Thesis Advisory Committee

Prof. Rekha Jain (Chairperson)

Prof. Kavitha Ranganathan

Prof. Rakesh Basant

Dr. Sudeep K. Krishnan

Open and Collaborative Innovation in US Healthcare:

The Case of Health Insurance Exchange (HIX)

Roadmap

INTRODUCTION – Literature Review and Gap Analysis

US HEALTHCARE AND HEALTH INSURANCE

OPEN INNOVATION

RESEARCH OBJECTIVES & METHODOLOGY

CASE STUDY – HEALTH INSURANCE EXCHANGE

IMPLICATIONS AND FUTURE RESEARCH

NETWORK AND COLLABORATION ANALYSIS

Introduction to Open Innovation

Traditional/Closed Model – Emphasis on organizational control for success of innovations

Competitive advantage by funding large projects

Open Innovation – A paradigm that assumes firms should use internal as well as external ideas and paths to commercialize their technology Chesbrough (2003)

Current Research on Open Innovation

Studies limited to conceptual foundation development based on limited empirical evidence

Current studies look at principles, individual drivers, and benefits of open innovation

Measures of Openness – Extent of Usage of External Sources

Partner characteristics (Type and number)

Phase openness

Intensity of collaboration

Context of Open Innovation Required Conditions

There exists co-operation between firms and other agents in the network

The objective of co-operation is creation, adoption or development of something new to the organization that essentially involves a market.

Open innovation refers to actual partnerships and is not limited to cooperation (for longer periods normally, shorter periods may also exist).

There is a permanent or quasi-permanent investment in the relationship by all partners.

Current study analyzes degree of openness and understands operationalization aspects of open innovation principles in US Healthcare Sector

Partnership as need of new reforms

Introduction to US Healthcare and Major Players

HealthCare reforms in US

Reduction of Cost and Quality of Care

Obamacare – Affordable Care Act

Major Players

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Research Questions & Methodology

What is open innovation in the US Healthcare Context and

how open innovation principles differ from the traditional

models of innovation?

How open innovation principles are operationalized in

Healthcare projects?

How does partner selection and opening up of organization

boundaries happen in such contexts?

Case Analysis of Health Insurance Exchange (HIX)

HIX - Introduction

HIX helps citizens

compare health insurance plans online,

select a plan,

apply for subsidies intended to make health insurance more affordable, and

receive verification of enrolment in a plan.

Requirements

Handle the needs of two distinct marketplaces—individuals and small employers

(businesses)

Provide assistance to purchasers

Facilitate applications for the premium tax credits and cost-sharing subsidies

offered under the ACA

Provide individuals with access to other health benefit programs (such as

Medicaid) through a “no wrong door” approach to coverage

Certify that health plans meet benefit standards

Network and Collaboration Analysis

Rationale to Collaborate

Formation Stage

Exchange Characteristics – Basic structure itself calls for collaboration

(Federal and state government, insurers)

Environmental Factors – Potential market, complementarity of partners,

transaction costs

Reforms Characteristics – ACA calls for insurance and government

bodies are bound to create exchanges

Rationale to Collaborate

Partner Selection

Execution

Network and Collaboration Analysis

Partner Selection

Basic structure itself calls for partnership

Insurance companies, federal and state government

Payer and Patients

Proposed New Partners

Providers – provision to access insurance policy by provider directly

Analytics Partners – help in plan selection, cost benefit analysis, online

platform support

Rationale to Collaborate

Partner Selection

Execution

Network and Collaboration Analysis

Execution

Development of online models, tools and platform for analysis and plan

selection

Desired project management

Identifying environmental risks

Control over processes (investment requirement from partners and

identifying roles and responsibilities)

Rationale to Collaborate

Partner Selection

Execution

Contributions

Contributions to Open Innovation Literature

Understanding basic concepts in a new domain

Exploring operationalization aspects of open innovation across a

project and identifying factors influencing its

Guidelines for Practitioners

Identification of prospective partners

Results will have high impact on HIX implementation

Future Research

Simulation Model: US census data and predictive model for usage

statistics and exploring cost

Influence of credit feature

Linkages with other policies and coordination of benefits