Open and Collaborative Innovation in US Healthcare: The Case of Health Insurance Exchange (HIX),...
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Transcript of Open and Collaborative Innovation in US Healthcare: The Case of Health Insurance Exchange (HIX),...
Dr. Sudeep K. Krishnan
Open and Collaborative Innovation in US Healthcare: The Case of Health Insurance Exchange (HIX)
Roadmap
INTRODUCTION – Literature Review and Gap AnalysisINTRODUCTION – Literature Review and Gap Analysis
US HEALTHCARE AND HEALTH INSURANCEUS HEALTHCARE AND HEALTH INSURANCE
OPEN INNOVATIONOPEN INNOVATION
RESEARCH OBJECTIVES & METHODOLOGYRESEARCH OBJECTIVES & METHODOLOGY
CASE STUDY – HEALTH INSURANCE EXCHANGECASE STUDY – HEALTH INSURANCE EXCHANGE
IMPLICATIONS AND FUTURE RESEARCH IMPLICATIONS AND FUTURE RESEARCH
NETWORK AND COLLABORATION ANALYSISNETWORK 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
5
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
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
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)
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