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All HBS Web
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- Faculty Publications (156)
- 2020
- Chapter
Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better
By: Leemore S. Dafny
Love it or hate it, the Affordable Care Act (ACA) embraced and extended the role of private markets in financing and delivering health care in the United States. Ten years after the ACA’s passage, it is unclear whether health care markets are better (along a range of...
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Keywords:
Health Care and Treatment;
Markets;
Laws and Statutes;
Outcome or Result;
Health Industry;
United States
Dafny, Leemore S. "Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better." Chap. 15 in The Trillion Dollar Revolution: How the Affordable Care Act Transformed Politics, Law, and Health Care in America, edited by Ezekiel J. Emanuel and Abbe R. Gluck. New York: PublicAffairs, 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...
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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
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.)
- November 9, 2019
- Article
Effect of Revealing Authors' Conflicts of Interests in Peer Review: Randomized Controlled Trial
By: Leslie K. John, George Loewenstein, Andrew Marder and Michael Callaham
Objective: To assess the impact of disclosing authors’ conflict of interest declarations to peer reviewers at a medical journal.
Design: Randomised controlled trial.
Setting: The study was conducted within the manuscript review process at the... View Details
Design: Randomised controlled trial.
Setting: The study was conducted within the manuscript review process at the... View Details
Keywords:
Conflicts Of Interest;
Peer Review;
Randomized Controlled Trial;
Scientific Publication;
Conflict of Interests;
Journals and Magazines;
Science
John, Leslie K., George Loewenstein, Andrew Marder, and Michael Callaham. "Effect of Revealing Authors' Conflicts of Interests in Peer Review: Randomized Controlled Trial." BMJ: British Medical Journal 367, no. 8221 (November 9, 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...
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Keywords:
Outcomes Reporting;
Outcomes Measurement;
Medicare;
Medicaid;
Health Care and Treatment;
Outcome or Result;
Measurement and Metrics
Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
- Article
Achieving Value in Highly Complex Acute Care: Lessons from the Delivery of Extra Corporeal Life Support
By: Michael Nurok, Jonathan Warsh, Erik Dong, Jeffrey Lopez, Mayumi Kharabi and Robert S. Kaplan
We applied a value (outcomes and cost) analysis to extracorporeal life support (ECLS), a relatively rare but very expensive ICU therapy with highly variable outcomes. To address the outcome component of the value approach, we created guidelines for ECLS delivery; to...
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Nurok, Michael, Jonathan Warsh, Erik Dong, Jeffrey Lopez, Mayumi Kharabi, and Robert S. Kaplan. "Achieving Value in Highly Complex Acute Care: Lessons from the Delivery of Extra Corporeal Life Support." NEJM Catalyst (October 31, 2019).
- 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...
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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.
- July 2019
- Article
Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements
By: Derek A. Haas, Xiaoran Zhang, Robert S. Kaplan and Zirui Song
In 2016, the Centers for Medicare & Medicaid Services (CMS) launched its first mandatory bundled payment program, the Comprehensive Care for Joint Replacement (CJR) model, by randomizing metropolitan statistical areas (MSAs) into the payment model. The paper analyzed...
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Keywords:
Medicare;
Medicaid;
Bundled Payments;
Health Care and Treatment;
Cost Management;
Performance Evaluation;
Outcome or Result
Haas, Derek A., Xiaoran Zhang, Robert S. Kaplan, and Zirui Song. "Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements." JAMA Internal Medicine 179, no. 7 (July 2019): 924–931.
- 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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Keywords:
Regulation;
Pharmaceuticals;
Healthcare;
Health Care and Treatment;
Price;
Governing Rules, Regulations, and Reforms;
Pharmaceutical Industry;
Germany
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.
- Article
Cybersecurity Features of Digital Medical Devices: An Analysis of FDA Product Summaries
By: Ariel Dora Stern, William J. Gordon, Adam B. Landman and Daniel B. Kramer
Objectives:
To more clearly define the landscape of digital medical devices subject to U.S. Food and Drug Administration (FDA) oversight, this analysis leverages publicly available regulatory documents to characterise the prevalence and trends of software and... View Details
To more clearly define the landscape of digital medical devices subject to U.S. Food and Drug Administration (FDA) oversight, this analysis leverages publicly available regulatory documents to characterise the prevalence and trends of software and... View Details
Keywords:
Digital;
Medicine;
FDA;
Health Care and Treatment;
Applications and Software;
Safety;
Cybersecurity;
Medical Devices and Supplies Industry
Stern, Ariel Dora, William J. Gordon, Adam B. Landman, and Daniel B. Kramer. "Cybersecurity Features of Digital Medical Devices: An Analysis of FDA Product Summaries." BMJ Open 9, no. 6 (June 2019).
- Article
Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System
By: Regina E. Herzlinger and Bacchus Barua
An analysis of Canada’s single-payer healthcare system shows the dangers of the proposed Medicare for All model. In fact, the Canadian healthcare system is costly and drives poor outcomes when compared to objective performance measures. Alternatively, the Swiss and...
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Keywords:
Healthcare Systems;
Universal Health Coverage;
Health Care and Treatment;
Insurance;
Canada;
Switzerland;
Netherlands
Herzlinger, Regina E., and Bacchus Barua. "Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System." Wall Street Journal (April 17, 2019).
- Article
Populism and the Return of the 'Paranoid Style': Some Evidence and a Simple Model of Demand for Incompetence as Insurance against Elite Betrayal
By: Rafael Di Tella and Julio J. Rotemberg
We present a simple model of populism as the rejection of “disloyal” leaders. We show that adding the assumption that people are worse off when they experience low income as a result of leader betrayal (than when it is the result of bad luck) to a simple voter choice...
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Di Tella, Rafael, and Julio J. Rotemberg. "Populism and the Return of the 'Paranoid Style': Some Evidence and a Simple Model of Demand for Incompetence as Insurance against Elite Betrayal." Journal of Comparative Economics 46, no. 4 (December 2018): 988–1005.
- Article
Defining, Measuring, and Improving Value in Spine Care
By: Robert S. Kaplan and Derek Haas
This chapter discusses how to measure and improve spine care outcomes and costs. Today’s commonly used outcome metrics, such as readmission and complication rates, are actually process and quality metrics. They are not the outcomes, such as improvement in pain and...
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Keywords:
Spine Care;
Outcomes Measurement;
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Cost;
Measurement and Metrics;
Performance Improvement;
Value
Kaplan, Robert S., and Derek Haas. "Defining, Measuring, and Improving Value in Spine Care." Seminars in Spine Surgery 30, no. 2 (June 2018): 80–83.
- Article
Performance Effects of Setting a High Reference Point for Peer‐Performance Comparison
By: Henry Eyring and V.G. Narayanan
We conduct a field experiment, based on a registered report accepted by the Journal of Accounting Research, to test performance effects of setting a high reference point for peer‐performance comparison. Relative to providing the median as a reference point for...
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Keywords:
Relative Performance Evaluation;
Reference Points;
Social Comparison;
Field Experiment;
Performance;
Performance Evaluation;
Education
Eyring, Henry, and V.G. Narayanan. "Performance Effects of Setting a High Reference Point for Peer‐Performance Comparison." Journal of Accounting Research 56, no. 2 (May 2018): 581–615.
- 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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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
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.)
- Article
TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear
By: Robert S. Kaplan, Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller and John I. Lowenstein
Purpose
To perform a cost analysis comparison for managing common ocular disorders in an eye emergency department (ED) versus an urgent care setting using a time-driven activity-based cost model (TDABC) to assist physicians and staff in appropriate allocation of...
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Keywords:
Time-driven Activity-based Cost Model;
Emergency Room;
Urgent Care Clinic;
Cost;
Analysis;
Activity Based Costing and Management;
Health Care and Treatment
Kaplan, Robert S., Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller, and John I. Lowenstein. "TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear." Journal of Academic Ophthalmology 10 (2018).
- January 2018
- Article
The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial
By: Leslie K. John, Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein and Kevin Volpp
Purpose: We tested the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally-available weight management program.
Design: A randomized trial tested the impact of employer subsidy: 100%; 80% 50% and a hybrid 50% subsidy... View Details
Design: A randomized trial tested the impact of employer subsidy: 100%; 80% 50% and a hybrid 50% subsidy... View Details
Keywords:
Affordable Care Act (ACA);
Subsidies;
Weight Loss;
Obesity;
Incentives;
Behavioral Economics;
Motivation and Incentives;
Behavior;
Health Disorders;
Health Care and Treatment;
Compensation and Benefits;
United States
John, Leslie K., Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein, and Kevin Volpp. "The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial." American Journal of Health Promotion 32, no. 1 (January 2018): 170–176.
- Article
The IT Transformation Health Care Needs
By: Nikhil R. Sahni, Robert S. Huckman, Anuraag Chigurupati and David M. Cutler
In recent years, health care organizations have made sizable investments in information technology. They’ve used their IT systems to replace paper records with electronic ones and to improve billing processes, thereby boosting revenue. But so far, IT has been of little...
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Keywords:
Health Care and Treatment;
Information Technology;
Performance Improvement;
Business Model
Sahni, Nikhil R., Robert S. Huckman, Anuraag Chigurupati, and David M. Cutler. "The IT Transformation Health Care Needs." Harvard Business Review 95, no. 6 (November–December 2017): 128–136.
- Article
Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT
By: Jonathan G. Rogg, Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang and Benjamin White
Study objectives: Facing increased utilization and subsequent capacity and budget constraints, EDs must better understand bottlenecks and their effect on process flow to improve process efficiency. The primary objective of this study was to identify bottlenecks in...
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Keywords:
Health Care;
Bottleneck;
Health Care and Treatment;
Operations;
Health Industry;
United States
Rogg, Jonathan G., Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang, and Benjamin White. "Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT." American Journal of Emergency Medicine 35, no. 10 (October 2017): 1510–1513.
- September 2017 (Revised February 2023)
- 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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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
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 February 2023.)
- September 2017
- Article
Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers
By: Robert S. Kaplan, Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam and Christopher J. Hartnick
Time-driven activity-based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic...
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Keywords:
Time-Driven Activity-Based Costing;
Activity Based Costing and Management;
Health Care and Treatment
Kaplan, Robert S., Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam, and Christopher J. Hartnick. "Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers." The Laryngoscope 127, no. 9 (September 2017).