This case study describes the situation faced by Bernal Aragón, the Director General of Hospital Clínica Bíblica (HCB), a Costa Rican hospital listed among the top hospitals in Latin America. The protagonist must define the strategy of the hospital, and choose among three principle growth paths: consolidate current operations, acquire new technology, or expand geographically. The case study is based on primary research conducted in conjunction with the company, including interviews with senior management and an abundant review of documents. This case study describes the trends in the social, economic, political, and technological environment of Costa Rica in 2013 and explains the intricacies of the public and private health care system in Costa Rica, emphasizing the strategic positioning of the leading private hospitals. The document also describes the possible impact of the United States' Patient Protection and Affordable Care Act (PPACA) on the hospital and insurance industry in the US and its influence on the medical tourism industry. This case study was written to be used in an MBA or Executive MBA Business Strategy course with a focus on strategic positioning.

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Brenes, E, Martínez, C., Pichardo, C., & (2016). Hospital Clínica Bíblica in 2013. Journal of Business Research, 69(9), 3839–3847. doi:10.1016/j.jbusres.2015.11.016