08.31.2017

Harvard Business School Case Study CareMore Health System

CareMore Health System—a physician-founded care delivery system and health plan—had developed and refined an innovative care model for at-risk seniors enrolled in Medicare managed care (i.e., Medicare Advantage) plans. CareMore's President, Sachin Jain, and his colleagues believed their model achieved the elusive goal of improving outcomes while reducing costs. A key mandate for Jain was to scale the CareMore model beyond its current 75,000 Medicare Advantage members in California, Arizona, Nevada, and Virginia. One approach to scaling was to maintain a focus on Medicare Advantage but expand into new geographic markets. Alternatively, CareMore could focus on serving new populations. For example, CareMore had recently started serving Medicaid (i.e., younger, low-income) patients in Tennessee and Iowa. This case allows for a discussion of whether diversifying to serve these new populations was the key to ensuring CareMore’s successful growth or a distraction from its core competency of caring for seniors.

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