Case Study

Between a rock and a hard place at RWH

4 pages
August 2020
Reference: IMD-7-2186

In the US, before performing surgery on a patient, a doctor first requests the patient’s insurance provider to approve the cost of surgery. To do so, the insurance company asks an expert to decide whether the surgery is necessary (make a “go/no-go decision”). Sandra is the CEO of RW Health (RWH), a startup that brokers a product (decisions on whether to authorize medical procedures) between suppliers (professors at partner medical schools) and clients (insurance companies). The demand for RWH’s service is growing rapidly, and Sandra’s biggest challenge is to deliver enough decisions. To increase its capacity, RWH recently signed an agreement with Major Medical School. However, last night, the director of MMS, informed Sandra that MMS would not be able to provide what it had contractually agreed to. What should Sandra do?

Learning Objective
  • Structure the decision process
  • Identify a better overarching question for the decision
  • Generate innovative options
  • Identify appropriate criteria to evaluate the options
Decision Making, Problem Solving, Strategic Thinking, Medical Diagnostics, Demand Growth, Contract Renegotiation, Evaluating Options, Medical Diagnosis
United States of America
Healthcare, Health and Medical Services, Finance and Insurance, Insurance
Generalized Experience
© 2020
Available Languages
Case clearing houses
IMD case studies are distributed through case clearing houses. In order to browse the collection and purchase copies please visit the links below.

The Case Centre

Cranfield University

Wharley End Beds MK43 0JR, UK
Tel +44 (0)1234 750903
Email [email protected]

Harvard Business School Publishing

60 Harvard Way, Boston MA 02163, USA
Tel (800) 545-7685 Tel (617)-783-7600
Fax (617) 783-7666
Email [email protected]

Asia Pacific Case Center

NUCB Business School

1-3-1 Nishiki Naka
Nagoya Aichi, Japan 460-0003
Tel +81 52 20 38 111
Email [email protected]


Research Information & Knowledge Hub for additional information on IMD publications

Discover our latest research
IMD's faculty and research teams publish articles, case studies, books and reports on a wide range of topics