ConQuest Battleground | IIM Shillong| Rural RPM Profitability Strategy

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1. About the Case Competition

Battleground 2025 is IIM Shillong’s flagship case study competition, known for its sharp operational and strategy problems across healthcare, fintech, and social impact domains. Team Strategix from IIM Rohtak, secured 2nd runners-up, competing against top B-school teams on a healthtech unit economics problem that demanded both financial rigour and ground-level empathy for rural India’s healthcare realities.

2. Problem Statement Overview

Medi-Connect, a rural remote patient monitoring (RPM) startup, is haemorrhaging on unit economics. Its current contribution margin stands at –$4 per user, driven by three compounding failures: hardware over-distribution with high RTO rates and kit breakage, doctor inefficiency from long unstructured consults and absent triage protocols, and a high CAC of $60 driven by costly digital ads that fail to build trust in rural markets. Month-1 churn is spiking because hardware is sent before users are engaged, and the absence of community-based delivery means the product arrives without the human context rural users need to adopt it. The business has strong underlying potential, chronic care monetisation, a large underserved TAM, but its cost structure makes scale actively destructive unless fixed at the unit level first.

3. What This Winning Deck Covers

The deck opens with a tight root cause analysis mapping three failure clusters, hardware logistics, doctor inefficiency, and trust deficit, and their downstream effects on CAC, churn, and contribution margin. Each cluster is traced to specific operational levers rather than surface symptoms, giving the diagnosis real consulting credibility.

The hardware strategy is restructured into three tiers: a Full RPM Kit for high-need chronic users only, a Lite Vitals Kit (3–5x cheaper) for general primary care users, and an On-Demand Kit sent only after Month 1 engagement is confirmed. The 1st-Month RPM Deferral is the deck’s sharpest micro-intervention, users subscribe without receiving hardware, AI triage and nurse follow-ups handle Month 1, and kits are dispatched only to users who demonstrate active engagement. This alone saves 30–40% of annual hardware cost and eliminates the single largest driver of early churn. The unit economics and hardware segmentation thinking here parallels the approach in Battleground: A Case Study Competition By IIM Shillong.

The community delivery model leverages ASHA workers as the trust and distribution layer — one shared RPM kit per ASHA worker serves 80–150 families, weekly “Vitals Day” camps screen 20–50 people in two hours, and micro-incentives make ASHA workers active acquisition partners. This ASHA-led model cuts CAC from $60 to $30–35 while simultaneously solving the trust deficit that digital-first acquisition cannot address in Bharat. The doctor efficiency lever uses AI protocols and mid-level providers to reduce doctor costs by $2.5–3.5 per user while pushing utilisation above 90%.

The deck closes with a board-level message framing the combined effect: contribution margin moves from –$4 to +$3, with a clear path to +$5–$7 CM within a year as CAC reduction and chronic-care monetisation compound.

Key Takeaways:

  • Hardware deferral in Month 1 is the single highest-ROI intervention in rural RPM, it eliminates churn-driven cost leakage before it starts
  • ASHA workers are not just a distribution channel, they are the trust infrastructure that makes rural healthtech adoption possible
  • Tiered hardware segmentation based on clinical need is more economically sound than blanket kit distribution
  • Contribution margin turnaround requires pulling three levers simultaneously- hardware, doctor cost, and CAC, not just one
  • Rural healthtech unit economics must account for behavioural adoption curves, not just financial cost structures

4. The Numbers

Current unit economics show ARPU at $30, COGS at $34, and contribution margin at –$4 per user. Post-intervention, COGS drops to $28, turning contribution margin positive at +$1.2, with a projected path to +$5–$7 CM within 12 months. Doctor cost reductions contribute –$2.5 to –$3.5 per user; hardware optimisation delivers –$2 to –$4; CAC falls from $60 to $30–35. One ASHA-led kit serves 80–150 families; weekly vitals camps enrol 500+ villagers per cycle.

5. Who Should Study This Deck

This deck is essential for students preparing for healthtech, operations, and unit economics case competitions, particularly those targeting IIM Shillong, IIM Calcutta, or any competition involving social impact business models with P&L pressure. MBA students interested in rural market strategy, healthtech startups, or consulting for impact-stage companies will find the three-lever unit economics framework and ASHA delivery model directly reusable. Students preparing for Battleground or similar case formats will benefit from studying how the deck moves cleanly from root cause to financial turnaround in a compact slide structure. Explore more winning healthtech and unit economics decks at CaseBuzz.

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