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- News (48)
- Research (104)
- Multimedia (6)
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- Article
Affording to Wait: Medicare Initiation and the Use of Health Care
By: Guy David, Philip Saynisch, Victoria Acevado-Perez and Mark D. Neuman
Delays in receipt of necessary diagnostic and therapeutic medical procedures related to the timing of Medicare initiation at age 65 years have potentially broad welfare implications. We use 2005–2007 data from Florida and North Carolina to estimate the effect of...
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Keywords:
Medicare;
Behavior;
Insurance;
Health Care and Treatment;
Insurance Industry;
Public Administration Industry;
Health Industry;
North Carolina;
Florida
David, Guy, Philip Saynisch, Victoria Acevado-Perez, and Mark D. Neuman. "Affording to Wait: Medicare Initiation and the Use of Health Care." Health Economics 21, no. 8 (August 2012): 1030–1036.
- November 2019
- Article
Many Medicare Beneficiaries with Serious Illness Report Financial Hardships Despite Coverage
By: Michael Anne Kyle, Robert J Blendon, John M Benson, Melinda K Abrams and Eric C Schneider
In a national survey, seriously ill Medicare beneficiaries described financial hardships resulting from their illness—despite high beneficiary satisfaction with Medicare overall and the fact that many have supplemental insurance. About half reported a serious problem...
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Kyle, Michael Anne, Robert J Blendon, John M Benson, Melinda K Abrams, and Eric C Schneider. "Many Medicare Beneficiaries with Serious Illness Report Financial Hardships Despite Coverage." Health Affairs 38, no. 11 (November 2019): 1801–1806.
- Article
Economic Principles for Medicare Reform
By: Amitabh Chandra and Craig Garthwaite
In this article, we develop an economic framework for Medicare reform that highlights trade-offs that reform proposals should grapple with but often ignore. Central to our argument is a tension in administratively set prices, which may improve short-term efficiency but...
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Keywords:
Medicare;
Value-based Care;
Health Care Reform;
Markets In Health Care;
Health Care and Treatment;
Value;
Governing Rules, Regulations, and Reforms
Chandra, Amitabh, and Craig Garthwaite. "Economic Principles for Medicare Reform." Annals of the American Academy of Political and Social Science 686, no. 1 (November 2019): 63 – 92.
- October 10, 2019
- Article
The Case for the Public Option Over Medicare for All
By: Regina E. Herzlinger and Richard Boxer
How can the United States better control its health care costs and quality and still achieve universal coverage? The strongest choice is not Medicare for All, which would eliminate private insurance; it’s the public option, which would allow people to choose from...
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Keywords:
Universal Health Coverage;
Public Option;
Medicare;
Health Care and Treatment;
Insurance;
Cost Management;
Quality;
United States
Herzlinger, Regina E., and Richard Boxer. "The Case for the Public Option Over Medicare for All." Harvard Business Review Digital Articles (October 10, 2019): 2–5.
- September 2022
- Article
Trends in Remote Patient Monitoring Use in Traditional Medicare
By: Mitchell Tang, Carter Nakamoto, Ariel Dora Stern and Ateev Mehrotra
Remote patient monitoring (RPM), the collection by patients of physiological measurements that are automatically sent to their health care practitioners, has been touted as a promising tool for improving chronic disease management. Interest in RPM has grown because of...
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Tang, Mitchell, Carter Nakamoto, Ariel Dora Stern, and Ateev Mehrotra. "Trends in Remote Patient Monitoring Use in Traditional Medicare." JAMA Internal Medicine 182, no. 9 (September 2022): 1005–1006.
- January 2, 2020
- Article
Medicare for All or Public Option: Can Either Heal Health Care?
By: Regina E. Herzlinger and James Wallace
The United States has serious health care problems: More than 27 million uninsured people, costs that are growing faster than income, and a staggering $37 trillion of unfunded liabilities in the Medicare program. Perhaps most alarming: The US ranks lowest among...
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Keywords:
Healthcare;
Public Option;
Medicare;
Health Care and Treatment;
Insurance;
Cost Management;
Problems and Challenges;
United States
Herzlinger, Regina E., and James Wallace. "Medicare for All or Public Option: Can Either Heal Health Care?" Harvard Business School Working Knowledge (January 2, 2020).
- Article
Spending Variation Among ACOs in the Medicare Shared Savings Program
By: Michael Anne Kyle, J. Michael McWilliams, Mary Beth Landrum, Bruce E. Landon, Paul Trompke, David J. Nyweide and Michael E. Chernew
OBJECTIVES: Understanding variation in spending across organizations, rather than across geographic areas, is important because care is delivered by organizations and interventions increasingly focus on organizations. Accountable care organizations (ACOs) are...
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Keywords:
Medicare;
Accountable Care Organizations;
ACOs;
Health Care and Treatment;
Spending;
Analysis
Kyle, Michael Anne, J. Michael McWilliams, Mary Beth Landrum, Bruce E. Landon, Paul Trompke, David J. Nyweide, and Michael E. Chernew. "Spending Variation Among ACOs in the Medicare Shared Savings Program." American Journal of Managed Care 26, no. 4 (April 2020): 170–175.
- July 2019
- Article
Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements
By: Derek A. Haas, Xiaoran Zhang, Robert S. Kaplan and Zirui Song
In 2016, the Centers for Medicare & Medicaid Services (CMS) launched its first mandatory bundled payment program, the Comprehensive Care for Joint Replacement (CJR) model, by randomizing metropolitan statistical areas (MSAs) into the payment model. The paper analyzed...
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Keywords:
Medicare;
Medicaid;
Bundled Payments;
Health Care and Treatment;
Cost Management;
Performance Evaluation;
Outcome or Result
Haas, Derek A., Xiaoran Zhang, Robert S. Kaplan, and Zirui Song. "Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements." JAMA Internal Medicine 179, no. 7 (July 2019): 924–931.
- January 2024
- Article
Cost of Exempting Sole Orphan Drugs from Medicare Negotiation
By: Matthew Vogel, Olivia Zhao, William B. Feldman, Amitabh Chandra, Aaron S. Kesselheim and Benjamin N. Rome
Importance: The Inflation Reduction Act (IRA) requires Medicare to negotiate prices for some high-spending drugs but exempts drugs approved solely for the treatment of a single rare disease.
Objective: To estimate Medicare spending and global... View Details
Objective: To estimate Medicare spending and global... View Details
Vogel, Matthew, Olivia Zhao, William B. Feldman, Amitabh Chandra, Aaron S. Kesselheim, and Benjamin N. Rome. "Cost of Exempting Sole Orphan Drugs from Medicare Negotiation." JAMA Internal Medicine 184, no. 1 (January 2024): 63–69.
- August 14, 2008
- Article
How Rehospitalizations Are Hurting Medicare
By: Robert C. Pozen
Pozen, Robert C. "How Rehospitalizations Are Hurting Medicare." Boston Globe (August 14, 2008).
- February 1993 (Revised August 1995)
- Case
Medicare Payment for Drugs and Medical Devices
Keywords:
Health Care and Treatment;
Business and Government Relations;
Medical Devices and Supplies Industry;
Health Industry;
Pharmaceutical Industry
Herzlinger, Regina E. "Medicare Payment for Drugs and Medical Devices." Harvard Business School Case 193-099, February 1993. (Revised August 1995.)
- March 2024
- Article
Medicare Price Negotiation and Pharmaceutical Innovation Following the Inflation Reduction Act
By: Matthew Vogel, Pragya Kakani, Amitabh Chandra and Rena M. Conti
The Inflation Reduction Act (IRA) requires Medicare to negotiate lower prices for some medicines with high Medicare spending. Using historical data from public and proprietary sources to apply the IRA's negotiation criteria retrospectively, we identify all drugs that...
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Keywords:
Policy;
Government Legislation;
Health Care and Treatment;
Negotiation;
Price;
Pharmaceutical Industry
Vogel, Matthew, Pragya Kakani, Amitabh Chandra, and Rena M. Conti. "Medicare Price Negotiation and Pharmaceutical Innovation Following the Inflation Reduction Act." Nature Biotechnology 42, no. 3 (March 2024): 406–412.
- 02 Jan 2020
- Op-Ed
Medicare for All or Public Option: Can Either Heal Health Care?
The United States has serious health care problems: More than 27 million uninsured people, costs that are growing faster than income, and a staggering $37 trillion of unfunded liabilities in the Medicare program. Perhaps most alarming:...
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- Article
Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System
By: Regina E. Herzlinger and Bacchus Barua
An analysis of Canada’s single-payer healthcare system shows the dangers of the proposed Medicare for All model. In fact, the Canadian healthcare system is costly and drives poor outcomes when compared to objective performance measures. Alternatively, the Swiss and...
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Keywords:
Healthcare Systems;
Universal Health Coverage;
Health Care and Treatment;
Insurance;
Canada;
Switzerland;
Netherlands
Herzlinger, Regina E., and Bacchus Barua. "Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System." Wall Street Journal (April 17, 2019).
- October 2012 (Revised October 2016)
- Case
Predilytics
By: Robert F. Higgins and Annelena Lobb
The management team at Predilytics, a healthcare analytics firm, must decide whether to accept a Series A venture capital financing deal. The company provided analytic services to healthcare plans, typically Medicare Advantage plans, in efforts to draw conclusions from...
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Keywords:
Analytics;
Healthcare;
Medicare;
Health Care and Treatment;
Mathematical Methods;
Health Industry;
New England;
United States
Higgins, Robert F., and Annelena Lobb. "Predilytics." Harvard Business School Case 813-023, October 2012. (Revised October 2016.)
- Article
Mandate Outcomes Reporting
By: Robert S. Kaplan and Michael E. Porter
Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to...
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Keywords:
Outcomes Reporting;
Outcomes Measurement;
Medicare;
Medicaid;
Health Care and Treatment;
Outcome or Result;
Measurement and Metrics
Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
- November 2023
- Article
Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients with Hypertension
By: Mitchell Tang, Carter Nakamoto, Ariel Dora Stern, Jose Zubizarreta, Felippe Marcondes, Lori Uscher-Pines, Lee Schwamm and Ateev Mehrotra
Background: Remote patient monitoring (RPM) is a promising tool for improving chronic disease management. Use of RPM for hypertension monitoring is growing rapidly, raising concerns about increased spending. However, the effects of RPM are still...
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Tang, Mitchell, Carter Nakamoto, Ariel Dora Stern, Jose Zubizarreta, Felippe Marcondes, Lori Uscher-Pines, Lee Schwamm, and Ateev Mehrotra. "Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients with Hypertension." Annals of Internal Medicine 176, no. 11 (November 2023): 1465–1475.
- March 2019
- Article
Evidence of Upcoding in Pay-for-Performance Programs
By: Hamsa Bastani, Joel Goh and Mohsen Bayati
Recent Medicare legislation seeks to improve patient care quality by financially penalizing providers for hospital-acquired infections (HAIs). However, Medicare cannot directly monitor HAI rates and instead relies on providers accurately self-reporting HAIs in claims...
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Keywords:
Medical Coding;
Health Policy;
Healthcare-acquired Conditions;
Medicare;
Health Care and Treatment;
Policy;
Performance Improvement;
Quality;
Measurement and Metrics;
Government Legislation
Bastani, Hamsa, Joel Goh, and Mohsen Bayati. "Evidence of Upcoding in Pay-for-Performance Programs." Management Science 65, no. 3 (March 2019): 1042–1060. (2015 INFORMS Health Applications Society best student (H. Bastani) paper award.)
- Fall 2008
- Article
Do Report Cards Tell Consumers Anything They Don’t Already Know? The Case of Medicare HMOs
By: Leemore S. Dafny and David Dranove
Dafny, Leemore S., and David Dranove. "Do Report Cards Tell Consumers Anything They Don’t Already Know? The Case of Medicare HMOs." RAND Journal of Economics 39, no. 3 (Fall 2008): 790–821.
- September 2022
- Article
Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities
By: Leemore Dafny, Christopher Ody and Teresa Rokos
The federal Anti-Kickback Statute prohibits biopharmaceutical manufacturers from directly covering Medicare enrollees’ out-of-pocket spending for the drugs they manufacture, but manufacturers may donate to independent patient assistance charities and earmark donations...
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Keywords:
Cost Sharing;
Prescription Drugs;
Drug Spending;
Medicare;
Dual Eligibility;
Cost;
Health Care and Treatment;
Philanthropy and Charitable Giving;
Pharmaceutical Industry
Dafny, Leemore, Christopher Ody, and Teresa Rokos. "Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities." Health Affairs 41, no. 9 (September 2022).