The rise of emerging-market MNEs (EMNEs) often is characterized as a process by which they catch up with the superior resources and capabilities of incumbent, developed-country MNEs (DMNEs). We argue that this characterization needs to be rethought as the requirements for competitive success in global markets are changing. Emerging markets are becoming more important, the value-for-money segment in developed countries is expanding, global retailers are gaining leverage, and the flexibility to deal with economic and political volatility is becoming a key organizational capability. Typically, EMNEs are stronger in these areas than DMNEs. This leads us to frame the competition between EMNEs and DMNEs as a race to the future in which each type of firm has capability holes that it needs to fill in order to thrive in the global economy of the future. We then discuss the strategies that EMNEs and DMNEs have been using to plug their respective capability holes. We hope future studies can apply this framework to analyze rivalry between EMNEs and DMNE in specific industries.

The U.S. health care system needs reform, but too often experts focus on top-down solutions stemming from federal policy changes. Such efforts alone, however, cannot fix a wasteful and misdirected system. What's needed is innovation driven by doctors, nurses, administrators, entrepreneurs, and even patients who are devising new solutions to daily challenges. This article looks at two examples of bottom-up innovation, each involving a radical transformation of health care delivery. The University of Mississippi Medical Center created a homegrown telehealth network to increase patient access to care; Iora Health developed a new business model that doubled down on primary care to reap large savings in secondary and tertiary care. These successful initiatives--one from an incumbent health care provider and one from a business start-up--demonstrate the potential of creative leaders to reshape the U.S. health system.

India might appear to be the last place on earth where you would find health care innovation. Although government programs have finally brought some infectious diseases under control, the nation's ability to meet the basic medical needs of its citizens remains abysmal. However, necessity spawns innovation. Despite the pressing demand and constrained supply, a few relatively new Indian hospitals have devised ways of providing world-class health care affordably--and to scale. The authors identified more than 40 hospitals in India with innovative strategies and selected nine that were consistently providing high-quality care at ultralow prices. To deliver on those dual commitments, the Indian exemplars developed three powerful organizational advantages: a hub-and-spoke configuration of assets, an innovative way of determining who should do what, and a focus on cost-effectiveness rather than just cost cutting. Those moves don't require changes in legislation; only a commitment to reverse the inexorable rise in costs. Indian hospitals, doctors, and administrators have traditionally looked to the West for advances in medical knowledge, but it's time the West looked to India for innovations in health care delivery.

A new breed of multinationals from emerging markets is appearing in many industries. Western firms are wrong to underestimate, as they often do, the competitive threat from these firms. The discussion here highlights the non-traditional competitive advantages these firms use to win at home and abroad and shows how these firms use internationalization not only to exploit competitive advantage but to bolster it. The article concludes with suggestions for how Western managers should respond to the competitive threat from emerging market multinationals.