MiracleFeet, a US-based non-profit, improves access to high-quality treatment of clubfoot in low-income countries, typically in partnership with public hospitals and local NGOs, by providing low-cost foot braces, training, advocacy, awareness-raising and financial and operational support. It aims to treat 100,000 children by 2024 across 70 countries - half of them middle-income countries. Having succeeded in low-income settings, it now plans to target middle-income countries, starting with the Philippines, convinced it can make an impact by taking a different strategic approach. However, the middle-income segment proves less straightforward than anticipated, even if healthcare infrastructure is more developed and families can cover some of the costs. The narrative follows the non-profit across a decade of development, culminating with the question: what can MiracleFeet do differently to ensure its service offering succeeds in the Philippines, and then rolled out to other middle-income countries?

Meddo is a healthcare service delivery innovation in India that simplifies the patient journey through outpatient services, lab tests, and medicines management. It was born out of a collaboration between a medical doctor who cofounded a hospital chain, and an entrepreneur who had led a major food-delivery service. The case allows for the exploration and growth of a business model innovation in the complex ecosystem of healthcare.

In 2013, Eastern Health Alliance (EHA) launched the Neighbours for Active Living programme to reduce hospital readmissions among seniors in eastern Singapore. At its core, 'Neighbours' addressed the health care and social needs of high-risk residents within their homes, while building social support systems around them through community outreach. The case discusses the asset-based approach that inspired the concept as well as challenges such as measuring its effectiveness and the impact on patient outcomes.

mySugr is a mobile health startup which allows us to explore several interlinked trends. One trend is the proliferation of health related applications, and an understanding of factors which seem to be related to success in the digital health space. Another trend is the role of patients in managing their own health, an issue of increasing importance as chronic diseases touch the lives of a growing number of individuals and consume an increasing part of the health budget. A third related concept is that of asset based approaches for health, a concept which seems to be linked to the success of a number of health apps.

PatientsLikeMe, an health online community formed to provide value for patients in exchange for sharing their health data, had grown substantially since its founding in 2004. By 2016 it had over 130 employees. However, convincing investors of the viability of the business model proves more challenging. Its three founders believe it has the potential to reshape the healthcare ecosystem, but its "not just for profit" approach is complex to communicate. In their ambition to improve the healthcare experience by capturing health outcomes and learning what works in the real world (beyond clinical trials) - they must attend to critical issues such as patient privacy in addition to setting their growth strategy.

Sanofi Pasteur's newly approved dengue vaccine, Dengvaxia, was unusual in that it was launched in the Philippines and other at-risk countries. By choosing to "flip the model" - launch in an emerging market setting as opposed to developed markets - it had to overcome various obstacles across the value chain, from registration to financing to supply. The company spent 20 years and invested $1.7 billion to develop Dengvaxia, taking several high-risk decisions and making trade-offs along the way. The case highlights the stakeholder interdependencies and uncertainties that remained as the vaccine implementation programme crept closer. If successfully resolved, it could potentially offer a blueprint for others.

Set in 2014, this case study examines the development and ongoing transition to value- and outcomes-based commissioning for diabetes care across North Central London (NCL). With the aim of improving health outcomes among their local populations, Clinical Commissioning Groups (CCGs) in NCL set out to tranform the delivery and funding of services. This involves incentivize providers to deliver on specific health outcomes that are important to patients via an integrated platform encompassing multiple entry points - primary, secondary, social care and community services.

Facing reduced government funding, yet committed to broadening access to its services, Sankara Eye Care, a chain of hospitals in India, was at a crossroads in 2015. Over the years it had developed a lean operational model to provide free care to approximately 80 percent of its non-paying patients (cross-subsidized by paying patients). Continuous improvements and further innovation, however, were needed to achieve its ambitious goal of expanding from 9 hospitals to 20 by 2020. The case highlights Sankara's key decisions, including issues of intrinsic and extrinsic motivation, moving from a charity to a business mindset, and determining the expansion strategy.

Manufacturers in developed countries can no longer rely on lean management practices to stay profitable. They face increasing competition from plants in large emerging economies that are able to produce on a large scale at a lower cost, while still providing high quality. The way forward, the authors suggest, can be glimpsed from analyzing past winners of Europe's annual Industrial Excellence Award. Those companies have succeeded by using one or more of these strategies: (1) Leveraging data flows to integrate closely with supply chain partners. Germany's Schmitz Cargobull, for example, has become a leading trailer manufacturer by using sophisticated information technology to help customers monitor their vehicles. (2) Creating value downstream in other parts of the supply chain. One example is Markem-Imaje, a maker of industrial printers for coding products; the company adds value for customers by offering a variety of ancillary services. (3) Collaboratively designing manufacturing processes that can rapidly evolve to meet customers' needs. A prime example is ASML, which works closely with customers and suppliers to make innovations in production technology for the semiconductor industry. (4) Specializing in customized products. Focusing on small runs of custom-designed products has been an effective strategy for companies like BuS Elektronik and the Daimler Group's Smart car division.

This case study presents an example of business model innovation in the context of primary care delivery. It documents the story of Laastari, a new IT-driven retail health clinic chain based in Finland, including the process that links conceptual strategy to implementation and practice, as well as the evolving stakeholder ecosystem of the company.

This case allows course participants to use a graphical simulation tool to explore several key factors that lead to customer response delays in service systems. A high-level discussion can then ensue on process flow management, including tools like segmentation, process standardization and scheduling, and resource utilization planning. The case requires the ProModel simulation software tool (not included, to be purchased separately), and computer simulation input files (available free from the author's website: http://faculty.insead.edu/stephen-chick/simulations ).

Compaq Computer Corp., like many manufacturers, faces operational choices that strongly influence the cost of capital engaged in inventory, customer response time, and potential product obsolescence. This case describes some key operations strategy choices regarding two types of inventory: operation inventory (e.g., flow) and tactical inventory (e.g., finished goods). Tradeoffs in inventory management and customer response time are explored in the context of a firm that is changing from a push manufacturing to a customer-oriented pull system. Optional computer simulations (B case) visually display the dynamics of push and pull systems, kanban squares, and their effect on inventory requirements and customer response times. The simulations require the ProModel simulation software tool (not included, to be purchased separately) and computer simulation model files (available from the authors' website: http://faculty.insead.edu/stephen-chick/simulations).