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Historically, the biggest obstacle that healthcare innovators, such as pharmaceutical and medical device manufacturers, needed to overcome on their way to market was securing approval by the U.S. Food & Drug Administration (FDA) or other international regulatory authorities. However, in the last decade, a new (sometimes even more challenging) hurdle had to be cleared: insurance coverage and reimbursement. Payers--either public payers, such as Medicare in the U.S. and the National Health Services (NHS) in the U.K., or private commercial payers, such as Blue Cross/Blue Shield and UnitedHealth Grou--could deny coverage for a technology that had received regulatory approval if they determined that the supporting evidence did not adequately demonstrate that the technology was superior to existing treatment alternatives that were already being reimbursed. This had the potential to create a potentially adversarial relationship between payers and innovators in cases where they had conflicting interpretations of the evidence regarding the cost, benefits, and risks of new technologies. The challenges to innovators in managing this conflict are illustrated in this case study by an example: the 2006 decision by the U.K.'s NHS to deny coverage for Exubera, a new form of inhaled insulin.

Sara Lee Corporation's acquisition binge in the 1980s and 1990s left the company with a portfolio of vastly different businesses operating independently of one another. It had experienced rapid top-line growth, but at the same time cash flows had declined. Sara Lee ignored both internal and external warning signs until a major transformation plan became necessary. This case examines the company's multiple turnaround attempts. The learning objective of the case is to analyze "early stage" turnaround efforts by examining how the company found itself in decline, evaluating its attempts to improve its performance, and assessing the turnaround plan.

The major reason for failure in initiating new growth projects in uncertain environments is the basic tenet of classic project management-the initial strategy is assumed to be correct, and large sums are expended without dealing with the fundamental assumptions. Discovery-driven planning is vastly different from conventional planning. In conventional planning, success means delivering numbers close to what you thought you would deliver. In discovery-driven planning, success means generating the maximum amount of useful learning for the minimum expenditure. Discovery-driven planning is most useful when the situation is highly uncertain.

California telecommunications company Wireworld is considering an acquisition of Nusantara Communications, a subsidiary of Indonesian conglomerate Bakrie & Brothers. Nusantara had invested $50 million in developing the advanced rural telephone system, which had the potential to provide much-needed telecommunications services to the mostly rural Indonesian population. If if were exported, the worldwide market for this product in the next five years was projected to be in the billions. Should Wireworld acquire this small company halfway around the world? Was it prepared to enter the Indonesian marketplace and beyond?

This is an MIT Sloan Management Review article. An industry platform involves not only one company's technology or service but also an ecosystem of complements to it that are usually produced by a variety of businesses. As a result, becoming a platform leader requires different business and technology strategies than those needed to launch a successful stand-alone product. Companies should decide early on whether they want to pursue a platform or a product strategy. The authors describe two fundamental approaches to building platform leadership, which they call "coring" and "tipping." "Coring" is using a set of techniques to create a platform by making a technology "core" to a particular technological system and market. When pursuing a coring strategy, would-be platform leaders should think about issues such as how to make it easy for third parties to provide add-ons to the technology and how to encourage third-party companies to create complementary innovations. Examples of successful coring include Google Inc. in Internet search and Qualcomm Inc. in wireless technology. However, the authors note, Qualcomm faces opposition from some companies in its business ecosystem. The authors cite EMC Corp.'s WideSky initiative in the early 2000s as an attempt at coring that did not succeed. EMC's competitors were not eager to adopt WideSky as a platform and instead supported an open-standards one managed through an industry group. "Tipping" is the set of activities that helps a company "tip" a market toward its platform rather than some other potential one. Examples of tipping include Linux's growth in the market for Web server operating systems; the Linux case study, the authors point out, demonstrates the power of a coalition of service providers and users to tip a market by supporting a particular platform. Another tipping strategy is for a company to bundle features from an adjacent market into its existing platform; the authors call this "tipping across markets."

This is an MIT Sloan Management Review article.

The Icelandic government outsourced its testing and metrology functions in 1997, and in 2008 two firms competed for most of the vehicle emissions testing and inspection business in Iceland. Frumherji was one of the two. In a physically isolated island nation of just over 300,000 residents, word-of-mouth information about customer service could make or break a firm in the marketplace. Karl Sigurdssson, Senior Manager of Frumherji's Vehicle Department, was seeking ways to enhance customer service, while at the same time retaining the high standards and integrity that were essential to the company's continued contractual role with the Icelandic government. He hired a consultant to gather process data and make observations about customer service, and was considering how to use the information to identify problems and introduce solutions. The case highlights current challenges for Frumherji, including perceived customer service, demand variability, waiting times, recording errors, and employee turnover. It also includes relevant information about Iceland's immigration patterns, the growing market for vehicle inspection and emission testing, and goverment policies. The case presents a step-by-step description of the process for inspecting and testing private vehicles at Frumherji's largest station, Hestháls, located in Reykjavik. Accompanying information includes processing times, reject rates (yield rates as the inverse), wait times, error loops, and problems introduced by the customers themselves. Images of the facility and photos of the work area at each step in the process bring a sense of reality to the descriptions.

Describes a highly successful effort by an Indian Charity to feed poor schoolchildren at lunchtime. This provides two significant benefits. It improves nutrition for the children, and helps keep them in school since the provided meal is occasionally the only meal they will have in the day. The organization has had great success in an urban environment, but now seeks a wholly different operations strategy as it stretches out to rural India.

Alejandro Ramirez, the CEO of Cinepolis, the largest film exhibitor in Latin America, sat in the back of row of the company's flagship movie theatre in Mexico City one evening in January 2005. The company was preparing to roll out an expensive new IT platform that streamlined box office, concession stand and warehouse operations. Despite resistance from some senior managers, Cinepolis was considering a thorough (and costly) training program. Ramirez knew he and his executive team had invested wisely in new technologies and now it was time to make those investments pay off.

In June 2004, as the newly appointed vice-president of the meals division, Jim Murphy was facing a crisis with one of General Mills' key brands, Hamburger Helper. The metrics for this brand had universally declined with marketing margin, volume, penetration, buy rate, facings, and advertising target rating points all down. In addition, Hamburger Helper was facing an increasingly competitive environment in the dinner category with Kraft, Lipton, ConAgra and Campbell's all recently entering the market. Brainstorming by Hamburger Helper's brand management team resulted in two potential solutions: (1) to reduce production costs through the simplification of the Hamburger Helper line by reducing the complexity of the product and eliminating the less successful SKUs and (2) to re-consider the way that innovation was employed in brand development. How should Jim Murphy and his brand management team in order to turn this brand crisis around?

At the time of the Mekong Corporation (Mekong) and the Vietnam Motor Vehicle Industry (A) case, product 9A96H002, some analysts felt that the Vietnamese automotive market was about to expand substantially. By 2007, the industry's capacity had increased enormously to nearly 150,000. However, the domestic sales had only expanded to approximately 40,000, and exports were negligible. This (B) case examines the government's interventionist policies that stimulated the expansion of production capacity while restraining vehicle sales. A key element was the continuation of very high import tariffs and other taxes that maintained a protected market for domestic manufacturers. In this context, Mekong continued to operate successfully. This case encourages students to consider the appropriate role of government in stimulating economic development, as well as appropriate corporate strategy in a protected market.

In the nearly 30 years since it was introduced, Six Sigma has evolved to mean different things in different circumstances and in different organizations, so that now it is difficult to identify a single, universally accepted definition. The purpose of this note is to provide a basic overview of Six Sigma by explaining its underlying principles and most commonly utilized methods while providing a brief review of its history. Finally, this note provides a brief summary of a Six Sigma case study illustrating the practical application of Six Sigma.

Samsung Electronics (Samsung) managing director had presented the new management philosophy for achieving leadership in a global market. The three-part strategy would prioritize quality, globalization, and multifaceted integration, in that order. After a restructuring effort, Samsung had emerged as a leader in the global electronics industry. Now, considering the new management philosophy and several other factors, the managing director faced the decision of whether Samsung should enter the Indian market.

In part A of this case, Samsung's managing director had to decide whether Samsung should enter the Indian market. Now, three years later, he was ready to relinquish the position. The three years had been very successful and the managing director was promoted to vice-president of global sales and marketing of display products. One of the first decisions facing the new managing director as he takes the position is what type of products Samsung should compete with in India. One option is to compete in the low and medium segments. Another option is to take the high end segment.

A company's ability to function during a flu pandemic is only as good as the weakest link in its supply chain. Hoffman-La Roche, the maker of a frontline antiviral drug, works closely with its suppliers to ensure that their preparedness plans are as robust as its own.

With so many management tools out there, from benchmarking to outsourcing, it's hard to decide which ones to try. To help executives make informed choices, the authors compare levels of use and satisfaction for the most popular tools, and chart the evolution of a select few.

Large organizations are by nature complex, but over the years new business challenges--globalization, innovative technologies, and regulations, to name a few--have conspired to add layer upon layer of complexity to corporate structure and management. Organizations have become increasingly ungovernable and unwieldy: Performance is declining; accountability is unclear; decision rights are muddy; and data are crunched repeatedly, often with no clear purpose in mind. To avoid frustration and inefficiency, executives need to systematically attack the causes of complexity in their companies. Ashkenas and his partners at Robert H. Schaffer & Associates have worked with dozens of firms to help them develop strategies for simplification. In this article, the author details the elements of a simplicity-minded strategy: Streamline the structure; prune products, services, and features; build disciplined processes; and improve managerial habits. ConAgra Foods' experience illustrates how one company turned itself around through careful execution of a simplicity strategy. The packaged-food supplier had become enormously successful by acquiring well known brands and then allowing them to operate autonomously, evolving into a $14 billion organization with more than 100 brands, a food services business, and a commodity trading operation. ConAgra, however, had no common method for reporting, tracking, or analyzing results. Over time, therefore, it became a highly unwieldy enterprise, riddled with inefficiencies and unable to communicate adequately with investors and other stakeholders. When CEO Gary Rodkin came on board in 2005, he invested in a series of initiatives to combat complexity. The tactic not only made life easier for customers and employees but also saved millions of dollars in costs. This article has an online interactive questionnaire that can help you assess your own company's level of complexity.

United Beverages' first product, GangBusters Interactive Beverages, has reached the stage of wide brand recognition. However, over the past 12 months, growth has stalled and the product development team at United Beverages is considering several ideas for future growth. The team must consider market and technical uncertainty as well as resource allocation issues as they define the new product-development strategy for United Beverages.