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Publications

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    • All HBS Web  (475)
      • Faculty Publications  (51)

      Patient Reported Outcome Measures Remove Patient Reported Outcome Measures →

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      • 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)...  View Details
      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
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      Kaplan, Robert S., and Karthik Ramanna. "How to Fix ESG Reporting." Harvard Business School Working Paper, No. 22-005, July 2021.
      • July 2021 (Revised October 2021)
      • 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’...  View Details
      Keywords: Health Care and Treatment; Outcome or Result; Cost Management; Activity Based Costing and Management; Mobile Technology; Health Industry; Boston
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      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 October 2021.)
      • July 2021
      • Article

      Medical Debt in the U.S., 2009–2020

      By: Ray Kluender, Neale Mahoney, Francis Wong and Wesley Yin
      Importance: Medical debt is an increasing concern in the US, yet there is limited understanding of the amount and distribution of medical debt, and its association with health care policies.

      Objective: To measure the amount of medical debt nationally and by...  View Details
      Keywords: Debt; Borrowing and Debt; Health Care and Treatment; United States
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      Kluender, Ray, Neale Mahoney, Francis Wong, and Wesley Yin. "Medical Debt in the U.S., 2009–2020." JAMA, the Journal of the American Medical Association 326, no. 3 (July 2021): 250–256.
      • June 2021
      • Article

      Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative

      By: Casey J. Allen, Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala and Matthew H.G. Katz
      We used national administrative data to assess multiple domains of value associated with enhanced recovery pathways for patients undergoing pancreatic surgery. Value metrics included in-hospital mortality, complication rates, length of stay (LOS), 30-day readmission...  View Details
      Keywords: Value-based Health Care; Health Care and Treatment; Analytics and Data Science; Outcome or Result; Measurement and Metrics; Performance Improvement
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      Allen, Casey J., Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala, and Matthew H.G. Katz. "Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative." Journal of Surgical Research 262 (June 2021): 115–120.
      • Article

      Use of Connected Digital Products in Clinical Research Following the COVID-19 Pandemic: A Comprehensive Analysis of Clinical Trials

      By: Caroline Marra, William J. Gordon and Ariel Dora Stern
      Objectives: In an effort to mitigate COVID-19 related challenges for clinical research, the U.S. Food and Drug Administration (FDA) issued new guidance for the conduct of ‘virtual’ clinical trials in late March 2020. This study documents trends in the use of...  View Details
      Keywords: Connected Digital Products; Telehealth; Remote Monitoring; Health Testing and Trials; Research; Governing Rules, Regulations, and Reforms; Technology
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      Marra, Caroline, William J. Gordon, and Ariel Dora Stern. "Use of Connected Digital Products in Clinical Research Following the COVID-19 Pandemic: A Comprehensive Analysis of Clinical Trials." BMJ Open 11, no. 6 (2021).
      • May 2021
      • Article

      Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency

      By: J. Hart, K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels and S.D. Halpern
      Background: Clinicians’ use of choice architecture, or how they present options, systematically influences the choices made by patients and their surrogate decision makers. However, clinicians may incompletely understand this influence....  View Details
      Keywords: Choice Architecture; Health Care and Treatment; Interpersonal Communication; Decision Choices and Conditions; Competency and Skills
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      Hart, J., K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels, and S.D. Halpern. "Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency." BMJ Quality & Safety 30, no. 5 (May 2021).
      • 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.
      • April 2021
      • Case

      ClearChoice Dental Implant Centers

      By: Robert S. Kaplan, Ashiana Jivraj and Jane Barrow
      The case illustrates the application of value-based health care to dental medicine. ClearChoice Dental Implant Centers was a rapidly-growing network of dentist-owned independent implant clinics. The targeted market included 23 million people, 15% of the US adult...  View Details
      Keywords: Value-based Health Care; Dental Medicine; Growth and Development Strategy; Expansion; Business Strategy; Customer Value and Value Chain; Customer Focus and Relationships; Health Industry; United States
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      Kaplan, Robert S., Ashiana Jivraj, and Jane Barrow. "ClearChoice Dental Implant Centers." Harvard Business School Case 121-082, April 2021.
      • 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
      Keywords: Electronic Health Records; Health Care and Treatment; Online Technology; Health Industry; Information Technology Industry
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      Holmgren, A Jay, Lance Downing, David W. Bates, Tait D. Shanafelt, Arnold Milstein, Christopher Sharp, David Cutler, Robert S. Huckman, and Kevin A. Schulman. "Assessment of Electronic Health Record Use Between U.S. and Non-U.S. Health Systems." JAMA Internal Medicine 181, no. 2 (February 2021): 251–259.
      • February 2021
      • Article

      Health Care Measurements That Improve Patient Outcomes

      By: Robert S. Kaplan, Lara Jehi, Clifford Y. Ko, Andrea Pusic and Mary Witkowski
      This article describes the challenges and solutions in determining whether a patient’s treatment has been successful. Such an assessment depends on multiple factors, including the patient’s pretreatment status; the qualifications of personnel performing the treatment;...  View Details
      Keywords: Outcomes Measurement; Health Care and Treatment; Outcome or Result; Measurement and Metrics
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      Kaplan, Robert S., Lara Jehi, Clifford Y. Ko, Andrea Pusic, and Mary Witkowski. "Health Care Measurements That Improve Patient Outcomes." NEJM Catalyst Innovations in Care Delivery 2, no. 2 (February 2021).
      • January 2021
      • Case

      Pearson: Efficacy 2.0

      By: Elie Ofek, Marco Bertini, Oded Koenigsberg and James Weber
      Pearson, which billed itself as the "world's learning company," faced a host of critical decisions in mid-2020. Several years prior, it had embarked on a new path that put the learner at the heart of the business and committed to a new strategic orientation. The new...  View Details
      Keywords: Efficacy; Learning; Outcome or Result; Measurement and Metrics; Brands and Branding; Marketing Communications; Strategic Planning; Education Industry
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      Ofek, Elie, Marco Bertini, Oded Koenigsberg, and James Weber. "Pearson: Efficacy 2.0." Harvard Business School Case 521-012, January 2021.
      • Article

      Value of New Performance Information in Healthcare: Evidence from Japan

      By: Susanna Gallani, Takehisa Kajiwara and Ranjani Krishnan
      Mandatory measurement and disclosure of outcome measures are commonly used policy tools in healthcare. The effectiveness of such disclosures relies on the extent to which the new information produced by the mandatory system is internalized by the healthcare...  View Details
      Keywords: Value Of Information; Feedback; Patient Satisfaction; Healthcare; Health Care and Treatment; Satisfaction; Information; Measurement and Metrics; Performance Improvement
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      Gallani, Susanna, Takehisa Kajiwara, and Ranjani Krishnan. "Value of New Performance Information in Healthcare: Evidence from Japan." International Journal of Health Economics and Management 20, no. 4 (December 2020): 319–357.
      • 2020
      • Working Paper

      Hospital Allocation and Racial Disparities in Health Care

      By: Amitabh Chandra, Pragya Kakani and Adam Sacarny
      We develop a simple framework to measure the role of hospital allocation in racial disparities in health care and use it to study Black and white Medicare patients who are treated for heart attacks—a condition where virtually everyone receives care, hospital care is...  View Details
      Keywords: Health Care and Treatment; Equality and Inequality; Race; Analysis
      Citation
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      Chandra, Amitabh, Pragya Kakani, and Adam Sacarny. "Hospital Allocation and Racial Disparities in Health Care." NBER Working Paper Series, No. 28018, November 2020.
      • May 21, 2020
      • Editorial

      Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?

      By: Leemore S. Dafny and J. Michael McWilliams
      Primary care clinicians are the front line for patients with suspected infection. We rely on them to diagnose, triage, and manage patients with potential or confirmed COVID infections. They are also responsible for keeping non-COVID medical conditions under control...  View Details
      Keywords: COVID-19; Primary Care; Health Pandemics; Health Care and Treatment; Financial Condition; Insurance
      Citation
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      Dafny, Leemore S., and J. Michael McWilliams. "Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?" Health Affairs Blog (May 21, 2020).
      • November 2019 (Revised December 2019)
      • Case

      Martini Klinik: Prostate Cancer Care 2019

      By: Michael E. Porter, Jens Deerberg-Wittram and Thomas W. Feeley
      Since its establishment in 2005, Hamburg’s Martini Klinik had single mindedly focused on prostate cancer care with a commitment to measure long-term health outcomes for every patient. A wholly owned subsidiary of the University Hospital Hamburg, Martini Klinik was a...  View Details
      Keywords: Health Care; Michael Porter; Jens Deerberg-Wittram; Clifford Marks; Prostate Cancer; Health Care Policy; Value Agenda; Integrated Practice Units; Outcomes Measurement; Health Care and Treatment; Value; Health Disorders; Insurance; Medical Specialties; Outcome or Result; Measurement and Metrics; Business Processes; Insurance Industry; Health Industry; Germany
      Citation
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      Porter, Michael E., Jens Deerberg-Wittram, and Thomas W. Feeley. "Martini Klinik: Prostate Cancer Care 2019." Harvard Business School Case 720-359, November 2019. (Revised December 2019.)
      • 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...  View Details
      Keywords: Outcomes Reporting; Outcomes Measurement; Medicare; Medicaid; Health Care and Treatment; Outcome or Result; Measurement and Metrics
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      Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
      • 2019
      • White Paper

      Impact-Weighted Financial Accounts: The Missing Piece for an Impact Economy

      By: George Serafeim, T. Robert Zochowski and Jennifer Downing
      Reimagining capitalism is an imperative. We need to create a more inclusive and sustainable form of capitalism that works for every person and the planet. Massive environmental damage, growing income and wealth disparity, stress, and depression within developed...  View Details
      Keywords: Impact-Weighted Accounts; IWAI; Background; Economic Systems; Economy; Corporate Social Responsibility and Impact; Measurement and Metrics; Financial Statements
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      Serafeim, George, T. Robert Zochowski, and Jennifer Downing. "Impact-Weighted Financial Accounts: The Missing Piece for an Impact Economy." White Paper, Harvard Business School, Boston, MA, September 2019.
      • Article

      Psychological Safety and Near Miss Events in Radiation Oncology

      By: Palak Kundu, Olivia Jung, Kathy Rose, Chonlawan Khaothiemsang, Nzhde Agazaryan, Amy C. Edmondson, Michael L. Steinberg and Ann C. Raldow
      Background: Near miss events, defined as harm averted due to chance, are learning opportunities in radiation oncology. Psychological safety is a feature of a learning environment characterized by interpersonal risk taking. We examine the effects of near miss type and...  View Details
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      Kundu, Palak, Olivia Jung, Kathy Rose, Chonlawan Khaothiemsang, Nzhde Agazaryan, Amy C. Edmondson, Michael L. Steinberg, and Ann C. Raldow. "Psychological Safety and Near Miss Events in Radiation Oncology." Journal of Clinical Oncology 37, no. 27 suppl. (September 20, 2019): 231.
      • Article

      Navy Medicine Introduces Value-Based Health Care

      By: Alee Hernandez, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III and Michael E. Porter
      In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could...  View Details
      Keywords: Military Health System; Health Care and Treatment; Cost Management; Projects
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      Hernandez, Alee, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III, and Michael E. Porter. "Navy Medicine Introduces Value-Based Health Care." Health Affairs 38, no. 8 (August 2019): 1393–1400.
      • 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...  View Details
      Keywords: Medical Coding; Health Policy; Healthcare-acquired Conditions; Medicare; Health Care and Treatment; Policy; Performance Improvement; Quality; Measurement and Metrics; Government Legislation
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      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.)
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