HLTH 6880 Week 4 Social Enterprise Business Model Example

LinkBP: A Business Model for Follow-Up Between Screening and Control of High Blood Pressure in Rural Western Kenya

Student Name

Walden University

HLTH 6880: Social Entrepreneurship and Innovation: A Global Perspective

Instructor Name

Month Day, Year

LinkBP: A Business Model for Follow-Up Between Screening and Control of High Blood Pressure in Rural Western Kenya

Introduction

LinkBP is a composite venture designed for the gap identified in Weeks 1 and 3: adults in rural western Kenya who are screened with high blood pressure but do not reach care, or do not stay in it. The model employs follow-up workers who take responsibility for each referred adult from the day of screening, escort the first clinic contact, check blood pressure at home monthly and send refill reminders. It is paid mainly by the county health department under a performance contract and partly by agricultural employers for their workforces. Beneficiaries pay nothing for the service. The blocks below follow the business model canvas (Osterwalder & Pigneur, 2010), and the prose after each block explains how it supports the others. All quantities are described by kind rather than as prices, because the venture has no operating data yet and invented prices would be impossible to check.

Value Proposition

For a referred adult in a farming household, LinkBP changes three things. The first clinic visit is arranged and confirmed rather than left to a paper slip. Blood pressure is checked at home each month, so a person learns whether treatment is working without losing a day's work. And when a refill is due, someone notices before the tablets run out. For the county health department, the value is a measurable rise in the share of referred adults who reach and stay in care, delivered through its own clinics and medicine supply. For employers, the value is a workforce whose high blood pressure is managed at low disruption to working hours. These are three different propositions, and the model does not pretend they are one.

Customer Segments, Beneficiaries and Payers

The beneficiaries are referred adults aged 35 and over in the rural sub-counties of the composite county. The payers are the county health department and, for a subset of beneficiaries, agricultural estates and cooperatives that employ them. These groups overlap but are not the same: every employer-paid beneficiary is also a county resident, but most county beneficiaries have no employer payer. That difference is stated here so that later weeks can test what happens when the two payers want different things, a risk that research on hybrid organizations treats as central to social enterprise governance (Battilana & Lee, 2014).

Channels and Key Activities

Beneficiaries are enrolled at the point of screening, whether at a county outreach event, a market-day stall or an employer health day. The follow-up worker records the reading and a phone number, agrees a day to visit and books the first clinic contact. Key activities are then a home or workplace visit within seven days, an escorted or confirmed first clinic visit within 30 days, a monthly blood pressure check and refill prompt and a referral back to the clinic when a reading is above the protocol's threshold. Each worker is assigned a caseload in one sub-county and carries a validated automatic cuff and a phone with a simple case-tracking application. Clinical decisions, including prescribing, stay with clinic staff; World Health Organization guidance supports protocol-based treatment by trained nurses and pharmacists, which is what the county clinics already provide (World Health Organization, 2021).

Key Resources and Partners

Key resources are the follow-up workers, their supervisors, the cuffs and phones and the case-tracking application. Key partners are the county health department, which contracts the service and runs the clinics and medicine supply; the clinics, which agree to confirm visits and share refill dates; and the employers, which host health days and pay for their employees' follow-up. The model is designed to strengthen the public system rather than replace it, which is the feature that made home-visit programs effective in comparable trials.

Cost Structure

Costs that scale with the number of enrolled adults are follow-up workers' pay, transport for home visits, airtime and data and the replacement of cuffs. Costs that do not scale, or scale in steps, are supervisors, each covering a fixed number of workers; the case-tracking application, licensed per organization; training curricula, developed once and delivered per cohort; and management and reporting. In the composite pilot of one sub-county, an illustrative budget would place most spending in worker pay and transport, with the fixed costs weighing heavily in the first year and less as enrollment grows. The model's viability depends on the per-person variable cost staying below what the county can pay per enrolled adult.

Revenue Streams

The main revenue stream is a county performance contract. The county pays a fixed amount per enrolled adult per quarter, described here as a price basis rather than a figure: set at or below the county's estimate of what a missed hypertension patient costs its facilities in emergency and inpatient care over the same period. A smaller bonus is paid per adult whose reading is below 140/90 mm Hg at the quarter's end. The county keeps paying for a reason it can see in its own records: more referred adults appear in clinic registers and fewer present late with complications.

The second stream is employer contracts. Estates and cooperatives pay a per-employee fee for enrollment and follow-up of staff found at workplace screening. Their reason to keep paying is fewer lost days and a benefit that helps them keep workers. This stream is expected to be the smaller of the two but more reliable in its payment timing.

Grants are used only for the pilot year, to fund start-up costs and an independent evaluation. The model says plainly that grants are not its revenue model: if, after the pilot, the county will not contract on these terms, LinkBP does not continue in that county. Grant-dependent ventures often discover that their real customer was the funder, and governance research on social enterprises warns that when the party paying differs from the party served, revenue can pull activity away from the mission (Ebrahim et al., 2014). Beneficiaries do not pay, because the earlier weeks showed that the cost of a clinic trip is already a barrier, and adding a fee would recreate the problem the venture exists to solve.

How the Blocks Hold Each Other Up

The blocks depend on each other in specific ways. The value proposition to the county is measurable only because the key activities produce clinic-confirmed visits and recorded readings. The revenue stream rewards the same outcome the beneficiary needs, a controlled reading, rather than visits or enrollments, which reduces the risk that the venture is paid for activity rather than for effect. The cost structure works only if workers carry enough cases to spread the fixed costs, which requires a sub-county with enough referred adults within travel distance. And the partner block is not optional: without the clinics' cooperation on confirmations and refill dates, the venture cannot show the county anything worth buying. If any one of these links fails, the model fails, which is why the beneficiary analysis, theory of change and measurement plan in later weeks each test one of them.

References

Battilana, J., & Lee, M. (2014). Advancing research on hybrid organizing: Insights from the study of social enterprises. Academy of Management Annals, 8(1), 397-441. https://doi.org/10.5465/19416520.2014.893615

Ebrahim, A., Battilana, J., & Mair, J. (2014). The governance of social enterprises: Mission drift and accountability challenges in hybrid organizations. Research in Organizational Behavior, 34, 81-100. https://doi.org/10.1016/j.riob.2014.09.001

Osterwalder, A., & Pigneur, Y. (2010). Business model generation: A handbook for visionaries, game changers, and challengers. Wiley.

World Health Organization. (2021). Guideline for the pharmacological treatment of hypertension in adults. World Health Organization.