Publications

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

Article

Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

By: Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman

The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with... View Details

Keywords: Health Care and Treatment; Cost Management; Insurance; Problems and Challenges

Article

The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit

By: Junaid Nabi and Robert S. Kaplan

The Centers of Medicare and Medicaid Services (CMS) recently announced that it will be removing more... View Details

Keywords: Ambulatory Care; Payment Policy; Health Care and Treatment; Governing Rules, Regulations, and Reforms

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

June 29, 2022
Other Article

Strategic Complexity? Using Experiments to Understand and Overcome Obfuscation

By: Michael Luca, Ginger Zhe Jin and Daniel Martin

Credit card companies must decide what product features to disclose to consumers, such as payment schedules, penalties, and fees--and also whether to present them clearly or bury them in the fine print. Firms face similar choices in settings ranging from privacy... View Details

Keywords: Obfuscation; Credit Cards; Strategic Incentives; Complexity; Agreements and Arrangements; Customers; Consumer Behavior; Financial Services Industry

2023
Article

Conduit Incentives: Eliciting Cooperation from Workers Outside of Managers' Control

By: Susanna Gallani

Can managers use monetary incentives to elicit cooperation from workers they cannot reward for their efforts? I study “conduit incentives,” an innovative incentive design, whereby managers influence bonus-ineligible workers’ effort by offering bonus-eligible employees... View Details

Keywords: Organizational Behavior Modification; Peer Monitoring; Persistence Of Performance Improvements; Crowding Out; Implicit Incentives; Compensation; Healthcare; Social Pressure; Image Motivation; Incentives; Motivation; Performance; Behavior; Motivation and Incentives; Compensation and Benefits; Governing Rules, Regulations, and Reforms; Organizational Culture; Health Industry; California

November 2020
Article

Accelerator or Brake? Cash for Clunkers, Household Liquidity, and Aggregate Demand

By: Daniel Green, Brian Melzer, Jonathan Parker and Arcenis Rojas

This paper evaluates the Car Allowance Rebate System (CARS) by comparing the vehicle purchases and disposals of households with eligible "clunkers" to those of households with similar, but ineligible, vehicles. CARS caused roughly 500,000 purchases during the program... View Details

Keywords: Automobiles; Purchasing; Government Incentives; Household; Financial Liquidity; Income; Behavior

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

July 31, 2017
Article

A Commitment Contract to Achieve Virologic Suppression in Poorly Adherent Patients with HIV/AIDS

By: Marcella Alsan, John Beshears, Wendy S. Armstrong, James J. Choi, Brigitte C. Madrian, Minh Ly T. Nguyen, Carlos Del Rio, David Laibson and Vincent C. Marconi

Objective: Assess whether a commitment contract informed by behavioral economics leads to persistent virologic suppression among HIV-positive patients with poor antiretroviral therapy (ART) adherence. Design: Single-center pilot randomized clinical trial and a... View Details

Keywords: Adherence; Antiretroviral Therapy; Behavioral Economics; Commitment Contract; Financial Incentives; HIV-1 Virologic Suppression; Health Disorders; Motivation and Incentives

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

Keywords: Value Creation; Cost Management; Health Care and Treatment; Customer Focus and Relationships; Health Industry

June 2024
Article

Enhancing Value and Well-Being: The Basket of Motivators Framework for Aligning Neurology Clinical Practices with Performance Outcomes

By: Peter N. Hadar, Susanna Gallani and Lidia Moura

Physician burnout, which is prevalent in neurology, has accelerated in recent years. While multifactorial, a major contributing factor to burnout is a payment model that rewards volume over quality, leaving physicians overburdened and unfulfilled. The aim of this... View Details

Keywords: Compensation and Benefits; Personal Development and Career; Well-being; Motivation and Incentives

January 2020
Article

Using Time-Driven Activity-Based Costing to Demonstrate Value in Perioperative Care: Recommendations and Review from the Society for Perioperative Assessment and Quality Improvement

By: O. Allin, R. D. Urman, A. F. Edwards, J. D. Blitz, K. J. Pfeifer, T. W. Feeley and A. M. Bader

A shift in health care payment models from volume toward value-based incentives will require deliberate input into systems development from both perioperative clinicians and administrators to ensure appropriate recognition of the value of all services... View Details

Keywords: Value-based Health Care; Outcomes; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost Management; Value; Activity Based Costing and Management

Research Summary

Health Care Management

Samuel S. Chun is studying pricing schemes for various health care services. He focuses on two aspects of the health care delivery problem. First, how do physicians respond to financial incentives and what are the characteristics of a pricing scheme which incents... View Details

June 2006 (Revised June 2007)
Background Note

The Challenge Facing the U.S. Healthcare Delivery System

By: Richard M.J. Bohmer and Carin-Isabel Knoop

Discusses the challenges currently facing the U.S. health care delivery system. These challenges frame the problems managers of delivery organizations are currently facing. They include a burgeoning gap between demand and supply. Demand for health care services is... View Details

Keywords: Health Care and Treatment; Health Industry; United States

05 Aug 2009
News

The Shifting Mission of Health Care Delivery Organizations

Article

Supporting Value-Based Health Care—Aligning Financial and Legal Accountability

By: Mark M. Zaki, Anupam B. Jena and Amitabh Chandra

U.S. health care payment and delivery-system reforms have focused on improving care by making organizations accountable for outcomes, quality, and costs. Payers have supported the implementation of accountable care organizations (ACOs), bundled-payment models, and... View Details

Keywords: Value-based Health Care; Accountability; Health Care and Treatment; United States

I am a second-year PhD student in the Health Policy and Management program at Harvard Business School where my advisor is Dr. Rob Huckman. I live in Brookline with my fiance Natalie and our two cats, Joe and Huey. Before grad school I was a research assistant in the... View Details

31 Oct 2022
Video

Health Minute: Susanna Gallani

July 2016
Case

'Golden Leash' Pay for Directors at The Dow Chemical Company

By: Ian Gow, Suraj Srinivasan and Neeraj Goyal

In November 2014, The Dow Chemical Company was faced with the prospect of a proxy battle with prominent hedge fund and activist investor Third Point Management. The activist had criticized Dow’s recent performance and advocated that the company split itself to maximize... View Details

Keywords: Motivation and Incentives; Governing and Advisory Boards; Executive Compensation; Investment Activism; Chemical Industry