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- March 2024
- Article
Do Safety Management System Standards Indicate Safer Operations? Evidence from the OHSAS 18001 Occupational Health and Safety Standard
By: Kala Viswanathan, Matthew S. Johnson and Michael W. Toffel
Problem definition: Given the enormous disruptions and costs of occupational injuries, companies and buyers are increasingly looking to voluntary occupational health and safety standards to improve worker safety. Yet because these standards only require...
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Keywords:
Occupational Health;
Occupational Safety;
Program Evaluation;
Safety Performance;
Injuries;
OHSAS 18001;
ISO 45001;
Working Conditions;
Safety;
Standards
Viswanathan, Kala, Matthew S. Johnson, and Michael W. Toffel. "Do Safety Management System Standards Indicate Safer Operations? Evidence from the OHSAS 18001 Occupational Health and Safety Standard." Art. 106383. Safety Science 171 (March 2024).
- March 2024
- Article
Medicare Price Negotiation and Pharmaceutical Innovation Following the Inflation Reduction Act
By: Matthew Vogel, Pragya Kakani, Amitabh Chandra and Rena M. Conti
The Inflation Reduction Act (IRA) requires Medicare to negotiate lower prices for some medicines with high Medicare spending. Using historical data from public and proprietary sources to apply the IRA's negotiation criteria retrospectively, we identify all drugs that...
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Keywords:
Policy;
Government Legislation;
Health Care and Treatment;
Negotiation;
Price;
Pharmaceutical Industry
Vogel, Matthew, Pragya Kakani, Amitabh Chandra, and Rena M. Conti. "Medicare Price Negotiation and Pharmaceutical Innovation Following the Inflation Reduction Act." Nature Biotechnology 42, no. 3 (March 2024): 406–412.
- January 19, 2024
- Article
Value-Based Health Care Can Transform the Treatment of Patients with Substance Use Disorder
By: Robert S. Kaplan and Sarah E. Wakeman
U.S. overdose deaths currently exceed 100,000 per year. New facilities, known as bridge clinics, are broadening access to high-quality care by offering outpatient substance use disorder (SUD) treatment with few access barriers. But many of the critical services offered...
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Kaplan, Robert S., and Sarah E. Wakeman. "Value-Based Health Care Can Transform the Treatment of Patients with Substance Use Disorder." Health Affairs Forefront (January 19, 2024).
- January 2024
- Article
A Cost Model for a Low Threshold Clinic Treating Opioid Use Disorder
By: Sarah E. Wakeman, Elizabeth Powell, Syed Shehab, Grace Herman, Laura Kehoe and Robert S. Kaplan
The US fee-for-service payment system under-reimburses clinics offering access to comprehensive treatments for opioid use disorder (OUD). The funding shortfall limits a clinic’s ability to expand and improve access, especially for socially marginalized patients with...
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Wakeman, Sarah E., Elizabeth Powell, Syed Shehab, Grace Herman, Laura Kehoe, and Robert S. Kaplan. "A Cost Model for a Low Threshold Clinic Treating Opioid Use Disorder." Journal of Behavioral Health Services & Research 51, no. 1 (January 2024): 22–30.
- January 2024
- Article
Cost of Exempting Sole Orphan Drugs from Medicare Negotiation
By: Matthew Vogel, Olivia Zhao, William B. Feldman, Amitabh Chandra, Aaron S. Kesselheim and Benjamin N. Rome
Importance: The Inflation Reduction Act (IRA) requires Medicare to negotiate prices for some high-spending drugs but exempts drugs approved solely for the treatment of a single rare disease.
Objective: To estimate Medicare spending and global... View Details
Objective: To estimate Medicare spending and global... View Details
Vogel, Matthew, Olivia Zhao, William B. Feldman, Amitabh Chandra, Aaron S. Kesselheim, and Benjamin N. Rome. "Cost of Exempting Sole Orphan Drugs from Medicare Negotiation." JAMA Internal Medicine 184, no. 1 (January 2024): 63–69.
- November 2023
- Article
Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients with Hypertension
By: Mitchell Tang, Carter Nakamoto, Ariel Dora Stern, Jose Zubizarreta, Felippe Marcondes, Lori Uscher-Pines, Lee Schwamm and Ateev Mehrotra
Background: Remote patient monitoring (RPM) is a promising tool for improving chronic disease management. Use of RPM for hypertension monitoring is growing rapidly, raising concerns about increased spending. However, the effects of RPM are still...
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Tang, Mitchell, Carter Nakamoto, Ariel Dora Stern, Jose Zubizarreta, Felippe Marcondes, Lori Uscher-Pines, Lee Schwamm, and Ateev Mehrotra. "Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients with Hypertension." Annals of Internal Medicine 176, no. 11 (November 2023): 1465–1475.
- 2023
- Working Paper
Are Hospital Quality Indicators Causal?
By: Amitabh Chandra, Maurice Dalton and Douglas O. Staiger
Hospitals play a key role in patient outcomes and spending, but efforts to improve their quality are hindered because we do not know whether hospital quality indicators are causal or biased. We evaluate the validity of commonly used quality indicators, such as...
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Keywords:
Quality;
Health Care and Treatment;
Measurement and Metrics;
Outcome or Result;
Health Industry
Chandra, Amitabh, Maurice Dalton, and Douglas O. Staiger. "Are Hospital Quality Indicators Causal?" NBER Working Paper Series, No. 31789, October 2023.
- October 2023
- Article
Health System Perspective on Cost for Delivering a Decision Aid for Prostate Cancer Using Time-Driven Activity-Based Costing
By: David R. Ho, Robert S. Kaplan, Jonathan Bergman, David F. Penson, Benjamin Waterman, Kristin C. Williams, Jefersson Villatoro, Lorna Kwan and Christopher S. Saigal
Previsit decision aids (DAs) have been shown to improve decisional quality. But the cost to deploy a DA has not been previously estimated. We interviewed or observed relevant personnel at three institutions that had implemented DA programs for men with prostate cancer....
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Keywords:
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Cost Accounting;
Health Industry
Ho, David R., Robert S. Kaplan, Jonathan Bergman, David F. Penson, Benjamin Waterman, Kristin C. Williams, Jefersson Villatoro, Lorna Kwan, and Christopher S. Saigal. "Health System Perspective on Cost for Delivering a Decision Aid for Prostate Cancer Using Time-Driven Activity-Based Costing." Medical Care 61, no. 10 (October 2023): 681–688.
- September–October 2023
- Article
Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using Time-Driven Activity-Based Costing Method: A Single Center Study
By: Aamir Ali, Jordana Phillips, Damir Ljuboja, Syed S. Shehab, Etta D. Pisano, Robert S. Kaplan and Ammar Sarwar
We use time-driven activity-based costing (TDABC) to measure the cost of performing breast imaging using different modalities: full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), contrast-enhanced mammography (CEM), US and MRI exams, and...
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Keywords:
Time-Driven Activity-Based Costing;
Health Care;
Breast Cancer;
Health Care and Treatment;
Cost;
Cost Accounting;
Health Industry
Ali, Aamir, Jordana Phillips, Damir Ljuboja, Syed S. Shehab, Etta D. Pisano, Robert S. Kaplan, and Ammar Sarwar. "Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using Time-Driven Activity-Based Costing Method: A Single Center Study." Journal of Breast Imaging 5, no. 5 (September–October 2023): 546–554.
- September 2023
- Article
The Health Costs of Dirty Energy: Evidence from the Capacity Market in Colombia
By: Achyuta Adhvaryu, Theresa Molina, Anant Nyshadham, Jorge Tamayo and Nicholas Torres
The health effects of “dirty” (fossil fuel driven) energy production are difficult to measure accurately due to the endogeneity of fuel choice. We exploit an electricity policy in Colombia that generates a price-based trigger for the use of thermal energy sources....
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Adhvaryu, Achyuta, Theresa Molina, Anant Nyshadham, Jorge Tamayo, and Nicholas Torres. "The Health Costs of Dirty Energy: Evidence from the Capacity Market in Colombia." Art. 103116. Journal of Development Economics 164 (September 2023).
- October 2023
- Article
What Does the Inflation Reduction Act Mean for Patients and Physicians?
By: Amitabh Chandra and Benedic Ippolito
The debate around prescription drug measures in the recently passed U.S. Inflation Reduction Act (IRA), which limit some patients’ out-of-pocket costs, has not fully addressed their effect on physicians and patients via their effect on payers. Reducing patients’ costs...
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Chandra, Amitabh, and Benedic Ippolito. "What Does the Inflation Reduction Act Mean for Patients and Physicians?" NEJM Catalyst Innovations in Care Delivery 4, no. 10 (October 2023).
- July–August 2023
- Article
Investing in Growth Through Uncertainty
By: Ranjay Gulati
When faced with disruptions and downturns, many leaders and companies instinctively focus on cutting costs to maintain profitability. But some identify opportunities and then take thoughtful action to emerge from crisis even stronger. That means not only planning for...
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Gulati, Ranjay. "Investing in Growth Through Uncertainty." Harvard Business Review 101, no. 4 (July–August 2023): 36–42.
- April 2023 (Revised January 2024)
- Background Note
Note on Healthcare in Ghana
By: Regina E. Herzlinger and Ben Creo
This note provides an overview of the healthcare system in Ghana. It discusses the public and private sector as well as traditional medical practice. It also discusses the country’s pharmaceutical industry. It is recommended as a companion to Professor Regina...
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Keywords:
Africa;
Pharmaceutical Companies;
Pharmacy Benefit Manager;
Health Care;
Health Care Costs;
Health Care Delivery;
Health Care Entrepreneurship;
Telehealth;
Health Equity;
Governing Rules, Regulations, and Reforms;
Health Care and Treatment;
Business and Government Relations;
Health Industry;
Health Industry;
Ghana
Herzlinger, Regina E., and Ben Creo. "Note on Healthcare in Ghana." Harvard Business School Background Note 323-112, April 2023. (Revised January 2024.)
- 2023
- Article
Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital
By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk
The COVID-19 pandemic raised awareness of the need to better understand where and how patient-level costs are incurred in health care organizations. This study used time-driven activity-based costing to estimate COVID-19 patient-level hospital costs in a Brazilian...
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Cardoso, Ricardo Bertoglio, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges, and Carisi Anne Polanczyk. "Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital." BMC Health Services Research 23, no. 198 (2023).
- February 2023
- Article
A Different Framework to Achieve Universal Coverage in the U.S.
By: Katherine Baicker, Amitabh Chandra and Mark Shepard
This JAMA Forum discusses alternative ways to achieve universal coverage in the US such as administrative simplification in the Affordable Care Act plans to increase enrollment, having a basic policy that would be available to everyone, and options for supplemental...
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Baicker, Katherine, Amitabh Chandra, and Mark Shepard. "A Different Framework to Achieve Universal Coverage in the U.S." e230187. JAMA Health Forum 4, no. 2 (February 2023).
- January 23, 2023
- Article
Digital Public Health Interventions at Scale: The Impact of Social Media Advertising on Beliefs and Outcomes Related to COVID Vaccines
By: Susan Athey, Kristen Grabarz, Michael Luca and Nils Wernerfelt
Public health organizations increasingly use social media advertising campaigns in pursuit of public health goals. In this paper, we evaluate the impact of about $40 million of social media advertisements that were run and experimentally tested on Facebook and...
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Keywords:
COVID-19 Pandemic;
Public Health;
Vaccines;
Social Media;
Advertising;
Power and Influence;
Health Care and Treatment
Athey, Susan, Kristen Grabarz, Michael Luca, and Nils Wernerfelt. "Digital Public Health Interventions at Scale: The Impact of Social Media Advertising on Beliefs and Outcomes Related to COVID Vaccines." e2208110120. Proceedings of the National Academy of Sciences 120, no. 5 (January 23, 2023).
- January 2023
- Case
Crow Holdings Development: Mass Timber Construction
By: John D. Macomber, Robert Hernandez and Kyle MertensMeyer
Jim McCaffery and Cody Armbrister of Crow Holdings Development evaluate the pros and cons of committing to mass timber construction instead of conventional concrete or steel for a new 260,000 SF multi-story office building in Texas. Benefits include substantially...
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Keywords:
Real Estate Development;
Architecture;
Air Quality;
Health & Wellness;
Office Property;
Sustainability;
Carbon Abatement;
Natural Environment;
Environmental Accounting;
Green Building;
Design;
Construction;
Cost vs Benefits;
Environmental Sustainability;
Construction Industry;
Real Estate Industry;
Texas
- December 2022
- Article
Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition
By: Anna Paula Beck da Silva Etges, Richard D. Urman, Anne Geubelle, Robert Kaplan and Carisi Anne Polanczyk
This communication announces the International Cost Standard Set Program. Its goal is to establish global standardized frameworks for measuring the costs of treating specific clinical conditions. A scientific committee, including 16 international healthcare cost...
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Keywords:
Time-Driven Activity-Based Costing;
Value-based Health Care;
Cost;
Health Care and Treatment;
Activity Based Costing and Management;
Health Industry
da Silva Etges, Anna Paula Beck, Richard D. Urman, Anne Geubelle, Robert Kaplan, and Carisi Anne Polanczyk. "Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition." Journal of Comparative Effectiveness Research 11, no. 17 (December 2022): 1219–1223.
- October 2022
- Case
Cost Plus Drugs
By: Alexander MacKay and James Barnett
In September 2022, Mark Cuban Cost Plus Drugs Company CEO Alex Oshmyansky considered the future of the company. Cost Plus Drugs was a retailer for more than 340 generic oral medications, selling their drugs at significantly lower prices than typical pharmacies....
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Keywords:
Business Ventures;
Decision Making;
Entrepreneurship;
Ethics;
Health;
Markets;
Social Enterprise;
Society;
Strategy;
Health Care and Treatment;
Business Divisions;
Factories, Labs, and Plants;
Health Industry;
Health Industry;
United States;
Texas
MacKay, Alexander, and James Barnett. "Cost Plus Drugs." Harvard Business School Case 723-362, October 2022.
- October 2022 (Revised January 2024)
- Case
mPharma: Scaling Access to Affordable Primary Care in Africa
By: Regina E. Herzlinger and Ben Creo
mPharma hopes to scale up to create the largest pan-African healthcare company ever to provide much-needed primary care in retail pharmacies; a reliable, fairly priced supply of drugs; and micro-insurance for drugs. They must prioritize launching a telemedicine...
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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;
Health 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 January 2024.)