Competing Against Luck: The Story of Innovation and Customer Choice

by Clayton M. Christensen

In 2009 I teamed with another of my terrific former students, Jason Hwang (now cofounder and chief medical officer of Icebreaker Health), to write The Innovator’s Prescription5—a book to explore why the cost of our health care system increases at an unsustainable rate, even as accessibility declines. Again, a key for unlocking this dilemma has been the Jobs to Be Done Theory. For example, the job of most people is that they want to be so healthy that they don’t even have to think about health. Yet, in systems where the providers of care are reimbursed for services they provide, they actually make money when the members of their system get sick—it’s effectively “sick care” rather than “health care.” When the members are healthy, the providers make little. In other words, the Jobs to Be Done of members and providers are not aligned in the US health care system. At some health care providers, such as Intermountain Healthcare, Kaiser Permanente, and Geisinger Health System, managers are aggressively working to align the jobs of providers and the consumers in their care. One of the most important ways they do this is by assuming responsibility for the cost of care—by insuring consumers, for instance. The organizations’ financial sustainability therefore depends on keeping consumers as healthy as possible over the course of their relationship with providers; and this dependency enables jobs-focused innovation around disease prevention, and care efficiency and effectiveness, to f...