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The case is based on data collected from in-depth interviews, and from company, third-party and regulatory–agency documents. In addition to prior conversations over several years between the company founders and the lead case writer, there were several rounds of interviews in 2023 with the surviving founder and in-depth interviews with eight of the company’s key managers. Company documents reviewed included bylaws, organization charts, profit and loss statements and staffing statistics, all from founding to sale. Also reviewed were documents and evaluations of company operations and performance produced by the merger & acquisition firm that handled the company’s eventual sale. The company owner insisted on complete disguise of the company and all its members and prohibited disclosure of detailed proprietary financial data.

At the strategic level, this case is about how the unique, complex and changing healthcare environment created opportunities and threats to which a women-owned and run start-up company, Aloe Health (AH), had to respond to become and remain successful. At the personal level, the case illustrates what it takes for an entrepreneur and leader having clinical but no real business acumen to start, expand and turn around a company and ultimately position it for a successful acquisition, continually learning and adapting along the way.

The case describes how two women who were friends for many years started up a home healthcare company later in their lives and grew it into the largest women-owned business of its kind in the USA. Based in the Southwest USA, an area with many factors conducive to success, they navigated the many complexities of US Medicare regulations to create a fully-integrated home healthcare company providing unskilled personal care, medically skilled homecare and end-of-life hospice services to thousands of clients. The case provides background on the founders and the home healthcare industry context, and details the steps taken to start up and build the company into a fairly successful enterprise; one of the largest of its kind in the region. The (A) case ends with one of the founders facing a crisis brought on by the death of her co-founder and the revelation of some significant organization dysfunctions, leaving her unable to profitably exit the company and unsure of whether she would be able to turn things around. The students are tasked with making recommendations for what she should do next.

The (B) case brings events up to fall 2023, describing the steps the surviving founder took to transform her leadership style and the company’s systems and culture, and to navigate the due diligence process associated with preparing for an (ultimately very successful) acquisition. It also shares the owner’s “lessons learned,” and briefly notes the current state of the acquired company and the many AH employees that it continues to employ.

The case provides ample information for students to appreciate the company’s strategy and the challenges of operating in the highly regulated health care industry. However, it is probably even better suited to illustrating the “soft” issues of new-venture management, such as the tendencies of founders to overload themselves by micro-managing their growing venture and not adapting to expansion, and for those with clinical backgrounds to focus on caring for patients and employees while overlooking business essentials and organization systems. It also illustrates how business partnerships among strong-willed individuals can produce dynamics in the founding team similar to a “marriage,” with affection and complementary talents, yet also tensions. It further illustrates the process of a successful turnaround strategy, and the “due-diligence” challenges of preparing for an acquisition.

This case has a range of course applications at multiple education levels. Although it is probably best suited for graduate and executive-level programs, it can also be selectively used in undergraduate classes, particularly if populated by upperclassman. It is ideally suited to courses on entrepreneurship and on healthcare management. For an entrepreneurship course, it could be positioned mid-way through the semester, after covering topics relating to the entrepreneurial mindset, founding teams and business models. It can be used to get the class focusing on competitive issues and the challenges of starting up a company in a highly regulated environment, on entrepreneurial founding-team characteristics and management tendencies (e.g. micro-management control tendencies), on transition issues from start up to growth stages and on exit strategies.

We believe this case is also well suited as a teaching exercise for students pursuing healthcare management studies in baccalaureate and graduate programs (MBA, MHA, MHS) in which instructors wish to broaden student exposure to a real-world scenario that focuses on entrepreneurial behavior in a healthcare setting (a topic of increasing interest to healthcare practitioners and managers given the current trend toward provider formation and ownership of health facilities). Here, the case may be used to focus on the complexities of the healthcare industry, the key differences between various healthcare service business models and on the challenges that technically (clinically) trained professionals often face when trying to manage a healthcare business. Ideal placement of the case would be in a capstone course, after students have been introduced to their functional coursework in topics such as introduction to management, organizational behavior and leadership, financial management and strategic thinking. The case also challenges students to apply knowledge obtained in specialized coursework in healthcare systems and policy, industry regulation, as well as healthcare reimbursement methods.

The case also may be used in organization behavior courses to focus on team, cultural and leadership issues and in strategic management courses to focus on strategy implementation. In addition, there are enough family business themes in the case (even though Aloe is not actually a family business) to use it in a course on managing family businesses.

Case information was mainly acquired through interviews with Richard Gammans, chief operating officer. Dr Gammans was a visiting professor at Fayetteville State University for a year, and two of the case authors developed personal friendships with Richard. Interviews were conducted over a two-year period as the accelerator got started. In addition, one author conducted a team-building session with the management team and one of the bio-startup researchers. An interview was also conducted with Clayton Duncan, chief executive officer, to gain his agreement with developing the case.

The Accele website included a write-up on each of the pharmaceutical startup companies. The write-up included a company summary, description of the science (disease and cure), the size of the market, results from testing, regulatory considerations and intellectual property. A literature review was conducted as the basis for the information on the pharmaceutical industry.

This case is about a biopharmaceutical accelerator founded in 2011 by two senior executives with experience in both large pharmaceutical companies and running biotech startup companies. The founders were successful in raising capital to start their first venture capital fund which they used to invest in four biotech startups. All four startups were working in very different disease areas. For example, one developed a drug to help with hearing loss that the department of defense was funding. Another of the startups discovered drug candidates that attack antibiotic-resistant bacteria. Biopharmaceutical accelerators were relatively new. They differed from business incubators because they invest in the startups and provide operational support, but the degree of support provided varies across accelerators. The Accele BioPharma accelerator operated in virtual, network type of organization, and Accele BioPharma provided primary strategic and operational management for the startups. The challenge in this case is to identify how the leaders managed the virtual network, and what additional resources were needed so that the management team could expand their ability to assist startups to get drugs approved by the food and drug administration.

This case is suitable recommended for undergraduate/graduate strategy, undergraduate/graduate organizational behavior, entrepreneurship and health-care management courses.

The case study will provide an opportunity for students to identify the challenges a business-to-business (B2B) organization in a commodity product category faces in a growing environment. The students will learn to analyze and evaluate different strategies for growth and profitability. The students will be equipped to make decisions based on financial and nonfinancial data and the trade-offs therein. The case study will enable students to understand the application of the concept of operating leverage in different business conditions.

The leadership team at Mangalam Organics Limited (MOL) was worried about the company’s future in December 2021. The chief strategy officer (CSO), Akshay Dujodwala; the chairman, Kamal Dujodwala and the managing director, Pankaj Dujodwala had watched MOL go through many ups and downs. MOL manufactured camphor powder and supplied it to tableters [1], who would convert it into tablets, essentially used for Puja [2] purposes in India. Camphor was a white, waxy terpenoid with a strong aroma. It was mainly a commodity business with no pricing power when MOL supplied it in bulk to tableters. They had ventured into the business-to-customer (B2C) [3] space with their consumer brand “Mangalam” camphor tablets, positioned for religious uses in homes. However, this formed a very small percentage of their turnover. With thin margins and a low growth rate, it was difficult for MOL to sustain and grow, especially in the B2B [4] business. To make matters worse, their manufacturing unit caught fire in 2015, causing a major blow to their business. Under the leadership of their CSO, Akshay, they implemented strategies that helped the company bring down costs and wastage. Akshay helped MOL diversify further into the B2C market through their brands, “CamPure” for home care products and “Cam+” for health-care products. Huge expenditures on marketing and advertising were incurred to promote these brands. The COVID-19 pandemic watched the world go through a terrible phase with lockdown and rising health issues (both physical and mental). Camphor found an interesting place in immunity and religious purposes due to its aromatherapy properties and evoking feelings of relaxation. The newfound use helped MOL achieve an unexpectedly higher turnover. But Akshay knew that camphor, by itself, was fickle in providing profitability. To sustain growth post-COVID-19, MOL would urgently need to look for growth options. After giving it a lot of thought, he was faced with three options – he could either focus on CamPure as a B2C option, or concentrate completely on camphor powder and aroma as an existing B2B option or take the third option to go in for a first of its kind exclusive stores for all types of puja items called Pooja Sangam. While all these options had their own pros and cons, he had to now decide which was the best financially viable option for MOL as a way forward.

The case study is designed at the postgraduate level in an Master of Business Administration and executive education programs. Given the nature of the issues in the case study, it can be included in courses such as business strategy and strategic marketing.

Teaching notes are available for educators only.

CSS 8: Marketing.

The case data are from a mix of secondary sources, which included company documents, webpages and blogposts, autobiographies co-written by Schultz, newspaper stories, news media and other publicly available videos, magazine articles, photographs of signed unionization statements, and webinar interview.

In late autumn 2021, the global retail coffee and foodservice company Starbucks dealt with employees at a few USA stores who initiated unionization efforts in an attempt to change their workplace. Their actions triggered a wave of similar attempts at Starbucks stores across the USA over the next few years. Employees amplified their voices on social media, stating both their love for the company and their disenfranchisement. They claimed to have little input about policies and workplace decisions that affected them and that leadership had not heard or adequately responded to concerns with staffing, safety, equipment, and abusive customers. Walkouts were staged and employees at numerous stores pursued unionization. In 2023, Laxman Narasimhan replaced Howard Schultz as CEO. His tenure started with the challenge of reengaging employees who claimed their collective voice was unheard by leadership Readers will consider what employee voice means in the context of baristas working for a large corporation, and how their emotions, commitment to and respect for the organization, and their desire to be heard, related to efforts to unionize and maintain employment.

This case can be used as a unit review to cover several organizational behavior topics or can be used with specific concepts for graduate or undergraduate students. The placement within the semester plan depends on which unit/concepts the instructor will pair with it, such as emotions in the workplace, a module on loyalty, voice and exit, or the introduction of employee voice and engagement. It can also be used in conjunction with cross-level concepts such as trust and leadership. For courses focused on talent management, employee relations, or human resource development, the case could be used to introduce multiple concepts or as a concluding assessment. It would best pair with topics such as employee satisfaction, exit, voice and loyalty, inclusive decision-making or emotions in the workplace. For a course in labor relations, the case could introduce the idea that employees’ experiences, emotions, and perceptions may be related to efforts to unionize.