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- April 2023
- Background Note
Note on Healthcare in Ghana
By: Regina E. Herzlinger and Ben Creo
This note accompanies case 323-033, “mPharma: Scaling Access to Affordable Primary Care in Africa” which discusses mPharma’s make-or-break strategic decisions. This note’s coverage of the Ghanaian healthcare system ranges from how care and drugs are delivered and...
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- 2023
- Article
A Randomized Trial of Behavioral Nudges Delivered through Text Messages to Increase Influenza Vaccination among Patients with an Upcoming Primary Care Visit
By: Mitesh S. Patel, Katherine L. Milkman, Linnea Gandhi, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Seung Hyeong Lee, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
Purpose: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates.
Design: Randomized, controlled trial.
Setting: Two health systems in the Northeastern US between September 2020 and... View Details
Design: Randomized, controlled trial.
Setting: Two health systems in the Northeastern US between September 2020 and... View Details
Keywords:
Vaccination;
Health Care and Treatment;
Interpersonal Communication;
Communication Technology;
Behavior;
Health Industry
Patel, Mitesh S., Katherine L. Milkman, Linnea Gandhi, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Seung Hyeong Lee, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp, and Angela L. Duckworth. "A Randomized Trial of Behavioral Nudges Delivered through Text Messages to Increase Influenza Vaccination among Patients with an Upcoming Primary Care Visit." American Journal of Health Promotion 37, no. 3 (2023): 324–332.
- December 2022
- Article
Collaborative Rooming: An Innovative Pilot Project to Overcome Primary Care Challenges
By: Gagandeep Singh, Jill G. Lenhart, Richard A. Helmers, Michele Renee Eberlee, Heather Costley, Joel B. Roberts and Robert S. Kaplan
Primary care physicians are overburdened with growing complexities and increasing expectations for primary care visits. To meet expectations, primary care physicians must multitask during visits and spend extra hours in the office for charting, billing, and...
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Singh, Gagandeep, Jill G. Lenhart, Richard A. Helmers, Michele Renee Eberlee, Heather Costley, Joel B. Roberts, and Robert S. Kaplan. "Collaborative Rooming: An Innovative Pilot Project to Overcome Primary Care Challenges." Wisconsin Medical Journal 121, no. 4 (December 2022): 306–309.
- October 2022 (Revised April 2023)
- Case
mPharma: Scaling Access to Affordable Primary Care in Africa
By: Regina E. Herzlinger and Ben Creo
mPharma is trying to create the largest pan-African healthcare company ever to provide much needed primary care and a reliable, fairly priced supply of drugs. Founder and CEO Greg Rockson must decide how best to achieve this lofty goal. He must prioritize launching a...
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Keywords:
Africa;
Pharmaceutical Companies;
Pharmacy Benefit Manager;
Health Care;
Health Care And Treatment;
Health Care Costs;
Health Care Delivery;
Health Care Entrepreneurship;
Telehealth;
Health Equity;
Corporate Strategy;
Social Entrepreneurship;
Equity;
Growth and Development Strategy;
Expansion;
Product Launch;
Customer Value and Value Chain;
Social Enterprise;
Multinational Firms and Management;
Pharmaceutical Industry;
Health Industry;
Africa
Herzlinger, Regina E., and Ben Creo. "mPharma: Scaling Access to Affordable Primary Care in Africa." Harvard Business School Case 323-033, October 2022. (Revised April 2023.)
- 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.
- 2022
- Article
Rapid Growth of Remote Patient Monitoring Is Driven by a Small Number of Primary Care Providers
By: Mitchell Tang, Ateev Mehrotra and Ariel Dora Stern
Growing enthusiasm for remote patient monitoring has been motivated by the hope that it can improve care for patients with poorly controlled chronic illness. In a national commercially insured population in the U.S., we found that billing for remote patient monitoring...
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Keywords:
Remote Monitoring;
Medical Billing;
Health Care Costs;
Telehealth;
Diabetes;
Chronic Disease;
Insurance Claims;
Diseases;
Primary Care Providers;
COVID-19 Pandemic;
Health Care and Treatment;
Insurance;
Cost;
Health Industry;
United States
Tang, Mitchell, Ateev Mehrotra, and Ariel Dora Stern. "Rapid Growth of Remote Patient Monitoring Is Driven by a Small Number of Primary Care Providers." Health Affairs 41, no. 9 (2022): 1248–1254.
- August 3, 2022
- Article
How Will Amazon Approach U.S. Primary Care?
By: Robert S. Huckman and Bradley Staats
Amazon has a playbook for reinventing businesses that it enters. It includes simplifying processes, experimenting to determine which new approaches work best, and continuously recombining its existing assets to come up with a better way to do things. It is likely to...
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Keywords:
Amazon;
Health Care;
Technology;
Primary Care;
Health Care and Treatment;
Information Infrastructure;
Health Industry;
Technology Industry;
United States
Huckman, Robert S., and Bradley Staats. "How Will Amazon Approach U.S. Primary Care?" Harvard Business Review (website) (August 3, 2022).
- April 2022
- Teaching Note
CVS Health: Prescription for Transformation
By: Rosabeth Moss Kanter and Catarina Martinez
In 2021, new CEO Karen Lynch (named the most powerful woman in business) considered the next transformation phase for CVS Health (a Fortune 5 corporate giant). The 2018 acquisition of Aetna insurance brought her to the company as part of its long evolution from a...
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Keywords:
Health;
COVID-19 Pandemic;
Primary Care;
Leadership;
Change Management;
Women Executives;
Retail;
Pharmacy;
Pharmacy Benefit Manager;
Clinical Trials;
Vaccination;
Acquisition;
Innovation and Invention;
Transformation;
Retail Industry;
Pharmaceutical Industry;
Health Industry;
United States
- 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).
- November 2021 (Revised December 2021)
- Case
Praava Health: A New Model for Bangladesh
By: Michael Chu
Launched in Dhaka, Bangladesh, in 2018, Praava Health (‘Praava’) delivered high-quality in-clinic primary and specialist care, backed by its own high quality diagnostic laboratories, imaging and pharmacy. Praava was founder Sylvana Sinha’s response to what she saw as a...
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Keywords:
Entrepreneurship;
Health Care and Treatment;
Investment Return;
Mobile and Wireless Technology;
Business Model;
Growth and Development Strategy;
Health Industry;
Bangladesh;
Asia
Chu, Michael. "Praava Health: A New Model for Bangladesh." Harvard Business School Case 322-067, November 2021. (Revised December 2021.)
- 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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Keywords:
Hospital;
Hospital Management;
Hospitals—administration;
Health Care;
Health Care Industry;
Health Care Investment;
Health Care Operations;
Health Pandemics;
Health Care and Treatment;
Operations;
Performance Improvement;
Investment;
Health Industry;
United States
Herzlinger, Regina E., and Barak D. Richman. "Preparing Hospitals for the Next Pandemic." Harvard Business Review Digital Articles (June 10, 2021).
- Article
A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor's Appointment
By: Katherine L. Milkman, Mitesh S. Patel, Linnea Gandhi, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via...
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Keywords:
Vaccination;
COVID-19;
Nudge;
Influenza;
Field Experiment;
Health;
Communication Strategy;
Behavior
Milkman, Katherine L., Mitesh S. Patel, Linnea Gandhi, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp, and Angela L. Duckworth. "A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor's Appointment." e2101165118. Proceedings of the National Academy of Sciences 118, no. 20 (May 18, 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....
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Keywords:
Choice Architecture;
Health Care and Treatment;
Interpersonal Communication;
Decision Choices and Conditions;
Competency and Skills
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).
- 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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Keywords:
Disease Management;
Team-based Care;
Health Care and Treatment;
Groups and Teams;
Performance
Pany, Maximilian J., Lucy Chen, Bethany Sheridan, and Robert S. Huckman. "Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care." Health Affairs 40, no. 3 (March 2021): 435–444.
- February 2021 (Revised March 2022)
- Case
Marvin: A Personalized Telehealth Approach to Mental Health
By: Regina E. Herzlinger, Eshani Sharma, Andrew Nguyen, Thomas Arsenault, Carin-Isabel Knoop and Julia Kelley
More than one third of Americans were said to suffer some type of behavioral health ailment at some point in their lifetime, with many people requiring chronic therapy or intervention. Despite significant clinical needs, access to reliable treatment has been difficult...
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Keywords:
Mental Health;
Applications;
Startup Management;
Telehealth;
Health Care Entrepreneurship;
Health & Wellness;
Health Care;
Health Care and Treatment;
Customization and Personalization;
Internet and the Web;
Entrepreneurship;
Growth and Development Strategy;
Applications and Software
Herzlinger, Regina E., Eshani Sharma, Andrew Nguyen, Thomas Arsenault, Carin-Isabel Knoop, and Julia Kelley. "Marvin: A Personalized Telehealth Approach to Mental Health." Harvard Business School Case 321-127, February 2021. (Revised March 2022.)
- September 2020
- Case
Walmart Health: Scaling During a Pandemic
By: Robert S. Huckman, Yoonjin Min and Marissa Thiel
Amidst the onset of COVID-19 pandemic in the United States, Marcus Obsborne, Vice President for Health and Wellness Transformation at Walmart was planning to scale its new health care clinic business, Walmart Health, to additional locations in Georgia and beyond....
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Keywords:
Health Care and Treatment;
Health Pandemics;
Health;
Service Delivery;
Growth and Development Strategy;
Health Industry;
United States;
Arkansas;
Georgia (state, US);
Texas
Huckman, Robert S., Yoonjin Min, and Marissa Thiel. "Walmart Health: Scaling During a Pandemic." Harvard Business School Case 621-061, September 2020.
- September 17, 2020
- Article
Protecting Vulnerable Older Patients during the Pandemic
By: Umar Ikram, Susanna Gallani, Jose F. Figueroa and Thomas W. Feeley
Older people (70 years and older) with multiple chronic conditions have the highest risk of being hospitalized and dying from COVID-19. The recent COVID-19 pandemic has highlighted how a strong primary care system can play an important role in protecting this group of...
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Keywords:
COVID-19;
High-risk Patients;
Primary Care;
Health Pandemics;
Health Care and Treatment;
Innovation and Invention;
Demographics;
Age
Ikram, Umar, Susanna Gallani, Jose F. Figueroa, and Thomas W. Feeley. "Protecting Vulnerable Older Patients during the Pandemic." NEJM Catalyst (September 17, 2020).
- August 2020
- Article
Do Physician Incentives Increase Patient Medication Adherence?
By: Edward Kong, John Beshears, David Laibson, Brigitte Madrian, Kevin Volpp, George Loewenstein, Jonathan Kolstad and James J. Choi
We conducted a randomized experiment (911 primary care practices and 8,935 nonadherent patients) to test the effect of paying physicians for increasing patient medication adherence in three drug classes: diabetes medication, antihypertensives, and statins. We measured...
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Keywords:
Health Economics;
Medication Adherence;
Physician Payment Incentives;
Primary Care;
Quality Improvement;
Health Care and Treatment;
Motivation and Incentives;
Behavior
Kong, Edward, John Beshears, David Laibson, Brigitte Madrian, Kevin Volpp, George Loewenstein, Jonathan Kolstad, and James J. Choi. "Do Physician Incentives Increase Patient Medication Adherence?" Health Services Research 55, no. 4 (August 2020): 503–511.
- 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...
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Keywords:
COVID-19;
Primary Care;
Health Pandemics;
Health Care and Treatment;
Financial Condition;
Insurance
Dafny, Leemore S., and J. Michael McWilliams. "Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?" Health Affairs Blog (May 21, 2020).
- July 2019 (Revised May 2020)
- Supplement
Piramal e-Swasthya (C): A New Name, Bigger Scope, and Public-Private Partnerships
By: Rosabeth Moss Kanter and Joyce J. Kim
In 2010, Anand Piramal acquired the Health Management Research Institute (HMRI), a healthcare venture, and merged it with his original digital healthcare startup Piramal e-Swasthya (PeS), so that PeS became Piramal Swasthya. After acquiring HMRI, Piramal Swasthya...
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Keywords:
Entrepreneur;
Healthcare;
Innovation;
Emerging Economies;
Scaling;
Social Enterprise;
Entrepreneurship;
Health Care and Treatment;
Innovation and Management;
Emerging Markets;
Growth and Development;
Organizational Change and Adaptation;
Partners and Partnerships;
India
Kanter, Rosabeth Moss, and Joyce J. Kim. "Piramal e-Swasthya (C): A New Name, Bigger Scope, and Public-Private Partnerships." Harvard Business School Supplement 320-012, July 2019. (Revised May 2020.)