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- March 31, 2022
- Article
Two Approaches to Capping Health Care Prices
By: Michael E. Chernew, Maximilian J. Pany and Leemore S. Dafny
High health care prices for the privately-insured contribute to high premiums, which put downward pressure on wages, and induce employers to reduce benefit generosity and charge employees more for coverage. As the average annual premium for family coverage currently...
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- February 24, 2022
- Article
Want to Prevent the Next Hospital Bed Crisis? Enlist the SEC
By: Regina E. Herzlinger and Richard Boxer
During the initial phases of the COVID-19 pandemic, many U.S. hospitals could not provide enough beds to meet demand. Solving the problem of inadequate capacity is of utmost importance in the “new normal,” which requires recognizing the ongoing need for hospital-based...
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- February 18, 2022
- Article
Transparency as a Solution for COVID-19 Related Hospital Capacity Issues
By: Regina E. Herzlinger and Richard Boxer
In the initial phases of the COVID-19 pandemic, many U.S. hospitals could not provide an adequate supply of beds to meet demand. Solving the problem of hospital bed capacity is of great importance in the “new normal,” which requires recognizing that SARS-CoV-2 is but...
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Keywords:
COVID;
COVID-19 Pandemic;
Health Care;
Health Care Demand;
Health Care Delivery;
Health Care Industry;
Health Care Operations;
Health Care Policy;
Transparency;
Hospital;
Hospital Management;
Hospitals;
Health Pandemics;
Health Care and Treatment;
Service Delivery;
Operations;
Performance Capacity;
Policy;
Health Industry
- 2022
- Working Paper
How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?
By: Leemore S. Dafny, Kate Ho and Edward Kong
Drug copayment coupons to reduce patient cost-sharing have become nearly ubiquitous for high-priced brand-name prescription drugs. Medicare bans such coupons on the grounds that they are kickbacks that induce utilization, but they are commonly used by...
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- 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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- January–February 2022
- Article
Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board
By: Robert S. Kaplan, Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman and Michael-Anne Browne
The U.S. Military Health System spends about $50 billion annually through its TRICARE health plans to provide care to 9.6 million active duty service members, retirees, and their families. TRICARE, historically, has used the predominant U.S. fee-for-service payment...
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- 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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- 2021
- Working Paper
The Anatomy of a Hospital System Merger: The Patient Did Not Respond Well to Treatment
By: Martin Gaynor, Adam Sacarny, Raffaella Sadun, Chad Syverson and Shruthi Venkatesh
There is an ongoing merger wave in the U.S. hospital industry, but it remains an open question how hospital mergers change, or fail to change, hospital behavior, performance, and outcomes. In this research, we open the “black box” of practices within hospitals in the...
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- October 2021 (Revised February 2022)
- Case
Hospital 57357: Aligning Performance Towards a Vision of a Cancer-Free Childhood
By: Susanna Gallani and Youssef Abdel Aal
The case follows the Children Cancer Hospital in Egypt, also known as Hospital 57357, as it goes through the roll-out of a new performance management system, which Dr. Sherif Abouel Naga, founder and CEO of the hospital, had championed. This was a critical juncture as...
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- Article
Health Equity, Schooling Hesitancy, and the Social Determinants of Learning
By: Meira Levinson, Alan C. Geller, Joseph G. Allen and John D. Macomber
At least 62 million K-12 students in North America—disproportionately low-income children of color— have been physically out of school for over a year due to the COVID-19 pandemic. These children are at risk of significant academic, social, mental, and physical harm...
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- 2021
- Working Paper
Fecal Microbiota Transplants (FMT): Case Histories of Significant Medical Advances
By: Amar Bhide and Srikant M. Datar
By 2013, after many decades of very slow development and adoption, Fecal Microbiota Transplantation procedures were attracting widespread attention. This case history chronicles the: 1) pioneering fecal transplants performed in the 20th century; 2) development of the...
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- June 10, 2021
- Article
Preparing Hospitals for the Next Pandemic
By: Regina E. Herzlinger and Barak D. Richman
The COVID-19 epidemic response has shown that the U.S. is blessed with heroic physicians and other health care providers, researchers, and facilities. But it has also revealed a health care system that was woefully unprepared for the surge of pandemic patients. In the...
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- Article
The Covid-19 Pandemic Should Not Delay Actions to Prevent Anticompetitive Consolidation in U.S. Health Care Markets
By: Leemore S. Dafny
This article describes potential regulatory and legislative reforms to assist antitrust enforcement agencies in halting anticompetitive acquisitions and practices, and preserving and promoting competition in health care markets.
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- Article
Biosimilars and Follow-On Products in the United States: Adoption, Prices, and Users
By: Ariel Dora Stern, Jacqueline L. Chen, Melissa Ouellet, Mark R. Trusheim, Zeid El-Kilani, Amber Jessup and Ernst R. Berndt
Biologic drugs account for a disproportionate share of the increase in pharmaceutical spending in the U.S. and worldwide. Against this backdrop, many look to the expanding market for biosimilars—follow-on products to biologic drugs—as a vehicle for controlling...
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- 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
- 2021
- Book
Global Goliaths: Multinational Corporations in the 21st Century Economy
By: C. Fritz Foley, James R. Hines Jr. and David Wessel
Globalization and multinational corporations have long seemed partners in the enterprise of economic growth: globalization-led prosperity was the goal, and giant corporations spanning the globe would help achieve it. In recent years, however, the notion that all...
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- Article
Ten Year Sunset Rule for Healthcare Regulation Is a Nonstarter and Discouragement to Post-COVID-19 Investment
By: Regina E. Herzlinger and Eugene Schneller
U.S. healthcare delivery has not benefitted from the same productivity growth as many other service industries, such as bricks and mortar retailing, a loss that has gravely diminished cost control and access. Regulatory capture, which creates barriers to venture...
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- March 2020
- Case
The Trouble with TCE
By: Vincent Pons, Rafael Di Tella and Galit Goldstein
Trichloroethylene, or TCE, was a chemical used by tens of thousands of businesses in the United States. It was an affordable tool for many. Yet, TCE had been associated with important health risks, including cancer and autoimmune disease. TCE potentially posed other...
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- March 2021
- Article
Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care
Scope-of-practice regulations, including prescribing limits and supervision requirements, may influence the propensity of providers to form care teams. Therefore, policy makers need to understand the effect of both team-based care and provider type on clinical...
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- February 2021
- Article
Assessment of Electronic Health Record Use Between U.S. and Non-U.S. Health Systems
By: A Jay Holmgren, Lance Downing, David W. Bates, Tait D. Shanafelt, Arnold Milstein, Christopher Sharp, David Cutler, Robert S. Huckman and Kevin A. Schulman
Importance: Understanding how the electronic health record (EHR) system changes clinician work, productivity, and well-being is critical. Little is known regarding global variation in patterns of use.
Objective: To provide insights into which EHR... View Details
Objective: To provide insights into which EHR... View Details