Product Overview

The existing US health care system is complex. Most individuals have health insurance coverage provided by various third-party payers. The payers include employers, health insurance carriers, and government-sponsored programs, such as nationally administered Medicare and Medicaid, which are offered by all 50 states with some support from the federal government. Each payer's program varies in terms of the health services covered as well as the amount of the cost of care allocated back to the individual in the form of visit copayments, individual deductibles, and other cost-sharing strategies. These offerings are administered by various health plans and many payers offer multiple administrative alternatives. For example, Medicare is administered nationally, but there are multiple "Medicare Advantage" alternatives available as well as the basic program offering. In addition, there are numerous Medicare supplemental plans available to increase the benefits for the individual recipient. Inspired by the common sense vision of healthcare's heroes, Concentric DPC's mission is to identify the people, strategies, and capital needed to help the US health care system heal itself. Based on continuous improvement design driven by continuous learning, Concentric DPC's human capital/technology initiatives deploy the power of entrepreneurial physicians in a free market. This social entrepreneurial approach responds distinctly to the incumbent relationship infrastructure of "fee-for-service" third-party reimbursement at the provider and self-funded payer levels. The Concentric DPC continuous-improvement infrastructure becomes practical, achievable, and self-perpetuating as incumbent leadership commits to catalyzing outcome-based health care solutions. It is distinctly relationship based, providing incumbent advisers ample opportunity to lead as continuous-improvement consultants to physicians and employers.

Learning Objectives

The objective of this case is to provide students with a comprehensive case in which they have the opportunity to identify and address the ways a mission-driven organization can spur social entrepreneurship. Specifically, students must address (1) The leadership role that the organization must assume in paving the way to become a standard of care and a model for how the incumbent relationship infrastructure of fee-for-service third-party reimbursement at the provider and self-funded payer levels could be disrupted with sustainable effect; (2) an understanding of the opportunities and challenges of creating an organization based on a highly disruptive technology; the importance and implications of social entrepreneurship in championing a technology within a particular (in this case medical) field forward; how, in health care, social capital principles may attract the status quo levers of power and use them to drive acceptance of and adherence to a continuously improving system of care; and understanding how to strike the balance between existing and new personal services and existing and new technologies to build resilience.