The US market is different in terms of the complexity of the health care system.

Question

The US market is different in terms of the complexity of the health care system. The companies offering solution in US market are basically large size concern. Conexia has sound business opportunities in US but to tap those opportunities will be a quite challenging task. After analyzing the factors for entry into US health care market, it has realized that due to excess competition and a complex payment and other legal requirements, it is very difficult to run its business whatever the way it might be opted.

Even, there were so many regulatory changes yet to come in the health care sector of USA. The RTA services are already provided by many local firms in respective market of US. Conexia further experienced that in the complex an inefficient health care market it will provide value to the American customers. They know well that the current capabilities of Conexia must be scaled up so as to run a successful business in US market, which is unknown and complex one. It should have a strong services quality so as to run in US market as patient are highly quality conscious. It must try to establish brand awareness for its current name so as to attract more number of customers which might be possible through local joint venture with a US firm. So, this market is totally different from the Argentina’s health care market.

Explanation / Answer

July 13, 2010 MITSloan Conexia: Entering the U.S. Market Katie Barrett, Anand Mohanrangan, Teru Tanaka, Yipeng Zhao "So, where do we go from here?" asked Luis Navas. Sitting in the Buenos Aires office of Conexia, a leading Argentinean IT services company that provided insurance claims solutions for the healthcare industry, Navas, the CEO, was continuing a long series of discussions with his partners Sebastian Letemendia, COO, and Alfredo Semeniuk, Director of Sales. On this particular day in mid-January 2010, they had just walked out of the final presentation given by a team of students from MIT Sloan's Global Entrepreneurship Lab (G-Lab), who had been helping Conexia devise a U.S. market entry strategy for its Real-Time Adjudication (RTA) solution. As Conexia's senior management had anticipated, entering the U.S. market posed a wide variety of challenges. In addition to the lack of brand awareness for Conexia's RTA product and the disjointed claims processes followed by U.S. health insurance companies, the U.S. healthcare market was going through a number of regulatory changes. Thinking back to a series of discussions with the G-Lab team, Letemendia said, "I knew it would not be easy. But I still believe we can provide value to U.S. customers." Navas agreed: "Considering our long-term growth goals, entering the U.S. market is a necessary step for Conexia. But in light of the challenges ahead, is it the step we should take now? Real-Time Adjudication (RTA) of Medical Insurance Claims Real-time claims adjudication was an IT solution which allowed health insurance companies (typically called payers) to pre-authorize medical services before they were rendered by doctors (providers). Traditionally, claims were submitted after the provider treated patients, leaving both patient and provider financially uncertain: patients about how much they would ultimately be This case was prepared by Katie Barrett, Anand 2010) under the supervision of lecturer M. Jonathan Lehrich Copyright2010, Katie Barrett, Anand Mohanrangan, Teru Tanaka, and Yipeng Zhao. This work is licensed under the Teru Tanaka, and Yipeng Zhao (MIT Sloan MBAs, Class of Creative Commons Attribution-Noncommercial-No Derivative Works 3 Franciaco, Calioma 410 uSAs .0 Unported License. To view a copy of this license visit s orgficensesby-nc-nd/3.0! or send a letter to Creative Commons, 171 Second Street, Suite 300, San nndla or send a lette to Creathve Commons, 171 Second Street Suite 300, San

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