, state and federal level, and explores the role of economic and cluster performance. Detailed historical economic and social data allows for an evaluation of policy results. The case finishes highlighting the main economic challenges the city was facing in 2012.

The case discusses the economic development of Estonia, covering specifically the period from regaining independence from the Soviet Union in 1991 until 2015. It tracks the process from the initial transition towards a market economy to becoming an EU member country, including the 2007 crisis and the government's response to it. The overall performance of the economy, the profile of its key clusters, and the quality of its business environment in 2015 are discussed. The case provides the background for an analysis of policy reforms in a transition economy, the role of legacy and geographical neighborhood for economic development, the implications of EU membership for an EU member country, and the relationship between microeconomic reforms and macroeconomic crisis.

The case tracks Vietnam's economic policy choices and performance from the end of the Vietnam war to the Doi Moi economic reforms and the economic transformation that followed. Throughout this period, the country had become a darling of the international aid community. As the country was preparing for the 2011 Party Congress, however, signs of growing economic frictions were becoming increasingly visible. The case closes by setting the scene for the challenges the new leadership was going to face.

The New Carolina Initiative case explores the process of fostering competitiveness in the subnational region, South Carolina, one of the poorest states in the United States. The case has been developed primarily for the use in the course "Microeconomics of Competitiveness", developing the concept of organizations for competitiveness in a subnational region and the elements of constructing an economic strategy. The case also outlines the adopted cluster vision of development for the state and the various task forces created to upgrade the business environment of the state. South Carolina's Council on Competitiveness, New Carolina, is an organization with significant capacity to mobilize regional actors in various task forces and cluster initiatives. Showcasing the complexity and organizational challenges of building a competitiveness initiative, the case emphasizes the importance of engagement from both private and public sector representatives. The case also provides an opportunity to discuss the competitive position of the South Carolina economy in 2011.

The Basque country, with a population of 2.1 million and covering 7,233 square kilometers, is an autonomous region located in the north of Spain, physically separated from it by the Pyrenees mountains. Presents the history of the region--highly prosperous at the turn of the 20th century, but nearing bankruptcy by the 1950s. By 2001, the Basque GDP per capita had risen to a level well ahead of Spain and most European countries. At the same time that the region was enjoying the spoils of admirably executed cluster initiatives, it was being threatened by the destabilizing violence of the Basque separatist extreme, a slowing global economy, and an always-precarious balance of power between the Basque's own government and the government of Spain.

In 2006, surgeon Ara Darzi identified several key areas, including acute stroke care, for improving health care across London. In response to his seminal call to action, stroke care was reorganized around eight hyper-acute stroke units covering London's five sectors, replacing the more than thirty units that previously delivered acute stroke care. This case profiles the roll-out of the new care delivery model in North Central London, where acute stroke care had previously been fragmented among five acute hospital trusts with varying care resources, capacity, and protocols. In the new model, stroke care would be delivered across facilities in an integrated fashion, with a single hyper-acute facility designated for care of the most acute and severe cases.

Great Western Hospital (GWH) is a community hospital in Wiltshire, South West England and one of England's largest maternity providers, responsible for delivering over 9,000 babies per year. The case discusses the efforts of Dr. Harini Narayan, consultant obstetrician and gynecologist, to reorganize antenatal care delivery at GWH. Rather than treating high-risk pregnancies as a homogeneous group, Dr. Narayan pioneered the development of eleven condition-based, high-risk clinics led by dedicated multidisciplinary teams of physicians, midwives and nurses. The case profiles the Multiple Pregnancy Clinic in particular and its impact on perinatal indicators and outcomes.

The Schon Klinik is a private, for-profit German hospital group trying to establish itself as a premium health care provider in a competitive German market. The case details Schon Klinik's founding, its early focus on measurement and improvement, and the design and implementation of a system-wide structure for measuring and reporting actual health outcomes. The case details the care cycle for eating disorder patients and highlights the role outcomes measurement has played in improving eating disorder care over time. It ends with a discussion of Schon's innovative bundled reimbursement models and challenges the reader to explore how to develop new pricing and care delivery models that encourage integration of care around patient medical conditions. The case also discusses the German health care system, its regulatory constraints, and Schon's attempts to change the paradigm of competition in the sector.

Although the U.S. retains profound competitive strengths--for instance, in higher education and entrepreneurship--those strengths are increasingly threatened by weaknesses in areas such as the tax code, basic education, macroeconomic policies, and regulation. Steps to reverse the loss will require a new focus by government and business leaders.

A location decision is, in many respects, a referendum on a nation's competitiveness. When a company decides, say, to build a new plant in China rather than in the United States, it is effectively voting on the question of which country can best enable its success in the global marketplace. Over the past three decades, business activities have become increasingly mobile, and more and more countries have become viable contenders for them. But new data--including the results of an unprecedented survey of 10,000 Harvard Business School alumni--suggest that the U.S. is not winning its appropriate share of location decisions, even for high-value business activities such as R&D that it has traditionally been able to attract. In part, this is because U.S. policy makers are not addressing weaknesses in the national business environment. There are also problems at the corporate level: Many location decisions are incremental shifts of activities offshore; imagine a bucket with many small pinpricks. For instance, a software firm promotes American developers to high-end positions and hires workers from Eastern Europe to do lower-end work. As such, the decisions appear not to warrant exhaustive analysis. At the same time, managers ignore substantial hidden costs associated with non-U.S. locations and overlook the benefits they could reap were they to invest instead in local communities. This article examines the strengths and weaknesses of U.S. locations, identifies the kinds of activities the U.S. must compete for, and outlines an agenda for action for government and business leaders.

State health care reform in Massachusetts has involved a phased process, focusing first on coverage expansion and then turning to delivery system innovation and cost containment. In 2006, the state adopted an individual mandate to obtain health care coverage which, along with a Medicaid expansion and creation of an exchange for two new health insurance programs, reduced the proportion of uninsured to below 3% within three years. In 2009, high and rising health care spending called into question the sustainability of these reforms. Massachusetts prepared to implement its second wave of changes, which included delivery system reforms and a proposed shift from fee-for-service to "global payments" covering all or most of an individual's care. The case examines the content and sequencing of both phases of health care reform in Massachusetts, enabling discussion of health care system-level strategy and the relationship between coverage, care delivery, and spending.