麦肯锡案例面试题

麦肯锡案例面试题：MagnaHealth案例分析(英文，有答案)面试,案例分析PracticeCasesMagnaHealthIntroductionTostepthroughthiscaseexample,wewillgiveyousomeinformation,askaquestion,andthen,whenyouareready,giveyouasampleanswer.Wehopethattheexercisewillgiveyouasenseoftheflowofacaseinterview.(Pleasenote,youcanstopthisexerciseandpickupwhereyouleftofflater.Yourcookiesmustbeontousethisfeature).Inthisexercise,youwillansweraseriesofquestionsasthecaseunfolds.Weprovideourrecommendedanswersaftereachquestion,withwhichyoucancompareyourownanswers.Wewanttoemphasizethatmostquestionsinacasestudydonothaveasinglerightanswer.Inalivecaseinterview,wearemoreinterestedinyourexplanationofhowyouarrivedatyouranswer,notjusttheansweritself.Aninterviewercanalwaysassessdifferentbutequallyvalidwaysofapproachinganissue,andthenbringyoubacktotheparticularlineofinquirythatheorshewantstopursue.Youshouldalsokeepinmindthatinalivecase,therewillbefarmoreinteractionwiththeinterviewerthanthisexerciseallows.Forexample,youwillhavetheopportunitytoaskclarifyingquestions.Finally,alivecaseinterviewwouldtypicallybecompletedin30-45minutes,dependingonhowthecaseevolves.Inthison-lineexercise,thereisnotimelimit.Therearetenquestionsinthison-linecasestudy.Thiscasestudyisdesignedtoroughlysimulateoneduringyourinterview,soyouwillnotbeabletoskipaheadtothenextquestionuntilyouhaveansweredtheoneyouareon.YoucanrefreshyourmemoryofpreviousanswersbyclickingthehighlightedQ&Alinkstotheleft.Toprinttheanswer,clickontheprinticonthatappearsintheTOPRIGHTcorner.Attheend,youcanprinttheentireon-linecasestudyatonce.StartCaseStudyClientGoal:Todeterminehowtoimproveitsfinancialsituation.OurclientisMagnaHealth,ahealthcarecompanyintheMidwest.Itbothinsurespatientsandprovideshealthcareservices.EmployerspayafixedpremiumtoMagnaforeachoftheiremployeesinreturnforwhichMagnacoversallnecessaryhealthservicesoftheemployee(rangingfromphysiciancareandmedicationstohospitalization).Magnacurrentlyhas300,000patientsenrolledinitsplan.Ithas300salariedphysicianemployeeswhoprovideabroadrangeofservicestopatientsinsixcenters.Thesephysiciansrepresentawiderangeofspecialtyareas,butnotallareas.WhenapatientneedsmedicaltreatmentinaspecialtyareanotcoveredbyaMagnaphysician,theyarereferredoutsideoftheMagnanetworkforcare,andMagnapaysallreferralcostsonafee-for-servicebasis.Magnadoesnotownanyhospitalsitself,insteadcontractingservicesfromseverallocalhospitals.Magna'sCEOhasretainedMcKinseytohelpdeterminewhatiscausingthedecliningprofitabilityandhowMagnamightfixit.QUESTION1WhatkeyareaswouldyouwanttoexploreinordertounderstandMagna'sdeclineinprofitability?ANSWER1Somepossibleareasaregivenbelow.Greatjobifyouidentifiedseveraloftheseandperhapssomeothers.Magna'srevenuesPricepaidbyemployerforemployeehealthcoverage.NumberofemployeescoveredbyMagna.Magna'scosts(orfixedandvariablecosts)Magna'smaincostcomponentsconsistofadministrative(non-medical)andmedicalcosts(e.g.,hospital,drugs,outpatientcare)OutpatientcostscanbesplitintointernalphysiciancostsversusexternalreferralcostsMagna'spatientbasedemographics/overallriskpromayaffectmedicalcostsQUESTION2TheteamdiscoversthatthedemographicsofMagna'ssubscribershavechangedsignificantlyinthepast5years,frommajorityindustrialworkers/laborerstomajorityofficeemployees.Knowingthis,arethereanyspecificareasyouwouldinvestigatefirst?ANSWER2Wearelookingforafewresponses,similartotheonesbelow:Claimcosts,asthechangeinthesubscriberbasewillchangetheprodiseases(e.g.,moreheartdisease/stressandlessworkrelatedinjury)Externalreferralcosts,duetothechangeinthediseaseprowhichtheyhavein-housecompetencyQUESTION3AfterreviewingthebasicsofMagna'sbusiness,yourteambelievesthatoneoftherootcausesofMagna'sfinancialproblemsishowitmanagesmedicalcosts,particularlythecostofreferralstospecialistsoutsideofitsphysiciannetwork.YourteamhasgatheredthefollowinginformationonMagnaanditsprimarycompetitor,SunshineHMO:NumberofpatientsAveragecostofreferral(permemberpermonth)MagnaHealth300,000$20SunshineHMO500,000$15WhatarethemostlikelyreasonsthattheaveragecostofreferralatMagnaishigherthanatSunshine?(Atthispointyoushouldfeelfreetoofferhypotheses,andyoucouldaskyourinterviewerquestionstoclarifytheinformation)ANSWER3Althoughthereareanumberofpossibleresponses,youmighthavethefollowingsuggestions:Referralpricing:MagnamightbepayingmorethanSunshineforspecialistservices(e.g.,itsoutsidecontractswithoncologistsmightbeathigherratesthanSunshine'scontracts).Numberofreferrals:Magna'sphysiciansmighthavedifferentpracticepatternsthanSunshinephysicians,i.e.,theymaybelesscomfortabletreatingheartdiseasepatientsorhavedifferenttraining/protocols.Mixofspecialties:Magna'smixofspecialtiesthatrequiresreferrals(cardiologyandneurosurgery)areprobablymoreexpensivespecialties(thancardiologyandpsychiatry,Sunshine'sreferralspecialties).Mixofpatients:Magnahassickerorolder(>65)patients(individualsover65aremorelikelytoneedmedicalcareinthespecialtyareasoutsideofMagna'snetwork,particularlycardiology).QUESTION4Whatanalyseswouldyoudoifthethingsyousuggestwerecontributingtothisproblem?ANSWER4Ingivingtheanswer,it'susefulifyouareclearabouthowtheanalysisyouareproposingwouldhelptoanswerthequestionposed.Youmighttakethefollowingapproach,wherewe'veoutlineddifferentareasofanalysis:Referralpricing:GaindataonpricescurrentlybeingpaidbyMagnaforasampleofcommonspecialtiesGainsimilardataforacompetitorifpossibleforanindustryaverage(perhapsthroughinterviewswithnon-Magnaspecialists)Numberofreferrals:InterviewMagnaphysiciansandnon-MagnaphysicianstoseeifanyobviousbehavioraldifferencesexistConsultindustrypublicationsonthisissueMixofspecialties:ChecknumberofreferralsbyspecialtyforMagnaandestimatesimilarforSunshineInterviewswithexternalspecialtiesusedbySunshinemayhelpagainhereMixofpatients:ComparedemographicdataforMagnaandSunshine:shouldbeeasytoobtainfromMagna;ascanoftheemployeeschemescoveredbySunshineshouldgiveagoodgeneralpictureoftheirdemographicprofileSeeifMagna'sreferralcosthasincreasedinlinewiththechangeindemographicsofthesubscribersQUESTION5Magna'sCEOhasahypothesisthatMagnaispayingtoomuchincardiologyreferralcostsforitspatientpopulation.HeaskstheMcKinseyteamtolookatMagna'scardiacpatientpopulationmorecloselyandtellhimhowmanyreferralsheshouldexpectonanannualbasis.Assumethefollowing:Magnahas300,000patientsinanyoneyear20percentofitspatientsareage65orolderIntheU.S.,patientswithseriousheartdiseasevisitspecialists(cardiologists)onaverageoffivetimesperyearYoushouldalwaysfeelfreetoaskyourintervieweradditionalquestionstohelpyouwithyourresponse.Inthiscase,youshouldrecognizetheneedtoknowtheprevalencerateofseriousheartdiseasetocompletethiscalculation.Onceasked,yourinterviewerwouldprovideyouwiththefollowinginformation:Theprevalencerateofseriousheartdiseaseinthe65+populationis30percentTheprevalencerateofseriousheartdiseaseintheunderage65populationis10percentANSWER5Whileyoumayfindthatdoingstraightforwardmathproblemsinthecontextofaninterviewisabittougher,youcanseethatitisjustamatterofbreakingtheproblemdown.Wearelookingforbothyourabilitytosettheanalysisupproperlyandthentodothemathinrealtime.Basedonthecorrectcalculations,yourresponseshouldbeasfollows:Magnashouldexpect210,000cardiacreferralsannuallybasedonitspatientpopulation.Youshouldhaveapproachedthecalculationsasfollowstoarriveatthatanswer:300,000totalpatients20percentx300,000=60,000patientsage65+18,000x5=90,000referralsperyear240,000Magnapatientsundertheageof65240,000patientsx10percent=24,000patientsunderage65withseriousheartdiseaseand24,000x5visitsperyear=120,000visitsperyeartotal90,000+120,000visitsperyear=210,000totalMagnapatientexternalcardiologyvisitsQUESTION6WhentheteamtellsMagna'sCEOthatbasedonMagna'spatientpopulationheshouldexpectabout210,000cardiologyreferralsayearheexclaims,"Wecurrentlypayfor300,000annualcardiologyreferralsforourpatientpopulation!"WhymightMagna'sannualcardiologyreferralsbesignificantlyhigherthanU.S.averages?Whatwouldyoudototrytoverifyifanyofthesewereakeycauseofthisproblem?ANSWER6Wewouldnotexpectyoutocomeupwithalloftheseanswers,butwehopesomeofyouranswersheadinthesamedirectionasours.Yoursmaybringsomeadditionalinsights.Ineithercase,besurethatyoucanclearlyexplainhowyourreasonswillbringyouclosertowhythereferralsmightbehigher.Thereareanumberofanswerstothesequestions,andyouareontherighttrackifyourresponsesincludedsomeoftheonesbelow:TheprevalencerateofheartdiseaseinMagna'spatientpopulationishigherthanaverage.Toseeifthiswasacauseoftheproblem,McKinseyshouldaudittheinternaldataonheartdiseaseprevalenceandcompareittoUSNationaldata.Magna'sprimarycarephysiciansarereferringpatientswhodonothaveseriousheartdiseasetospecialists.Theteamshouldinterviewspecialiststogettheiropinion,orfollowthroughasampleofpatientswhowerereferred.Primarycarephysiciansarenotcomfortable(e.g.,theyarepoorlytrainedorinexperienced)treatingcardiacpatients,eventhosewithminorproblems;theywanttoavoidmalpracticesuits.McKinseyshouldinterviewMagnaphysiciansandinstituteanexternalreview.Magnadoesn'thaveclearguidelinesonwhenphysiciansshouldbereferringpatientstospecialists(orifguidelinesexist,physiciansarenotcomplyingwiththem).Theteamshouldgainanexpertopiniononthecurrentguidelinestoseeifthiswasakeycauseoftheproblem.Therearenoincentivesorpenaltiestopreventphysiciansfromreferringpatientswithlessseriousproblemstospecialists.Inordertoverifythisisakeycauseoftheproblem,theteamshouldreviewincentiveschemesiftheyexist.Theyshouldalsocomparesimilarcompanies/situations(e.g.,prescriptioncontrolmechanisms,etc.).QUESTION7Atthispointinthestudy,youbumpintoMagna'sHeadofHealthServicesinthecorridor.Heisresponsibleforallmattersrelatedtotheprovisionofservicestosubscribers,bothinsideandoutsidetheMagnaNetwork.Heasksyouifyouhavemadeanyprogress.Howwouldyourespond?ANSWER7Thinkaboutthepersonyouaretalkingwith,andhowbesttocommunicatethefindingsyouhavecomeupwithsofar.Theabilitytocometoalogical,defensiblesynthesisbasedontheinformationavailableatanypointinanengagementiscriticaltotheworkwedo.Eventhoughwe'dconsiderourselvestobeearlyintheoverallprojectatthispointinthecase,wedowanttobeabletoshareourcurrentperspective.Oneidealanswerwouldincludethefollowingpoints:FindingsWehaveinvestigatedallthedriversofprofitforMagna.Althoughthereislikelytoberoomforimprovementinalotofareas,itseemstheclaimscostisabigareaforimprovement.Relativetothemarketandtocompetitors,Magnaseemstohavehighclaimscostperpatient.Ourinitialindicationisthattheremaybehighestroomforimprovementsinthecostofreferralsoutsidethenetwork.Thereareanumberofreasonsastowhythismaybehappening(listasinpreviousquestion).NextStepsWeareworkingtopindownthemostsignificantreasonswhyMagnahashighclaimscostperpatient.Wearegoingtobelookingintootherareassuchasreductionpotentialinothercosts,aswellasimprovementpotentialintermsofpremiumsorothersourcesofrevenue.QUESTION8Aftersomeadditionalinvestigation,yourteamthinksthatchangingthebehaviorofMagna'sprimarycarephysicianshaspotentialtoreducecardiacreferralcostswhilemaintaininghigh-qualitycare.Theteambelievesthatintroducingsomesortofincentiveplanforphysiciansmighthelpreducethereferralrate.Theteam'sideaforapilotplanistoincreaseoverallfeesthatMagnapaystoprimarycarephysicianstohandlemoreoftheirpatients'basiccardiologyneeds.Overallfeeincreaseswouldtotal$1million.Inadditiontotheteam'sproposal,Magna'smedicaldirectorwantstopilotthefollowingidea:Magnapaysbonusesof$100,000peryeartoeachofthe10primarycarephysicianswiththelowestcardiacreferralratesconsistentwithgoodpatientoutcomes.Althoughtheteammentionstothemedicaldirectorthatthereareotherissuestoconsiderrelatingtothepilotthatarenotfinancial,suchastheethicalimpactofincentivizingphysiciansnottoreferpatientstospecialisttreatment,hewantstheteamtodothefirstcalculationincludingbothideas.HowmanyfewercardiologyreferralswillMagnaneedtohaveinordertorecoupthecostofthepilotincentiveplan(includingtheteam'sandthemedicaldirector'sidea)?Forsimplicity'ssassume:Thecostofacardiologyreferralis$200.Magnacurrentlyhas300,000cardiologyreferralsperyear.ANSWER8Iftheincentiveplanreducescardiologyreferralsby3.3percentor10,000referrals,Magnawillrecoupthecostoftheincentiveplan.Onepotentialapproachtothecalculation:$1million+(10*$100,000)=$2millionforincentiveplan$2million/$200=10,000referrals10,000referrals/300,000totalreferrals=3.3percentreductionwouldpayforincentiveprogramQUESTION9Yourteamprojectsthattheincentiveplanhasthepotentialtoreducereferralsby5percentinitsfirstyear,andanadditional2percentinitssecondyear.Iftheseprojectionsarecorrect,howmuchreferralcostcouldMagnasaveintotaloverthefirsttwoyearsoftheincentiveplan?ANSWER9Referralcostswouldbe$4.14millionlowerinthesecondyear.OverthetwoyearsMagnawouldsave$7.14million.Onepotentialapproachtothecalculation:Year1SavingswithProgram300,000totalreferrals5percentreductioninreferrals=15,000referrals15,000x$200=$3.0millioninsavingsinyear1Year2SavingswithProgram285,000totalreferrals2percentreductioninreferrals=5,700referrals5,700x$200=$1.14millioninsavings$3+$1.14=$4.14millioninsavingsTherefore,totalcumulativesavingsoverthe2years=Year1savings+Year2savings=$3.0m+$4.14m=$7.14m.QUESTION10YourteampresentsitsphysicianincentiveproposaltoMagna'sCEO.TheCEO,inconsultationwithhismedicaldirector,agreesthatthisisfeasibleandsaysthattheywilldefinitelypilottheoverallhigherfeestoprimarycarephysicianstohandlemoreofthebasiccardiologyneedsandtheywillthinkabouttheideawiththebonusesagainduetotheethicalconcernstheteamraised.AttheendofthemeetingtheCEOsays,"Iliketheworkyou'vedone,butevenifwedidimplementthebonuspaymentit'snotenoughtoaddressourcurrentfinancialsituation.PhysiciansareprofessionalswhocaredeeplyaboutpatientcareandIthinkthere'salimittohowmuchcostwecan