Publications

January 2024
Background Note

Evaluating Innovations in the Organization of Primary Care: What Type of Innovation Is It and How Well Does It Align with the Six Factors?

By: Regina E. Herzlinger and James Wallace

How can we evaluate if innovative health care ventures can do good—benefit society—and do well—become financially viable? This question is the topic of the first module in the Innovating in Health Care course book.

This note and "Health Stop (A): What Type... View Details

Keywords: Business Model; Health Care and Treatment; Collaborative Innovation and Invention; Mission and Purpose; Alignment; Health Industry

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... View Details

Keywords: Health Care and Treatment; Cost; Equality and Inequality; Health Industry

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

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

January–February 2024
Article

Shared Service Delivery Can Increase Client Engagement: A Study of Shared Medical Appointments

By: Ryan W. Buell, Kamalini Ramdas, Nazlı Sönmez, Kavitha Srinivasan and Rengaraj Venkatesh

Problem Definition: Clients and service providers alike often consider one-on-one service delivery to be ideal, assuming – perhaps unquestioningly – that devoting individualized attention best improves client outcomes. In contrast, in shared service delivery, clients... View Details

Keywords: Health Care and Treatment; Customer Satisfaction; Outcome or Result; Performance Improvement

December 2023 (Revised February 2024)
Case

Transforming Healthcare Delivery at Karolinska University Hospital

By: Susanna Gallani, Mary Witkowski, Elena Corsi and Nikolina Jonsson

The case study examines the journey toward value-based healthcare at Karolinska University Hospital. The hospital's ambitious shift to a patient-centered care delivery model, accompanied by the construction of a new facility, encountered challenges such as high costs,... View Details

Keywords: Change Management; Transformation; Transition; Business Organization; Communication Strategy; Information Infrastructure; Service Delivery; Organizational Change and Adaptation; Organizational Structure; Health Industry; Sweden; Europe

December 2023
Teaching Note

Buurtzorg

By: Ethan Bernstein and Tatiana Sandino

Teaching Note for HBS Case No. 122-101. As co-founders of home nursing company Buurtzorg, Jos de Blok and Gonnie Kronenberg prized both self-management and organizational learning. Buurtzorg’s 10,000 nurses across 950 neighborhood nursing teams in the Netherlands were... View Details

Keywords: Health Care and Treatment; Employee Relationship Management; Knowledge Dissemination; Knowledge Management; Management Practices and Processes; Organizational Design; Organizational Structure; Groups and Teams; Learning; Health Industry; Netherlands

December 12, 2023
Article

Prices for Common Services at Quaternary vs Nonquaternary Hospitals

By: Brandon W. Yan, Maximilian J. Pany and Leemore S. Dafny

Using commercial health insurance claims data from 2017-2019, we assessed whether quaternary hospitals charged higher prices for common, unspecialized services also offered by nonquaternary hospitals. We found quaternary-hospital price premiums of 8.2 percent, on... View Details

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

December 4, 2023
Comment

The Great Resignation, Employment, and Wages in Health Care

By: Amitabh Chandra and Louis-Jonas Heizlsperger

Notwithstanding concerns about staffing levels and burnout in health care, federal wage and employment data does not support the suggestion that a COVID-19 pandemic-related spike in quitting has had an enduring impact for hospitals or physician offices. Employment in... View Details

Keywords: Resignation and Termination; Employment; Wages; Health Industry

December 2023
Article

Association of Hospital System Affiliation with COVID-19 Capacity Burden

By: Zachary Levin, Pinar Karaca-Mandic, Richard J. Boxer and Regina E. Herzlinger

What is the message? The COVID-19 pandemic exposed the highly variable and uncoordinated responses by hospitals. The authors found that while the non-top ten system affiliated hospitals had a larger COVID-19 share index relative to independent hospitals, top-ten system... View Details

Keywords: COVID-19 Pandemic; Resource Allocation; Health Pandemics; Demographics; Health Care and Treatment; Health Industry

2023
Working Paper

Healthcare Provider Bankruptcies

By: Samuel Antill, Jessica Bai, Ashvin Gandhi and Adrienne Sabety

Healthcare firms are increasingly filing for Chapter 11 bankruptcy. Using two strategies, we show causal evidence that bankruptcies harm patients through increased worker turnover. First, in an online experiment, experienced nurses assess hypothetical employers and... View Details

Keywords: Insolvency and Bankruptcy; Health Care and Treatment; Outcome or Result; Retention; Health Industry

October 2023
Supplement

Hey Jane: Background on Abortion in the U.S.

By: Rembrand Koning, Geraldine Pena-Galea and Sarah Mehta

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

October 2023
Case

Hey Jane: Delivering Abortion Pills to the Doorstep

By: Rembrand Koning, Geraldine Pena-Galea and Sarah Mehta

This case tells the story of Hey Jane, a telehealth clinic founded in 2020 that provides virtual medication abortion services to eligible patients in nine U.S. states. By January 2023, the company had served more than 20,000 patients and raised nearly $10 million in... View Details

Keywords: Operations; Business Startups; Health Care and Treatment; Growth and Development Strategy; Health Industry; Health Industry; United States

October 2023
Supplement

Hey Jane: Early Investor Pitch Deck

By: Rembrand Koning

Keywords: Health Care and Treatment; Operations; Entrepreneurial Finance; Health Industry; Health Industry; United States

October 2023 (Revised March 2024)
Case

KOKO Networks: Bridging Energy Transition and Affordability with Carbon Financing

By: George Serafeim, Siko Sikochi and Namrata Arora

The problem was massive: two million hectares of African forests were lost annually to charcoal production for cooking, an area equivalent to 13 times Greater London, resulting in one billion tons of carbon emissions yearly. At the same time, an estimated 700,000... View Details

Keywords: Clean Tech; Digital; Carbon Credits; Carbon Offsetting; Climate Change; Entrepreneurship; Energy Sources; Environmental Sustainability; Health; Market Design; Business Startups; Transition; Environmental Regulation; Policy; Energy Industry; Consumer Products Industry; Africa; Kenya; Rwanda

October 2023
Background Note

What Leaders Need to Know about Mental Health

By: Boris Groysberg, Robin Abrahams, Liana Groysberg, Natalia Groysberg and Abhijit Naik

This paper will provide an overview of the nature of anxiety and depression, the particular vulnerabilities and stresses of CEOs, and suggestions for managing mental health in the workplace. View Details

Keywords: CEO; Mental Health; Health Care and Treatment; Health Disorders; Leadership; Well-being

2023
Working Paper

The Political Economy of a 'Miracle Cure': The Case of Nebulized Ibuprofen and Its Diffusion in Argentina

By: Sebastian Calónico, Rafael Di Tella and Juan Cruz Lopez Del Valle

We document the diffusion of nebulized ibuprofen in Argentina as a treatment for COVID-19. As the pandemic spread, this clinically unsupported drug reached thousands of patients, even some seriously ill, despite warnings by the regulator and medical societies. Detailed... View Details

Keywords: COVID-19; Health Care and Treatment; Health Pandemics; Adoption; Behavior; Governing Rules, Regulations, and Reforms; Learning

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October 2023
Case

Vida Health: Transforming Chronic Disease Treatment

By: William Sahlman and Nicole Tempest Keller

San Francisco based Vida Health, founded by Stephanie Tilenius, former vice president of Commerce and Payments at Google, was a B2B digital health startup focused on the treatment of cardiometabolic conditions, such as diabetes and obesity. Its innovative digital... View Details

Keywords: Corporate Strategy; Growth and Development Strategy; Demand and Consumers; Health Care and Treatment; Product Marketing; Risk and Uncertainty; Technological Innovation; Health Industry; Health Industry; United States; California; San Francisco

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... View Details

Keywords: Quality; Health Care and Treatment; Measurement and Metrics; Outcome or Result; Health Industry

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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.... View Details

Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost Accounting; Health Industry