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  • All HBS Web  (332)
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    • All HBS Web  (332)
      • Faculty Publications  (59)

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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)...  View Details
      Keywords: Time-Driven ABC; Health Care Costs; Activity Based Costing and Management; Health Care and Treatment
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      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...  View Details
      Keywords: Costs; Value; Healthcare; Health Care and Treatment; Cost Management
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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).
      • 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...  View Details
      Keywords: Military Health System; Value-based Healthcare; Health Care and Treatment; United States
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      Kaplan, Robert S., Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman, and Michael-Anne Browne. "Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board." Military Medicine 187, nos. 1-2 (January–February 2022): 12–16.
      • 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....  View Details
      Keywords: Healthcare; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost
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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.
      • 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
      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
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      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.
      • 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...  View Details
      Keywords: Health Care Demand; Amenities; Health Care Quality; Cataracts; Surgery; Health Care and Treatment; Demand and Consumers; Quality; Learning; Mexico
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      Adhvaryu, Achyuta, Emilio Gutierrez, Anant Nyshadham, and Jorge Tamayo. "Diagnosing Quality: Learning, Amenities, and the Demand for Health Care." Harvard Business School Working Paper, No. 21-110, March 2021.
      • 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.  View Details
      Keywords: Antitrust Law; Health Care and Treatment; Consolidation; Price; Spending; Cost Management; Governing Rules, Regulations, and Reforms; Competition; United States
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      Dafny, Leemore S. "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." Government Testimony, Washington, DC, United States, April 2021.
      • 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...  View Details
      Keywords: Health Care; COVID-19; Regulation; Health Care and Treatment; Health Pandemics; Governing Rules, Regulations, and Reforms; Investment
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      Herzlinger, Regina E., and Eugene Schneller. "Ten Year Sunset Rule for Healthcare Regulation Is a Nonstarter and Discouragement to Post-COVID-19 Investment." Journal of Health Care Finance 47, no. 4 (Spring 2021). (Special Commentary.)
      • 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...  View Details
      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
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      Herzlinger, Regina E., Alec Petersen, Natalie Kindred, and Sara M. McKinley. "Philips: Redefining Telehealth." Harvard Business School Case 321-135, March 2021. (Revised January 2022.) (As companion reading for this case, see: Regina E. Herzlinger and Charles Huang. "Note on Bundled Payment in Health Care," HBS Background Note 312-032.)
      • 2021
      • Other Unpublished Work

      As Healthcare Costs Escalate, A New George and Regi Herzlinger Industry Award Shines a Spotlight on Innovation Education

      By: Regina E. Herzlinger
      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.  View Details
      Keywords: Health Care and Treatment; Management; Innovation and Invention; Education
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      "As Healthcare Costs Escalate, A New George and Regi Herzlinger Industry Award Shines a Spotlight on Innovation Education." Commission on Accreditation of Healthcare Management Education (CAHME), March 2021.
      • 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...  View Details
      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
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      Schwartzstein, Joshua, Amitabh Chandra, and Amram Migdal. "Value-Based Insurance Design at Onex." Harvard Business School Case 921-023, January 2021.
      • 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...  View Details
      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
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      Fetter, Trevor, and Kira Seiger. "Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care." Harvard Business School Case 321-049, November 2020. (Revised April 2021.)
      • 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...  View Details
      Keywords: Family-centered Care; Value-based Healthcare; Time-Driven Activity-Based Costing; Health Care and Treatment; Value; Activity Based Costing and Management
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      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).
      • 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...  View Details
      Keywords: Healthcare; Public Option; Medicare; Health Care and Treatment; Insurance; Cost Management; Problems and Challenges; United States
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      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

      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...  View Details
      Keywords: Healthcare; Public Option; Universal Health Coverage; Health Care and Treatment; Cost Management; Quality; United States
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      Herzlinger, Regina E., and Richard Boxer. "A Public Option Can Be a Triple Win for U.S. Healthcare." Health Management, Policy and Innovation 4, no. 3 (December 2019).
      • 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...  View Details
      Keywords: Regulation; Pharmaceuticals; Healthcare; Health Care and Treatment; Price; Governing Rules, Regulations, and Reforms; Pharmaceutical Industry; Germany
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      Stern, Ariel Dora, Felicitas Pietrulla, Annika Herr, Aaron S. Kesselheim, and Ameet Sarpatwari. "The Impact of Price Regulation on the Availability of New Drugs in Germany." Health Affairs 38, no. 7 (July 2019): 1182–1187.
      • 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...  View Details
      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
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      Ibanez, Maria, Jonathan R. Clark, Robert S. Huckman, and Bradley R. Staats. "Discretionary Task Ordering: Queue Management in Radiological Services." Management Science 64, no. 9 (September 2018): 4389–4407. (Working paper available here. Winner of the 2017 Best Paper Competition of the POMS College of Healthcare Operations Management. Featured in Forbes, Quartz, and Inc.)
      • 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...  View Details
      Keywords: Health Care; Healthcare Costs; Health Insurance; Health Care and Treatment; Cost; Insurance; Innovation and Invention; Health Industry; United States
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      Herzlinger, Regina E., and James Wallace. "Health Savings Accounts: Enabling Consumer Participation." Harvard Business School Case 318-110, February 2018.
      • 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...  View Details
      Keywords: Value Based Health Care; Bundled Payments; Health Care and Treatment; Cost Management; Value Creation; Supply Chain Management; Customer Value and Value Chain; Health Industry; Medical Devices and Supplies Industry; United States; Netherlands
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      Kaplan, Robert S., Michael E. Porter, Thomas W. Feeley, and Alee Hernandez. "Medtronic: Navigating a Shifting Healthcare Landscape." Harvard Business School Case 718-471, January 2018. (Revised June 2018.)
      • 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...  View Details
      Keywords: Precision Medicine; Healthcare; Innovation; Cancer; Cancer Research; Health Care; Technology; Health Care and Treatment; Innovation Leadership; Disruptive Innovation; Entrepreneurship; Decision Choices and Conditions; Health Industry; Insurance Industry; Utah; United States; North America
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      Hamermesh, Richard G., Kathy E. Giusti, Robert S. Huckman, and Julia Kelley. "Intermountain Healthcare: Pursuing Precision Medicine." Harvard Business School Case 818-018, September 2017. (Revised December 2017.)
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