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November 2019
Article

A Review of Bundled Payments in Total Joint Replacement

By: Olivia Manickas-Hill, Kevin J. Bozic and Thomas W. Feeley

The Bundled Payments for Care Improvement (BPCI) initiative, developed by the U.S. Center for Medicare & Medicaid Innovation, aims to reduce health care expenditures while maintaining or improving patient outcomes.
Several published reports evaluating the impact... View Details

Keywords: Bundled Payments; Health Care and Treatment; Cost Management

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October 2016 (Revised March 2019)
Case

Carrum Health: Scaling Bundled Payments

By: Robert S. Huckman and Sarah Mehta

Founded in 2014, Carrum Health helped self-insured employers located in three markets (San Diego, California; Seattle, Washington; and San Francisco, California) save money on their employees’ planned surgeries. It did so by contracting directly with top-quality... View Details

Keywords: Health Financing; Health Insurance; Value-based Healthcare Reimbursements; Bundled Payments; Innovation; Scale; Health; Health Care and Treatment; Cost Management; Growth and Development Strategy; Decision Choices and Conditions; Health Industry; California; San Francisco; San Diego; Seattle

June 2014 (Revised April 2015)
Case

OrthoChoice: Bundled Payments in the County of Stockholm (A)

By: Michael E. Porter, Clifford M. Marks and Zachary C. Landman

It was the waiting that drew the attention of the Stockholm County Council. In 2008, patients seeking a hip or knee replacement in Stockholm County faced wait times of up to two years of sometimes debilitating pain, intermittent missed work and income, and the trials... View Details

Keywords: Bundled Payment; Health Care Quality; Health Care; Sweden; Hip Replacement; Knee Replacement; Orthopedics; Health Care and Treatment; Health Disorders; Health; Health Industry; Sweden

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... View Details

Keywords: Medicare; Medicaid; Bundled Payments; Health Care and Treatment; Cost Management; Performance Evaluation; Outcome or Result

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June 2014 (Revised April 2015)
Supplement

OrthoChoice: Bundled Payments in the County of Stockholm (B)

By: Michael E. Porter, Clifford M. Marks and Zachary C. Landman

By the end of 2008, all major hospitals (one of which was private) and three private specialized orthopedic centers signed OrthoChoice contracts. In 2009, hip and knee replacements in the County of Stockholm for relatively healthy patients began being reimbursed. By... View Details

Keywords: Hip Replacement; Bundled Payment; Knee Replacement; Value Agenda; Strategy; Health Care Industry; Health; Health Care and Treatment; Health Disorders; Health Industry; Sweden

September 2011 (Revised August 2014)
Background Note

Note on Bundled Payment in Health Care

By: Regina E. Herzlinger and Charles C. Huang

The note explains how bundled health care payment differs from fee-for-service payment, provides examples of the difference between the two, describes early innovators in bundling and their results, provides guidance on how to make it happen, and elucidates the legal... View Details

Keywords: Health Care and Treatment; Price; Cost Management; Health Industry

October 19, 2015
Article

Getting Bundled Payments Right in Health Care

By: Robert S. Kaplan, Derek A. Haas, Dereesa Reid, Jonathan Warsh and Michael E. West

Bundled payments—single payments that cover all the care for a patient’s medical condition or treatment over a specified timeframe—are increasingly being deployed to motivate the delivery of better patient outcomes at lower costs. Hoag Orthopedic Institute (HOI), a... View Details

Keywords: Health Care and Treatment; Product Marketing; Health Industry

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Article

How to Design a Bundled Payment around Value

By: Robert S. Kaplan, Mary L. Witkowski, Larry Higgins, Jon Warner and Michael Sherman

February 2018
Article

Development and Feasibility of Bundled Payments for the Multidisciplinary Treatment of Head and Neck Cancer: A Pilot Program

By: Tracy Spinks, Alexis Guzman, Beth M. Beadle, Seohyun Lee, Ron Walters, Jim Incalcaterra, Ehab Hanna, Amy Hessel, Randal Weber, Sandra Denney, Lee Newcomer and Thomas W. Feeley

Purpose: Despite growing interest in bundled payments to reduce the costs of care, this payment method remains largely untested in cancer. This 3-year pilot tested the feasibility of a 1-year bundled payment for the multidisciplinary treatment of head and neck... View Details

Keywords: Health Care and Treatment; Cost Management

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November 8, 2018
Article

Transitioning Payment Models: Fee-for-Service to Value-Based Care

By: Thomas W. Feeley and Namita Seth Mohta

In a survey of the NEJM Catalyst Insights Council in July 2018, 42% of respondents say they think value-based reimbursement models will be the primary revenue model for U.S. health care. Indeed, this transition is already happening. Respondents report that a quarter of... View Details

Keywords: Payment Methods; Value-based Healthcare Reimbursements; Health Care and Treatment; Value; Transformation

November 25, 2015
Article

Developing Bundled Reimbursement for Cancer Care

By: Thomas Feeley, Tracy E. Spinks and Alexis Guzman

This case study describes the development of a bundled reimbursement pilot for head and neck cancer patients treated at the University of Texas MD Anderson Cancer Center. The study describes the steps involved and the challenges to new alternative payment models in... View Details

Keywords: Insurance; Health Care and Treatment; Insurance Industry; Health Industry

Article

Participation in a Voluntary Bundled Payment Program by Organizations Providing Care After an Acute Hospitalization

By: A Jay Holmgren, Julia Adler-Milstein and Lena M. Chen

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Article

Time-Driven Activity-Based Costing for Surgical Episodes

By: Peter Najjar, Matt Strickland and Robert S. Kaplan

Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services... View Details

Keywords: Surgery; Time-Driven Activity-Based Costing; Bundled Payments; Health Care and Treatment; Cost Management

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August 2015 (Revised August 2015)
Case

Hoag Orthopedic Institute

By: Robert S. Kaplan and Jonathan Warsh

Two groups of orthopedic surgeons form a joint venture with a community hospital to establish Hoag Orthopedic Institute, a for-profit hospital and two ambulatory service centers. By controlling and integrating all aspects of the patients' medical treatment, the... View Details

Keywords: Outcomes Measurement; Bundled Payment; Health Care; Activity-based Costing And Management; Measurement and Metrics; Activity Based Costing and Management; Competitive Strategy; Medical Specialties; Health Care and Treatment; Outcome or Result; Health Industry

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

February 2021
Case

New England Baptist Hospital: Getting Paid for Value

By: Robert S. Kaplan, Mary Witkowski, Toby E. Emanuel and Syed S. Shehab

New England Baptist Hospital (NEBH), a national leader in adult orthopedic care, has the lowest rate of complications and 30-day readmissions in New England, but gets paid 30% less for its surgeries than nearby institutions. NEBH introduces, with several large... View Details

Keywords: Healthcare; Healthcare Spending; Healthcare Innovation; Healthcare Industry; Health Care Outcomes; Health Care Delivery; Health Care Reform; Bundled Payments; Health Care and Treatment; Spending; Innovation and Invention; Value Creation; Strategy; Health Industry; North America

September 2012 (Revised May 2015)
Case

Philips-Visicu

By: Regina E. Herzlinger, Natalie Kindred and Sara M. McKinley

Would the advent of global payment models and ACOs create sufficient demand for a telemedicine offering covering the care continuum, from hospitals to the home? This was the decision facing Royal Philips Electronics (Philips), the Netherlands-based producer of... View Details

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

September 2017
Case

Tencent

By: John R. Wells and Gabriel Ellsworth

Tencent had undergone many transformations since it was founded in 1998 as a simple messaging service. In 2017, it was the largest online games provider in China with a wide range of game types, China’s largest social networking service provider with several of the... View Details

Keywords: Tencent; Tencent Holdings; WeChat; Social Networking; Social Networks; Gaming; Gaming Industry; Video Games; Computer Games; Mobile Gaming; Portals; Payments; Mobile Payments; O2O; Online-to-offline; E-commerce; Messaging; Subscription Model; Freemium; Mobile App Industry; Smartphone; PC; Monetization Strategy; Antitrust; Streaming; Cloud Computing; Artificial Intelligence; Big Data; Alibaba; Facebook; JD.com; Tesla; Bundling; Synergies; Digital Strategy; Imitation; Licensing; Agility; Entry Barriers; Online Platforms; Advertising; Digital Marketing; Business Ventures; Acquisition; Mergers and Acquisitions; Business Conglomerates; Business Units; Business Growth and Maturation; Business Organization; For-Profit Firms; Joint Ventures; Restructuring; Communication; Communication Technology; Blogs; Interactive Communication; Interpersonal Communication; Entertainment; Film Entertainment; Games, Gaming, and Gambling; Music Entertainment; Investment; Investment Portfolio; Price; Profit; Revenue; Geographic Scope; Cross-Cultural and Cross-Border Issues; Global Strategy; Multinational Firms and Management; Globalized Markets and Industries; Business History; Innovation Strategy; Technological Innovation; Business or Company Management; Goals and Objectives; Growth and Development Strategy; Product Positioning; Social Marketing; Network Effects; Emerging Markets; Market Entry and Exit; Digital Platforms; Industry Growth; Monopoly; Media; Distribution Channels; Product Development; Service Delivery; Organizational Change and Adaptation; Organizational Structure; Public Ownership; Problems and Challenges; Business and Government Relations; Groups and Teams; Networks; Opportunities; Social and Collaborative Networks; Strategy; Adaptation; Business Strategy; Commercialization; Competition; Competitive Advantage; Competitive Strategy; Cooperation; Corporate Strategy; Diversification; Expansion; Horizontal Integration; Vertical Integration; Segmentation; Information Technology; Internet and the Web; Mobile and Wireless Technology; Internet and the Web; Applications and Software; Information Infrastructure; Digital Platforms; Internet and the Web; Mobile and Wireless Technology; Value Creation; Communications Industry; Entertainment and Recreation Industry; Financial Services Industry; Information Industry; Information Technology Industry; Media and Broadcasting Industry; Motion Pictures and Video Industry; Music Industry; Service Industry; Technology Industry; Telecommunications Industry; Video Game Industry; Web Services Industry; Asia; China; Canton (province, China)

2015
Working Paper

How Should We Pay for Health Care?

By: Michael E. Porter and Robert S. Kaplan

Improving the way we pay for health care must be a central component in health care reform. Payment reform must link provider reimbursement and accountability to improving patient value: better health outcomes delivered at lower cost. Today’s deeply flawed... View Details

Keywords: Competition; Value; Health Industry

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