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- 2023
- Article
Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital
By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk
The COVID-19 pandemic raised awareness of the need to better understand where and how patient-level costs are incurred in health care organizations. This study used time-driven activity-based costing to estimate COVID-19 patient-level hospital costs in a Brazilian...
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Cardoso, Ricardo Bertoglio, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges, and Carisi Anne Polanczyk. "Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital." BMC Health Services Research 23, no. 198 (2023).
- December 2022
- Article
Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition
By: Anna Paula Beck da Silva Etges, Richard D. Urman, Anne Geubelle, Robert Kaplan and Carisi Anne Polanczyk
This communication announces the International Cost Standard Set Program. Its goal is to establish global standardized frameworks for measuring the costs of treating specific clinical conditions. A scientific committee, including 16 international healthcare cost...
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Keywords:
Time-Driven Activity-Based Costing;
Value-based Health Care;
Cost;
Health Care and Treatment;
Activity Based Costing and Management;
Health Industry
da Silva Etges, Anna Paula Beck, Richard D. Urman, Anne Geubelle, Robert Kaplan, and Carisi Anne Polanczyk. "Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition." Journal of Comparative Effectiveness Research 11, no. 17 (December 2022): 1219–1223.
- June 2022
- Article
A New Initiative to Track HIV Resource Allocation and Costs
By: Ryan McBain, AK Nandakumar, Michael Ruffner, Carlyn Mann, Mai Hijazi, Susanna Baker, Linden Morrison, Kalipso Chalkidou, Shufang Zhang, Iris Semini, Fern Terris-Prestholt, Steven Forsythe, Sarah Byakika, Joshua Musinguzi and Robert S. Kaplan
In early 2020, several global health institutions – including the Global Fund to Fight AIDS, Tuberculosis and Malaria; Joint United Nations Program on HIV/AIDS (UNAIDS); United States Agency for International Development; and Office of the Global AIDS Coordinator at...
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Keywords:
Activity Based Costing;
HIV;
Cost;
Health Care;
Healthcare;
Health Care and Treatment;
Activity Based Costing and Management;
Resource Allocation;
Health Industry;
Africa
McBain, Ryan, AK Nandakumar, Michael Ruffner, Carlyn Mann, Mai Hijazi, Susanna Baker, Linden Morrison, Kalipso Chalkidou, Shufang Zhang, Iris Semini, Fern Terris-Prestholt, Steven Forsythe, Sarah Byakika, Joshua Musinguzi, and Robert S. Kaplan. "A New Initiative to Track HIV Resource Allocation and Costs." Bulletin of the World Health Organization 100, no. 6 (June 2022): 358–358A.
- October 2022
- Article
It’s Not Just the Prices: Time-Driven Activity-Based Costing for Initiation of Veno-Venous Extracorporeal Membrane Oxygenation at Three International Sites—A Case Review
By: Michael Nurok, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes and Robert S. Kaplan
The United States spends more for intensive care units (ICUs) than do other high-income countries. We used time-driven activity-based costing (TDABC) to analyze ICU costs for initiation of extracorporeal membrane oxygenation (ECMO) for respiratory failure to estimate...
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Keywords:
Healthcare;
Cost;
Time-Driven ABC;
Health Care and Treatment;
Cost Management;
Activity Based Costing and Management;
Health Industry
Nurok, Michael, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes, and Robert S. Kaplan. "It’s Not Just the Prices: Time-Driven Activity-Based Costing for Initiation of Veno-Venous Extracorporeal Membrane Oxygenation at Three International Sites—A Case Review." Anesthesia & Analgesia 135, no. 4 (October 2022): 711–718.
- September 2022
- Article
Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia
By: Chen Wei, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak and Paul C. Zei
Cardiac SBRT is a novel way of treating refractory ventricular tachycardia (VT) that may be less costly than catheter ablation, owing to its noninvasive, outpatient nature. We applied time-driven activity-based costing to both procedures. The direct and total...
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Wei, Chen, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak, and Paul C. Zei. "Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia." Pacing and Clinical Electrophysiology 45, no. 9 (September 2022): 1005–1179.
- July, 2022
- Article
Telehealth Visits After Shoulder Surgery: Higher Patient Satisfaction and Lower Costs
By: Evan A. O'Donnell, Jillian E. Haberli, Andres Muniz Martinez, Daniel Yagoda, Robert S. Kaplan and Jon J.P. Warner
Purpose and Methods: The study compared the cost of telemedicine visits with in-person clinic visits for routine follow-up after common shoulder surgeries. It also evaluated the safety and patient experience with telemedicine visits. Time-driven activity-based costing...
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Keywords:
Telehealth;
Patient Satisfaction;
Health Care and Treatment;
Communication Technology;
Health Industry
O'Donnell, Evan A., Jillian E. Haberli, Andres Muniz Martinez, Daniel Yagoda, Robert S. Kaplan, and Jon J.P. Warner. "Telehealth Visits After Shoulder Surgery: Higher Patient Satisfaction and Lower Costs." Journal of the American Academy of Orthopedic Surgeons Global Research and Reviews 6, no. 7 (July, 2022).
- May 2022
- Article
Variance Analysis: New Insights from Health Care Applications
By: Robert S. Kaplan and Susanna Gallani
We use a health care application to illustrate how variance analysis can be used to benchmark costs across similar service delivery sites. Variances for personnel costs, typically the largest cost component in service organizations, are calculated for price, quantity,...
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Keywords:
Variance Analysis;
Benchmarking;
Time-Driven Activity-Based Costing;
Health Care;
Activity Based Costing and Management;
Health Care and Treatment;
Service Delivery;
Service Industry
Kaplan, Robert S., and Susanna Gallani. "Variance Analysis: New Insights from Health Care Applications." Issues in Accounting Education 37, no. 2 (May 2022): 27–36.
- February 8, 2022
- Article
Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions
By: Alan Yang, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson and Robert S. Kaplan
In 2017, patients made 145 million visits to emergency departments (EDs), generating $76.3 billion in charges. About a third of ED visits, however, were for conditions that were treatable in lower-resourced settings. We used time-driven activity-based costing (TDABC)...
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Keywords:
Time-Driven ABC;
Health Care Costs;
Activity Based Costing and Management;
Health Care and Treatment
Yang, Alan, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson, and Robert S. Kaplan. "Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions." NEJM Catalyst (February 8, 2022).
- Article
Costs Without Value When Treating Pediatric Behavioral Patients in the ED
By: Marcella Jewell, Syed S. Shehab, Robert S. Kaplan, Jack Fanton and Joeli Hettler
Pediatric Emergency Department (ED) visits have greatly increased in recent years. An academic pediatric ED that annually treats about 1,000 behavioral health patients conducted a study to assess the true cost of caring for nonacute behavioral health patients. It...
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Jewell, Marcella, Syed S. Shehab, Robert S. Kaplan, Jack Fanton, and Joeli Hettler. "Costs Without Value When Treating Pediatric Behavioral Patients in the ED." NEJM Catalyst Innovations in Care Delivery 3, no. 2 (February 2022).
- 2022
- Article
Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing
By: Nikhil G. Thaker, Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley and Steven J. Frank
Integrated quality improvement (QI) and cost reduction strategies can help increase value in cancer care. We applied standard QI and TDABC methods to improve workflow efficiency and reduce costs for MRI-guided prostate brachytherapy. We constructed process maps,...
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Keywords:
Brachytherapy;
Quality Improvement;
Prostate;
Time-Driven Activity-Based Costing;
Cost Accounting;
Health Care and Treatment;
Performance Efficiency;
Health Industry
Thaker, Nikhil G., Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley, and Steven J. Frank. "Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing." Brachytherapy 21, no. 1 (2022): 49–54.
- Article
Time-Driven Activity-Based Costing in Breast Cancer Care Delivery
By: Navraj S. Nagra, Elena Tsangaris, Jessica Means, Michael J. Hassett, Laura S. Dominici, Jennifer R. Bellon, Justin Broyles, Robert S. Kaplan, Thomas W. Feeley and Andrea L. Pusic
We used time-driven activity-based costing (TDABC) to calculate the complete cost of breast cancer care—initial treatment planning, chemotherapy, radiation therapy, surgical resection and reconstruction, and ancillary services (psychosocial oncology, physical therapy....
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Nagra, Navraj S., Elena Tsangaris, Jessica Means, Michael J. Hassett, Laura S. Dominici, Jennifer R. Bellon, Justin Broyles, Robert S. Kaplan, Thomas W. Feeley, and Andrea L. Pusic. "Time-Driven Activity-Based Costing in Breast Cancer Care Delivery." Annals of Surgical Oncology 29, no. 1 (January 2022): 510–521.
- November–December 2021
- Article
Successfully Implementing TDABC in Health-Care Provider Organizations
By: Susanna Gallani and Gregory Sabin
This article describes some of the common obstacles that challenge the success of TDABC implementation in health-care provider organizations and suggests potential remedies and preventive measures.
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Keywords:
Time-Driven Activity-Based Costing;
Implementation;
Health Care and Treatment;
Activity Based Costing and Management
Gallani, Susanna, and Gregory Sabin. "Successfully Implementing TDABC in Health-Care Provider Organizations." Cost Management 35, no. 6 (November–December 2021): 29–33. (Commissioned Article.)
- November 2021
- Article
Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing
By: Tyler R. McClintock, David F. Friedlander, Aiden Y. Feng, Mahek A. Shah, Daniel J. Pallin, Steven L. Chang, Angela M. Bader, Thomas W. Feeley, Robert S. Kaplan and George E. Haleblian
Objective. To characterize full cycle of care costs for managing an acute ureteral stone using time-driven activity-based costing.
Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
Keywords:
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Cost;
Activity Based Costing and Management
McClintock, Tyler R., David F. Friedlander, Aiden Y. Feng, Mahek A. Shah, Daniel J. Pallin, Steven L. Chang, Angela M. Bader, Thomas W. Feeley, Robert S. Kaplan, and George E. Haleblian. "Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing." Urology 157 (November 2021): 107–113.
- Article
A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal
By: Jiayin Xue, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg and Kevin Schulman
U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital...
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Keywords:
Time-Driven Activity-Based Costing;
Cost Accounting;
Health Care and Treatment;
Health Industry;
India;
Nepal;
United States
Xue, Jiayin, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg, and Kevin Schulman. "A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal." NEJM Catalyst Innovations in Care Delivery 2, no. 9 (September 2021).
- 2021
- Working Paper
How to Fix ESG Reporting
By: Robert S. Kaplan and Karthik Ramanna
Investors, advocacy groups, academics, and the 200 CEOs of the US Business Roundtable have asked corporations to take on an added purpose beyond a narrow pursuit of shareholder value. In response, many companies now issue ESG (Environmental, Societal, and Governance)...
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Keywords:
ESG Reporting;
Sustainability;
Corporate Purpose;
Greenhouse Gas;
Activity-Based Costing;
Environmental Sustainability;
Environmental Management;
Corporate Social Responsibility and Impact;
Measurement and Metrics;
Goals and Objectives;
Agreements and Arrangements;
Corporate Accountability
Kaplan, Robert S., and Karthik Ramanna. "How to Fix ESG Reporting." Harvard Business School Working Paper, No. 22-005, July 2021.
- July 2021 (Revised July 2022)
- Case
Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care
By: Robert S. Kaplan, Navraj S. Nagra and Syed S. Shehab
Dr. Andrea Pusic, breast cancer reconstruction surgeon, wants to extend outcomes measurement beyond traditional surgical metrics of infections, complications, and survival rates. The case describes her development of a new mobile phone app, which collects patients’...
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Keywords:
Health Care and Treatment;
Outcome or Result;
Cost Management;
Activity Based Costing and Management;
Mobile and Wireless Technology;
Health Testing and Trials;
Surveys;
Health Industry;
Boston
Kaplan, Robert S., Navraj S. Nagra, and Syed S. Shehab. "Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care." Harvard Business School Case 122-010, July 2021. (Revised July 2022.)
- May 2021
- Article
Value-Based Healthcare in Urology: A Collaborative Review
By: Chanan Reitblat, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh and Boris Gershman
Context:
In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and... View Details
In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and... View Details
Keywords:
Value-based Healthcare;
Integrated Practice Units;
Outcome Measurement;
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Value;
Cost Management;
Strategy;
Outcome or Result;
Measurement and Metrics
Reitblat, Chanan, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh, and Boris Gershman. "Value-Based Healthcare in Urology: A Collaborative Review." European Urology 79, no. 5 (May 2021): 571–585.
- Article
A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018
By: J. Chirenda, B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison and R. S. Kaplan
Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and...
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Keywords:
Time-Driven Activity-Based Costing;
Provider Cost;
Health Care and Treatment;
Cost Management;
Activity Based Costing and Management;
Zimbabwe
Chirenda, J., B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison, and R. S. Kaplan. "A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018." BMC Health Services Research 21, no. 242 (2021).
- Article
Assessing the Value of Pediatric Aerodigestive Care
By: Robert S. Kaplan, Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher and Evan Propst
Leaders at six hospitals conducted a research study to assess and compare the health outcomes and costs of pediatric aerodigestive care. Four of the hospitals delivered care with an integrated practice unit (IPU) while two delivered care traditionally, with isolated...
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Keywords:
Time-Driven Activity-Based Costing;
Value-based Health Care;
Integrated Practice Unit;
Health Care and Treatment;
Cost Management;
Performance Improvement
Kaplan, Robert S., Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher, and Evan Propst. "Assessing the Value of Pediatric Aerodigestive Care." NEJM Catalyst Innovations in Care Delivery 1, no. 4 (July–August 2020).
- Article
Quantifying the Benefits from a Care Coordination Program for Tracheostomy Placement in Neonates
By: Christen Caloway, Alisa Yamasaki, Kevin M. Callans, Mahek Shah, Robert S. Kaplan and Christopher Hartnick
Value-based care models are becoming instrumental in structuring clinical care delivery in our healthcare climate. Our objective was to determine the value associated with implementation of a Family-Centered Care Coordination (FCCC) program for neonates undergoing...
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Keywords:
Family-centered Care;
Value-based Healthcare;
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Value;
Activity Based Costing and Management
Caloway, Christen, Alisa Yamasaki, Kevin M. Callans, Mahek Shah, Robert S. Kaplan, and Christopher Hartnick. "Quantifying the Benefits from a Care Coordination Program for Tracheostomy Placement in Neonates." International Journal of Pediatric Otorhinolaryngology 134 (July 2020).