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- 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
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
- 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
Keywords: Health Care; Philips; Visicu; Telemedicine; eICU; Accountable Care Organization; ACO; Bundled Payment; Hospital To Home; Patient Monitoring Devices; Home Health Care; Health Care and Treatment; Communication Technology; Quality; Safety; Performance Productivity; Performance Capacity; Performance Efficiency; Consumer Behavior; Emerging Markets; Health Industry; Telecommunications Industry; 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
- 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
- Article
Operational Efficiency and Effective Management in the Catheterization Laboratory
By: Grant W. Reed, Michael L. Tushman and Samir R. Kapadia
Operational efficiency is a core business principle in which organizations strive to deliver high-quality goods or services in a cost-effective manner. This concept has become increasingly relevant to cardiac catheterization laboratories, as insurers move away from... View Details
- 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
- 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
- Article
Adding Value by Talking More
By: Robert S. Kaplan, Derek A. Haas and Jonathan Warsh
The prevailing fee-for-service payment model has led health care administrators and physician practices to impose severe constraints on the time physicians spend talking, for which they are reimbursed poorly or not at all. New value-based reimbursement models, however,... View Details
- 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
- July–August 2016
- Article
How to Pay for Health Care
By: Michael E. Porter and Robert S. Kaplan
The United States stands at a crossroads in how to pay for health care. Fee for service, the dominant model in the United States and many other countries, is now widely recognized as perhaps the biggest obstacle to improving health care delivery. A battle is currently... View Details
- 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
- 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
- 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
- November–December 2014
- Article
Using Time-Driven Activity-Based Costing to Identify Value-Improvement Opportunities in Healthcare
By: Robert S. Kaplan, Mary L. Witkowski, Megan Abbott, Alexis Guzman, Laurence Higgins, John Meara, Erin Padden, Apurva Shah, Peter Waters, Marco Weidemeier, Samuel Wertheimer and Thomas W. Feeley
As healthcare providers cope with pricing pressures and increased accountability for performance, they should be rededicating themselves to improving the value they deliver to their patients: better outcomes and lower costs. Time-driven activity-based costing offers... View Details
- 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
- 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
- Article
How to Design a Bundled Payment around Value
By: Robert S. Kaplan, Mary L. Witkowski, Larry Higgins, Jon Warner and Michael Sherman
- March 2013
- Other Article
Redesigning Primary Care: A Strategic Vision to Improve Value by Organizing Around Patients' Needs
By: Michael E. Porter, Erika A. Pabo and Thomas H. Lee
Primary care in the United States currently struggles to attract new physicians and to garner investments in infrastructure required to meet patients' needs. We believe that the absence of a robust overall strategy for the entire spectrum of primary care is a... View Details
Keywords: Health
- 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
Keywords: Health Care; Philips; Visicu; Telemedicine; eICU; Accountable Care Organization; ACO; Bundled Payment; Hospital To Home; Patient Monitoring Devices; Home Health Care; Health Care and Treatment; Communication Technology; Quality; Safety; Performance Productivity; Performance Capacity; Performance Efficiency; Consumer Behavior; Emerging Markets; Health Industry; Telecommunications Industry; Netherlands
- 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