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Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment Negotiation Strategy / MBA Resources

Introduction to Negotiation Strategy

Negotiation Strategy solution for Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment case study


At Oak Spring University, we provide corporate level professional Negotiation Strategy and other business case study solution. Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment case study is a Harvard Business School (HBR) case study written by Amitabh Chandra, Anjani Datla. The Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment (referred as “Health Oregon” from here on) case study provides evaluation & decision scenario in field of Leadership & Managing People. It also touches upon business topics such as - negotiation strategy , negotiation framework, Health, Market research, Personnel policies, Social enterprise, Social responsibility.

Negotiation strategy solution for case study Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment ” provides a comprehensive framework to analyse all issues at hand and reach a unambiguous negotiated agreement. At Oak Spring University, we provide comprehensive negotiation strategies that have proven their worth both in the academic sphere and corporate world.


BATNA in Negotiation Strategy


Three questions every negotiator should ask before entering into a negotiation process-

What’s my BATNA (Best Alternative To a Negotiated Agreement) – my walkaway option if the deal fails?

What are my most important interests, in ranked order?

What is the other side’s BATNA, and what are his interests?



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Case Description of Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment Case Study


In 2008, the state of Oregon had the budget to enroll 10,000 individuals into Medicaid. But officials knew that demand for Medicaid would be far greater. To give all poor, uninsured Oregonians a fair chance at receiving health insurance, the state established a lottery. In this simple lottery, renowned economists Katherine Baicker (at Harvard) and Amy Finkelstein (at MIT) found a rare and promising natural experiment. For decades, evidence on the impacts of health insurance on health was dominated by observational studies, which offered inconclusive answers. Under the Oregon lottery, some individuals were randomly selected from a waiting list to receive insurance while others were not, enabling comparison between the two groups, and in effect creating a randomized experiment. The Oregon health experiment, as it came to be known, would finally give economists and policymakers rigorous evidence on how access to health insurance affected the provision and use of health care, and ultimately, influenced the health and well-being of the population. By 2016, as part of the Patient Protection and Affordable Care Act, an estimated 25 million Americans were set to obtain health insurance, 12 million under Medicaid alone; driving home the need to find conclusive answers to these longstanding questions. Case number 2019.0


Case Authors : Amitabh Chandra, Anjani Datla

Topic : Leadership & Managing People

Related Areas : Health, Market research, Personnel policies, Social enterprise, Social responsibility




Seven Elemental Tools of Negotiation that can be used in Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment solution


1. Satisfies everyone’s core interests (yours and theirs)


By interests, we do not mean the preconceived demands or positions that you or the other party may have, but rather the underlying needs, aims, fears, and concerns that shape what you want. Negotiation is more than getting what you want. It is not winning at all cost. Number of times Win-Win is better option that outright winning or getting what you want.





2. Is the best of many options

Options are the solutions you generate that could meet your and your counterpart’s interests . Often people come to negotiations with very fixed ideas and things they want to achieve. This strategy leaves unexplored options which might be even better than the one that one party wanted to achieve. So always try to provide as many options as possible during the negotiation process . The best outcome should be out of many options rather than few options.


3. Meets legitimate, fair standards

When soft bargainers meet hard bargainers there is always the danger of soft bargainers ceding more than what is necessary. To avoid this scenario you should always focus on legitimate standards or expectations, clearly understanding the arbitrage . Standards are often external and objective measures to assess the fairness such as rules and regulations, financial values & resources , market prices etc. If the negotiated agreement is going beyond the industry norms or established standards of fairness then it is prudent to get out of the negotiation.


4. Is better than your alternatives or BATNA

Every negotiators going into the negotiations should always work out the “what if” scenario. The negotiating parties in the “Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment” has three to four plausible scenarios. The negotiating protagonist needs to have clear idea of – what will happen if the negotiations fail. To put it in the negotiating literature – BATNA - Best Alternative to a Negotiated Agreement. If the negotiated agreement is not better than BATNA (Negotiations options), then there is no point in accepting the negotiated solution.


5. Is comprised of clear, realistic commitments

One of the biggest problems in implementing the negotiated agreements in corporate world is – the ambiguity in the negotiated agreement. Sometimes the negotiated agreements are not realistic or various parties interpret the outcomes based on their understanding of the situation. It is critical to do negotiations as water tight as possible so that there is less scope for ambiguity.


6. Is the result of effective communication?

Many negotiators make the mistake of focusing only on the substance of the negotiation (interests, options, standards, and so on). How you communicate about that substance, however, can make all the difference. The language you use and the way that you build understanding, jointly solve problems, and together determine the process of the negotiation with your counterpart make your negotiation more efficient, yield clear agreements that each party understands, and help you build better relationships.


7. Managing relationship with counterparty

Another critical factor in the success of your negotiation is how you manage your relationship with your counterpart and other people doing the mediation. According to “Amitabh Chandra, Anjani Datla”, the protagonist may want to establish a new connection or repair a damaged one; in any case, you want to build a strong working relationship built on mutual respect, well-established trust, and a side-by-side problem- solving approach.




Different types of negotiators – what is your style of negotiation

According to Harvard Business Review , there are three types of negotiators – Hard Bargainers, Soft Bargainers, and Principled Bargainers.

Hard Bargainers – These people see negotiations as an activity that they need to win. They are less focused less on the real objectives of the negotiations but more on winning. In the “Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment ”, do you think a hard bargaining strategy will deliver desired results? Hard bargainers are easy to negotiate with as they often have a very predictable strategy

Soft Bargainers – These people are focused on relationship rather than hard outcomes of the negotiations. It doesn’t mean they are pushovers. These negotiators often scribe to long term relationship rather than immediate bargain.

Principled Bargainers – As explained in the seven elemental tools of negotiations above, these negotiators are more concern about the standards and norms of fairness. They often have inclusive approach to negotiations and like to work on numerous solutions that can improve the BATNA of both parties.

Open lines of communication between parties in the case study “Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment” can make for an effective negotiation strategy and will make it easier to negotiate with this party the next time as well.





NPV Analysis of Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment



References & Further Readings

Amitabh Chandra, Anjani Datla (2018), "Expanding Health Insurance to Millions: Learning from the Oregon Health Insurance Experiment Harvard Business Review Case Study. Published by HBR Publications.


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