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- 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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- 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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- 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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- 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
- Working Paper
Diagnosing Quality: Learning, Amenities, and the Demand for Health Care
By: Achyuta Adhvaryu, Emilio Gutierrez, Anant Nyshadham and Jorge Tamayo
We study the role of amenities in increasing demand for underutilized healthcare services. We evaluate the offer of a high-amenity diagnostic consultation for cataracts with a randomized price and find that a lower price for the high-amenity consultation increases...
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- 2021
- Government Testimony
How Health Care Consolidation Is Contributing to Higher Prices and Spending, and Reforms That Could Bolster Antitrust Enforcement and Preserve and Promote Competition in Health Care Markets
By: Leemore S. Dafny
Reforms to antitrust law and enforcement can help to address rising healthcare prices and spending.
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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 2021 (Revised January 2022)
- Case
Philips: Redefining Telehealth
By: Regina E. Herzlinger, Alec Petersen, Natalie Kindred and Sara M. McKinley
As one of the world’s largest healthcare companies, Philips sought to reach beyond the walls of the hospital and expand its hospital-to-home program to gain future competitive advantage through technology solutions combining predictive analytics with care delivery. By...
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Keywords:
Health Care;
Philips;
Visicu;
Telemedicine;
eICU;
Accountable Care Organization;
ACO;
Bundled Payment;
Hospital To Home;
Patient Monitoring Devices;
Home Health Care;
Health Care and Treatment;
Communication Technology;
Quality;
Safety;
Performance Productivity;
Performance Capacity;
Performance Efficiency;
Consumer Behavior;
Emerging Markets;
Health Industry;
Telecommunications Industry;
Netherlands
- 2021
- Other Unpublished Work
As Healthcare Costs Escalate, A New George and Regi Herzlinger Industry Award Shines a Spotlight on Innovation Education
The winners of the first ever CAHME/George and Regi Herzlinger Innovation Education Award have just been announced. Regi Herzlinger explains why rewarding, supporting, and encouraging innovation education is so critical to solving the challenges of our industry.
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- January 2021
- Case
Value-Based Insurance Design at Onex
By: Joshua Schwartzstein, Amitabh Chandra and Amram Migdal
The operating executives of Health and Benefits for Onex Partners, Megan Jackson Frye and Sam Camens, faced a challenge: Healthcare costs for employees of Onex’s portfolio companies were continuing to rise above the consumer price index, reflecting broader trends...
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Keywords:
Decision Making;
Cost vs Benefits;
Decision Choices and Conditions;
Decisions;
Finance;
Behavioral Finance;
Insurance;
Health;
Health Care and Treatment;
Human Resources;
Compensation and Benefits;
Markets;
Demand and Consumers;
Consumer Behavior;
Social Psychology;
Behavior;
Interests;
Motivation and Incentives;
Perception;
Health Industry;
Insurance Industry;
North America;
United States
- November 2020 (Revised April 2021)
- Case
Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care
By: Trevor Fetter and Kira Seiger
This case describes the increasing investment by private equity (PE) firms in patient care and other healthcare services. The case focuses on investments in physician staffing firms and roll-up strategy investments in physician practice management (PPM). Included in...
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Keywords:
Business Ventures;
Acquisition;
Mergers and Acquisitions;
Business Model;
Change;
Disruption;
Fluctuation;
Trends;
Customers;
Customer Value and Value Chain;
Ethics;
Fairness;
Finance;
Equity;
Insurance;
Private Equity;
Geography;
Geographic Scope;
Health;
Health Care and Treatment;
Markets;
Demand and Consumers;
Supply and Industry;
Industry Structures;
Ownership;
Ownership Type;
Private Ownership;
Relationships;
Agency Theory;
Business and Community Relations;
Business and Shareholder Relations;
Business and Stakeholder Relations;
Networks;
Strategy;
Competition;
Consolidation;
Expansion;
Integration;
Horizontal Integration;
Vertical Integration;
Value;
Value Creation;
Health Industry;
Insurance Industry;
United States
- 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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- 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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- Article
A Public Option Can Be a Triple Win for U.S. Healthcare
By: Regina E. Herzlinger and Richard Boxer
The United States needs to control healthcare costs and quality while reaching universal coverage. The strongest choice is a public option that allows people to choose between Medicare and private payers. But a public option needs sustainable financing mechanisms that...
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- July 2019
- Article
The Impact of Price Regulation on the Availability of New Drugs in Germany
By: Ariel Dora Stern, Felicitas Pietrulla, Annika Herr, Aaron S. Kesselheim and Ameet Sarpatwari
The 2011 German Pharmaceutical Market Restructuring Act (“AMNOG”) subjected branded, non-rare disease drugs to price regulation based on an assessment of their clinical benefit. Assessment outcomes range from “major added benefit” to “less benefit than the appropriate...
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- September 2018
- Article
Discretionary Task Ordering: Queue Management in Radiological Services
By: Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats
Work-scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks...
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Keywords:
Discretion;
Scheduling;
Queue;
Healthcare;
Learning;
Experience;
Decentralization;
Operations;
Service Operations;
Service Delivery;
Performance;
Performance Effectiveness;
Performance Efficiency;
Performance Improvement;
Performance Productivity;
Decisions;
Time Management;
Cost vs Benefits;
Health Industry
- February 2018
- Case
Health Savings Accounts: Enabling Consumer Participation
By: Regina E. Herzlinger and James Wallace
Health savings accounts (HSAs), a creation of the 2003 Medicare Modernization Act, had become an integral part of the drive toward consumer-driven health care. Coupled with high-deductible health plans, HSAs allowed consumers to directly control a significant part of...
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- January 2018 (Revised June 2018)
- Case
Medtronic: Navigating a Shifting Healthcare Landscape
By: Robert S. Kaplan, Michael E. Porter, Thomas W. Feeley and Alee Hernandez
Medtronic is adapting its strategy to changes in healthcare competition and payments. It has decided to develop new relationships with payers, hospitals, and physicians to become more accountable for patient outcomes and total costs. The case describes new forms of...
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- September 2017 (Revised December 2017)
- Case
Intermountain Healthcare: Pursuing Precision Medicine
By: Richard G. Hamermesh, Kathy E. Giusti, Robert S. Huckman and Julia Kelley
Headquartered in Salt Lake City, Intermountain Healthcare operates 23 hospitals and hundreds of clinics in Utah and Idaho and provides insurance to approximately 850,000 patients through its insurance arm, SelectHealth. In 2013, Intermountain, known for its commitment...
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