Bob Higgins is a Senior Lecturer at Harvard Business School and a Founder and General Partner at Causeway Media Partners. Causeway is focused on backing young growth companies in sports media. Bob is also Founding Partner at Highland Capital Partners. He created and currently teaches a course in the EC called Entrepreneurship in Healthcare IT and Services (EHITS). For several years, Bob taught the first year course, The Entrepreneurial Manager. He is a member of the Health Care Initiative, the Social Enterprise Initiative, and the Harvard Faculty Committee for the MD/MBA program. In addition, he has served as a director of the National Venture Capital Association and as President of the New England Venture Capital Association.
Earlier, he was the Executive Director of the John A. Hartford Foundation in New York, a private foundation that supports programs in medical research and health care management. He managed two other New York foundations prior to the Hartford Foundation: the Robert Sterling Clark Foundation and the Florence Vanderbilt Burden Foundation.
From 1971 to 1973, Bob served in Washington as the Assistant to the head of the International Division of the Treasury and as Assistant to the Secretary of Commerce. Prior to going to Washington, he was on active duty in the Army as an officer at the United States Military Academy at West Point.
Bob is a member of the Council on Foreign Relations, and he was elected to the American Academy of Arts and Sciences. He was graduated from the Harvard Business School and Harvard College.
Higgins, Robert F., and James Barnett. "An eSports Profile: Team Liquid & aXiomatic." Harvard Business School Case 819-076, January 2019. (Revised January 2019.)
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Formula E’s season three is nearly complete. CEO Alejandro Agag needs to examine his business model to ensure the racing series is positioned to grow sustainably in the years to come.
Higgins, Robert F., Susie Ma, and James Weber. "Formula E Championship Racing (B)." Harvard Business School Supplement 819-012, December 2018.
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Formula E founder and CEO Alejandro Aga obtained the rights to develop a new electric car racing series from the Fédération Internationale de l’Automobile (FIA). Agag needed to develop the series from scratch—developing a race car, finding teams willing to race, cities willing to host races, and sponsors, media partners, and investors willing to fund the series. The first race was one year away. How should Agag go about developing this new series?
Founded in 2012, DraftKings helped change the fantasy sports landscape by popularizing daily fantasy sports (DFS), or short-term fantasy sports tournaments that offered big cash prizes to winners. The company’s valuation exceeded $1 billion by 2015, but DraftKings soon faced intense scrutiny from government agencies about whether its business model violated federal laws preventing sports betting and online gambling. Then, in May 2018, the U.S. Supreme Court overturned a federal law that had prohibited states from legalizing sports betting. Now that states could legalize sports betting, what should DraftKings’ next steps be?
In 2016, Michael Rubin’s Fanatics was the U.S.’ largest sports e-commerce company, and operator of the official online store for all the major American sports leagues. That year, Fanatics began to dabble in manufacturing licensed sports merchandise, securing limited permissions from leagues to manufacture apparel in response to ‘micro-moments,’ sudden surges of interest in a team or player that were too abrupt for the league’s usual licensees to react to. The success of these efforts raised the possibility that Fanatics might make a play to displace a major athletic wear manufacturer as the official merchandise licensee of a major sports league. For a company with little manufacturing infrastructure and experience however, it was unclear whether this was an advisable step for Fanatics, or how they would go about it.
In 2015, National Hockey League (NHL) commissioner Gary Bettman was weighing two major decisions: whether to expand the league to a new city, and whether to conclude a digital media rights deal with Major League Baseball Advanced Media (MLBAM). Expansion required a careful balance between the needs of existing teams, and of parallel fan bases in the U.S. and Canada. Between two candidate expansion cities, Las Vegas, NV and Quebec, QC, Bettman would have to decide to expand to either, neither, or both. If the NHL accepted MLBAM’s offer, it would be one of sports’ first digital media rights deals, and the first time one major sport had outsourced its digital media production to another. This case also explores the history of the National Hockey League and labor relations between the league and its players.
Higgins, Robert F., and James Barnett. "The Drone Racing League: Building the Sport of the Future." Harvard Business School Case 819-015, October 2018.
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In late 2016, Russ D’Souza and Jack Groetzinger, co-founders of the online event ticketing platform SeatGeek, faced some difficult decisions. In the company’s seven-year history, SeatGeek had positioned itself primarily as an aggregator, facilitating ticket transactions between sellers and buyers on the “secondary ticket market.” But in early 2016, D’Souza and Groetzinger had decided to pursue the “primary ticket market”—contracting directly with the sports teams and venues that issued tickets to events, a space dominated by Ticketmaster. This move would require SeatGeek to confront Ticketmaster, an established incumbent, develop or acquire the back-end software necessary to enable primary market ticket sales, and establish partnerships with sports teams and event venues. Entering the primary market would also likely necessitate a Series D funding round.
Spark Therapeutics is a pioneering gene therapy startup. It was spun out of The Children’s Hospital of Philadelphia (CHOP). The company had taken with it much of the intellectual property and talent that CHOP had developed. The company is considering an initial public offering. In addition, several large pharma companies have expressed interest in partnering with Spark to develop its hemophilia B program. Also, the company is working with the FDA on a potential change to its protocol. The CEO is preparing for a board meeting, and he is contemplating the best path to deal with these challenges and opportunities.
This is the syllabus and course outline for "Entrepreneurship in Healthcare IT and Services (EHITS)" taught by Prof. Bob Higgins in the spring of 2018. Contains the course overview, objectives, goals and themes.
In 2013, Street League Skateboarding, a professional skateboarding league founded in 2010, just concluded its annual Street League World Tour. The growing action-sports property had purchased time on ESPN2 to air its events, and though ESPN was the most-watched sports television network in the U.S., Street League President Brian Atlas had become impatient with the network’s lack of support. Atlas planned to meet with network representatives in the coming months to discuss their 2014 contract, but he was recently approached by FOX Sports, which had just launched the new FOX Sports 1 cable television network and was working to sign sports properties. Atlas considered Street League’s relationship with ESPN, the league’s finances, and attempts to raise capital. For a new action-sports property such as Street League, what business model made the most sense?
Fola Laoye is the Group Managing Director of Hygeia Group, a Nigerian healthcare insurer and provider, and she is deciding on the optimal strategy to grow the provider arm of her business. Hygeia Group was founded in the 1980s by her physician parents, and although operating a healthcare company in Nigeria offered challenges particularly in human resources and infrastructure, by 2011, it had expanded to include three hospital and clinic sites and a large insurance company. The company has just received a large equity investment from an international private equity company, and it has decided to focus on expanding tertiary care capabilities in its hospitals. A consulting team has identified cardiology, oncology, and advanced surgery (orthopedic and minimally invasive) as areas with strategic potential. However, Laoye must decide which of these options offers the greatest growth opportunities. In addition, as her company grows, she must decide how best to structure the payer and provider aspects of her business in a way that maximizes synergies for both.
This case explores the relationship between Tenet Healthcare, the third largest for-profit hospital chain, and its subsidiary Conifer Health Solutions, a health services company. Conifer's IT programs help healthcare providers with revenue cycle management and population health management; the case provides an overview of both sectors. Conifer has been growing rapidly, leading some to question what the best relationship is for Tenet and Conifer going forward. The current parent-subsidiary arrangement presents synergies as well as potential conflicts.
By January 2015, Whistle Sports, a multi-platform sports network for millennials, had attracted over 54 million online subscribers on YouTube, Instagram, Twitter, Facebook, Google+, and Vine. It established partnerships with several professional sports leagues and amassed 225 partner channels on YouTube. Its revenue was largely generated through advertisements featured on YouTube. Whistle Sports recently announced that it raised $32 million in Series B financing, enough to bring the company into 2016. John West (MBA 1995), founder and CEO, wondered how the company should allocate its resources over the next year in order to become profitable and ensure future growth.
Dr. Patrice Milos is the first CEO of Claritas Genomics (Claritas) and she faces a number of challenges in scaling the young company. Claritas was formed around a lab spun out from Boston Children's Hospital (BCH) which had performed genomic tests for the hospital. Now Milos has to generate new business for Claritas from pediatric hospitals around the country and provide a high level of timely service to its clients. The company also has a research mission to build a database of genomic information to improve the scientific understanding of various diseases.
Milos needs to find customers and strategic partners to reach the company's goals, but with whom should Claritas partner? A healthcare IT or software company? Healthcare technology and instruments companies? Other hospitals? What does the company need from its partners in order to reach scale? Was this the right time to bring in pure financial investors such as venture capital or private equity companies?
The case describes this health and wellness service company and poses the question: should RedBrick stay on the path of building out its product platform, or should the RedBrick platform be launched directly to health insurers, ACOs, or directly to customers?
Claritas Genomics was formed in January 2013 when BCH spun out its Genetics Diagnostic Lab into a fully commercial entity. Claritas offered over 100 genomic tests to detect a range of conditions, including autism and intellectual disabilities, and was developing new tests that provided clearer and more relevant information for physicians to use in treating patients. Claritas wanted to increase the speed at which genomic research discoveries occurred and translate this research into better diagnostic tests. To achieve this, it planned to collaborate with other children's hospitals through a research network it was developing. BCH was the company's majority owner, and Life Technologies (Life), a major manufacturer of sequencing equipment and services, was a minority owner. By the end of the year the CEO of Claritas Genomics, Dr. Patrice Milos, had to put Claritas in a position to grow and needed to have in place the software and IT platforms—the databases, search tools, and other programs—that would help the company reach scale.
Steward Health has raised private equity and has converted from not-for-profit to for-profit. The case describes its Accountable Care Organization (ACO) and asks whether it should continue this experiment.
This is the syllabus and course outline for "Entrepreneurship in Healthcare IT and Services (EHITS)" taught by Prof. Bob Higgins in the fall of 2013. Contains the course overview, objectives, goals and themes.
This note provides an overview of three key healthcare IT areas: electronic medical records and electronic health records, revenue cycle management, and telemedicine. This note also contains a glossary of key terms and acronyms in this space as well as exhibits detailing unit economics, market dynamics, and key players.
Tim Curran, CEO of Sample6, a start-up biotechnology company developing a novel food safety diagnostics platform, must decide how to partner with food industry players. How can he best convince leaders in this mature industry to adopt a new technology and improve food safety? Additionally, he faces a number of questions related to product development, marketing, regulatory compliance, and dynamic industry trends. This case provides an overview of food safety in the United States, and focuses on the strategic goal of transforming food safety from a "necessary evil" to a brand-enhancing differentiator.
This is the teaching note associated with HBS Case #813035. The case should enable students to identify emerging challenges, evaluate Rock Health's funding model, debate the effectiveness of its incubation service and assess its long-term viability.
Rock Health was a San Francisco–based nonprofit organization offering accelerator services to spur innovation at the intersection of healthcare and technology. The company was the creation of Halle Tecco (HBS '11) and her HBS classmate Nate Gross (HBS '11), who met early in their first year at the HBS Healthcare Club meeting and decided to undertake a year-long field study that married their shared interests in healthcare, technology, and entrepreneurship. Rock Health supported health-tech entrepreneurs with a startup grant of $20,000, office space, and a wide variety of professional support services. Entrepreneurial teams that participated in Rock Health's programs promoted services ranging from data-driven technologies that helped manage stress to mobile tools that attempted to diagnosis medical conditions as diverse as Alzheimer's disease and foot ulcers. The case is set in August 2011 as Rock Health is wrapping up its third group of entrepreneurs in a Boston program and planning for its fourth class at the home office. The case should enable students to identify emerging challenges, evaluate Rock Health's funding model, debate the effectiveness of its incubation service, and assess its long-term viability.
The management team at Predilytics, a healthcare analytics firm, must decide whether to accept a Series A venture capital financing deal. The company provided analytic services to healthcare plans, typically Medicare Advantage plans, in efforts to draw conclusions from massive amounts of patient data. The company still had enough funding from a seed round to operate on a low-key basis for a few more months, but the team hoped to move forward aggressively and scale its business. They also needed to make business choices about next steps.
In 2001, Vertex Pharmaceuticals Incorporated acquired the San Diego-based biotech company, Aurora Biosciences. The combination of Vertex's and Aurora's technologies would improve the flow of novel drug candidates into development. However, several questions related to the integration of Aurora into Vertex were still unresolved, the most pressing being Aurora's major collaboration with the Cystic Fibrosis Foundation (CFF). Were venture philanthropy and foundation deals an appropriate funding mechanism for a public company like Vertex? How could the board of Vertex and the CFF fundamentally align the objectives of a for-profit company with those of a non-profit institution? Those were the questions faced by the Vertex executives.
This is the teaching note related to HBS case 808005. In 2001, Vertex Pharmaceuticals Incorporated acquired the San Diego-based biotech company, Aurora Biosciences. The combination of Vertex's and Aurora's technologies would improve the flow of novel drug candidates into development. However, several questions related to the integration of Aurora into Vertex were still unresolved, the most pressing being Aurora's major collaboration with the Cystic Fibrosis Foundation (CFF). Were venture philanthropy and foundation deals an appropriate funding mechanism for a public company like Vertex?
Higgins, Robert F. "Vertex Pharmaceuticals and the Cystic Fibrosis Foundation: Venture Philanthropy Funding for Biotech (TP)." Harvard Business School Teaching Plan 813-021, October 2012.
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In January 2001, Dick Burnham, CEO of Odyssey Healthcare, and Odyssey's Board of Directors were considering selling the hospice care company to a larger provider or making an initial public offering (IPO). With 38 hospice locations in 21 states, Odyssey had been providing care to the terminally ill since its first location opened in 1996. Since then, the company had grown rapidly through a series of acquisitions, development of new hospice locations, and organic growth. Odyssey had just realized its first profitable year in 2000—recording a net income of $3.1 million—and was still a relatively young company. In addition, the hospice industry was subject to extensive federal, state, and local regulations relating to payment for hospice services and conduct of operations. Burnham was unsure how the market would react to a company with such government-dependent revenue streams. Additionally, the recent collapse of the "dot-com" boom in 2000 might make it impossible to float an IPO at all given the prevailing market conditions. On a positive note, however, healthcare companies were commonly thought to be recession proof and thus might be a sound investment in the event of a down-turning economy. Burnham had to decide if this was the right time for an exit, and if so, what the best exit would be.
Higgins, Robert F., Virginia Fuller, and Umer Raffat. "Odyssey Healthcare." Harvard Business School Case 809-052, September 2008. (Revised June 2013.)
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Robert F. Higgins, Rosie O'Donnell, Sophie LaMontagne and Brent Kazan
In mid-March 2007, Chris Kryder sat in his office and thought about how to best finance his company's growth. Over the previous five years as founder and CEO of D2Hawkeye, a Waltham, Massachusetts-based healthcare analytics company, Kryder had grown the firm from a six-person start-up into a leading developer and provider of medical analytics in the U.S. He had three term sheets in hand—two from strategic investors and one from a venture capital firm. Each offer had its advantages and disadvantages and Kryder needed to decide which offer to accept.
In January 2006, eClinicalWorks (eCW) had an acquisition opportunity that could fundamentally change the way they had done business since the inception of the company in 1999. eClinicalWorks was a privately run business in the healthcare information technology field that took in $25 million in revenue in 2005. Revenues for 2006 were projected to reach $40 million. This successful electronic medical record (EMR) company had grown thanks to their reliable software and responsive customer service. The company had achieved this growth without the help of any outside financing. The five co-founders of eCW, who treated each other like an extended family, invested years of sweat equity and hard work to shape eCW as they wanted. They were also proud of their company culture, which de-emphasized traditional company hierarchies and encouraged independent thinking and cooperative working arrangements across departments. Keeping the company private, in their view, had helped them to maintain this culture. The opportunity to acquire another EMR company offered eCW the chance to grow quickly in an industry that is estimated to take in more than $40 billion in overall revenues in 2007. But this acquisition would require outside financing of some sort. Was this the moment to accelerate the rate of growth to which eCW had become accustomed—catching up with, rather than anticipating, how their customer base would expand? Or should they maintain the same approach that had worked so well since 1999?
Kyruus is used in a course at HBS on Entrepreneurship in Healthcare IT and Services (EHITS). It describes a young company that has built a very large database on physicians. The company has had some early successful pilots with prominent customers, but it is now faced with choices on which markets to pursue. These markets each offer opportunity, but the company must make some decisions. As is often the case in early stage companies, these choices will affect a number of things, including organizational needs and capital requirements.
Generation Health, a pioneer in the new field of genetics benefit management and a newly formed company, faces many strategic issues. CEO Per Lofberg is in the midst of negotiating a partnership with a major pharmacy benefit management company. As part of these negotiations, Lofberg must decide whether the time is right for such a strategic partner when Generation Health has only been founded for a year. At the same time, Lofberg must recruit for the critical position of Chief Medical Officer while also making decisions about Generation Health's stance on various regulatory issues that will affect the industry long-term.
Describes the career path and insights of Stanley Lapidus, a successful serial entrepreneur in the medical and life sciences industry. Lapidus is the founder of Cytyc Corp. (NASDAQ: CYTC) and EXACT Sciences (NASDAQ: EXAS) and is currently the CEO of his third start-up, Helicos BioSciences. Gives students insight into the skills and experiences that are helpful in building successful medical technology companies.
Robert F. Higgins, Jacob Ian Broder-Fingert, Eliot Sherman and Sidhartha Palani
Presents the issues faced while building an innovative company in an emerging space with new intellectual property from the perspective of a venture capitalist. Beth Seidenberg, a partner at the venture capital firm Kleiner Perkins Caufield & Byers (KPCB), had helped create iZumi Bio, a company with ambitious prospects that she believed had the potential to become "the" definitive stem cell company. iZumi sought to bring under its banner key intellectual property (IP) from the nascent field of stem cell technology. As such, iZumi would need to acquire the rights to several groundbreaking scientific developments that had recently occurred in labs around the world. Seidenberg needed to decide whether to commit to the next major tranche of the investment. Charged with finalizing her decision in less than 24 hours, Seidenberg weighed the pros and cons of the next round of financing. Was it really possible to pull together such a broad range of IP under one umbrella? Was the international mix of IP going to be too difficult to manage? Was it too early for stem cell technology to be successfully commercialized?
Higgins, Robert F., Jacob Ian Broder-Fingert, Eliot Sherman, and Sidhartha Palani. "iZumi." Harvard Business School Case 809-105, January 2009. (Revised July 2010.)
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Higgins, Robert F., Richard G. Hamermesh, and Erin Seefeld. "Cynthia Fisher and the Rearing of ViaCell (TN)." Harvard Business School Teaching Note 808-115, January 2008. (Revised January 2009.)
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In May 2005, Steve Bollinger was about to become president and chief operating officer of Pervasis Therapeutics, a small cell therapy start-up in Cambridge, Mass. If proven successful, Pervasis' product, Vascugel, could change the way vascular disease is treated and have a major impact in a large and underserved population. However, Vascugel had not yet gone into human clinical trials, and getting it to market would mean navigating the FDA approval process, as well as raising the capital necessary to finance the endeavor. It was up to Bollinger to decide on a strategy for Vascugel's clinical trials. In addition, he would have to decide how much money the company needed to raise, taking into account the interests of the company's founders and existing venture investors. Finally, while Bollinger was expected to lead the company for the next two to three years, Pervasis' board was planning to launch a search for a permanent CEO in the future.
NatuRi Corporation was a start up, founded in 2005, aiming to manufacture a cholesterol-lowering drug made from the byproducts of rice bran oil production. With operations split between Chennai, India and Boston, Massachusetts, NatuRi faced several challenges, including securing funding for the organization. NatuRi had captured the attention of at least four potential investors willing to offer an investment. Its managers were challenged to weigh their options and to determine which of the four potential investors currently interested in their venture would be most appropriate for NatuRi's future growth. In addition, the founders had only a short period of time to decide whether or not to accept a Seed and Series A term sheet from a well known venture capital firm. Poses the question of how the company's financing should be structured and how much equity the founders should relinquish in exchange for the start-up capital.
Donald N. Sull, Robert F. Higgins, Linda A. Cyr and Bijan Salehizadeh
Conor Medsystems had developed a drug-eluting stent that could capture significant share of the $5 billion global market. Chief executive officer, Frank Litvack, is considering alternative sources of financing to test the device.
Sull, Donald N., Robert F. Higgins, Linda A. Cyr, and Bijan Salehizadeh. "Conor Medsystems." Harvard Business School Case 804-180, April 2004. (Revised May 2007.)
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Describes the start up of Viacord, a Boston-based medical services firm founded by Cynthia Fisher (HBS MBA) in 1993. Told from Fisher's perspective, the entrepreneur details the conceptualization and launch of the business and the many obstacles and expenses faced in the company's first seven years. Fisher describes the venture capital negotiations and a merger with a biotech company that led to the creation of ViaCell in 2000. Fisher explains how her role changed from founder and CEO of Viacord to president and then board member of ViaCell, and carries the firm's story to the successful 2005 IPO.
Describes the U.S. FDA with particular emphasis on its role in the development of new drugs, biologic products, and medical devices today. Provides context for the drug approval process by describing the FDA's history and organizational structure.
Describes the business development process in biotechnology companies. Topics covered include: participants in the licensing process and their interests, the major steps in the licensing process, the terms that are part of most agreements, and the most contentious issues that arise in the implementation of licensing agreements.
Grove International Partners, one of the world's largest international real estate private equity funds, is actively seeking new investment opportunities in the seniors housing industry. The firm has identified two potential opportunities--one located in Japan and one in the United Kingdom--that would place it at the leading edge of one of the most lucrative and socially meaningful health care services markets in the world. Grove evaluates these two opportunities and decides which one, if either, to pursue.
Higgins, Robert F., Carin-Isabel Knoop, and Suzanne Petrela. "Grove International Partners." Harvard Business School Case 806-096, February 2006. (Revised April 2006.)
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Higgins, Robert F., Richard G. Hamermesh, and Erin Seefeld. "Stan Lapidus: Profile of a Medical Entrepreneur (TN)." Harvard Business School Teaching Note 806-149, March 2006.
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Higgins, Robert F., Richard G. Hamermesh, and Erin Seefeld. "Conor Medsystems (TN)." Harvard Business School Teaching Note 806-150, March 2006.
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Describes the evolution of a start-up venture in the pathology lab segment of the clinical lab business. U.S. Labs tries a series of business models before running out of cash. The company is in dire need of financing, as its venture capital backers are refusing to put up more capital and its bank is calling its loan. Discusses how the CEO is willing to put up his own funding and still believes in the company's future.
