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All HBS Web
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- Faculty Publications (310)
- August 2020
- Article
Do Physician Incentives Increase Patient Medication Adherence?
By: Edward Kong, John Beshears, David Laibson, Brigitte Madrian, Kevin Volpp, George Loewenstein, Jonathan Kolstad and James J. Choi
We conducted a randomized experiment (911 primary care practices and 8,935 nonadherent patients) to test the effect of paying physicians for increasing patient medication adherence in three drug classes: diabetes medication, antihypertensives, and statins. We measured...
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Keywords:
Health Economics;
Medication Adherence;
Physician Payment Incentives;
Primary Care;
Quality Improvement;
Health Care and Treatment;
Motivation and Incentives;
Behavior
Kong, Edward, John Beshears, David Laibson, Brigitte Madrian, Kevin Volpp, George Loewenstein, Jonathan Kolstad, and James J. Choi. "Do Physician Incentives Increase Patient Medication Adherence?" Health Services Research 55, no. 4 (August 2020): 503–511.
- July 2020
- Article
Healthy Business? Managerial Education and Management in Healthcare
By: Nicholas Bloom, Renata Lemos, Raffaella Sadun and John Van Reenen
We investigate the link between hospital performance and managerial education by collecting a large database of management practices and skills in hospitals across nine countries. We find that hospitals that are closer to universities offering both medical education...
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Keywords:
Management;
Hospitals;
Mortality;
Education;
Health Care and Treatment;
Performance Improvement;
Business Education;
Management Practices and Processes
Bloom, Nicholas, Renata Lemos, Raffaella Sadun, and John Van Reenen. "Healthy Business? Managerial Education and Management in Healthcare." Review of Economics and Statistics 102, no. 3 (July 2020): 506–517.
- Article
The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding
By: Brian Franklin, Sharif Vakili, Robert S. Huckman, Sarah Hosein, Nicholas Falk, Katherine Cheng, Maria Murray, Sheila Harris, Charles A. Morris and Eric Goralnick
Delayed access to inpatient beds for admitted patients contributes significantly to emergency department (ED) boarding and crowding, which have been associated with deleterious patient safety effects. To expedite inpatient bed availability, some hospitals have...
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Keywords:
Health Care Delivery;
Emergency Room;
Operations Improvement;
Operations Management;
Health Care and Treatment;
Service Delivery;
Operations;
Management;
Performance Improvement;
Service Operations
Franklin, Brian, Sharif Vakili, Robert S. Huckman, Sarah Hosein, Nicholas Falk, Katherine Cheng, Maria Murray, Sheila Harris, Charles A. Morris, and Eric Goralnick. "The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding." Annals of Emergency Medicine 75, no. 6 (June 2020): 704–714.
- Article
Treatment Of Opioid Use Disorder Among Commercially Insured U.S. Adults, 2008–17
By: Karen Shen, Eric Barrette and Leemore S. Dafny
There is abundant literature on efforts to reduce opioid prescriptions and misuse, but comparatively little on the treatment provided to people with opioid use disorder (OUD). Using claims data representing 12–15 million nonelderly adults covered through commercial...
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Keywords:
Opioid Treatment;
Medication-assisted Treatment;
Substance Use Disorder;
Private Insurance;
Health Disorders;
Health Care and Treatment;
Insurance;
United States
Shen, Karen, Eric Barrette, and Leemore S. Dafny. "Treatment Of Opioid Use Disorder Among Commercially Insured U.S. Adults, 2008–17." Health Affairs 39, no. 6 (June 2020): 993–1001.
- May 21, 2020
- Editorial
Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?
By: Leemore S. Dafny and J. Michael McWilliams
Primary care clinicians are the front line for patients with suspected infection. We rely on them to diagnose, triage, and manage patients with potential or confirmed COVID infections. They are also responsible for keeping non-COVID medical conditions under control...
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Keywords:
COVID-19;
Primary Care;
Health Pandemics;
Health Care and Treatment;
Financial Condition;
Insurance
Dafny, Leemore S., and J. Michael McWilliams. "Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?" Health Affairs Blog (May 21, 2020).
- January 2, 2020
- Article
Medicare for All or Public Option: Can Either Heal Health Care?
By: Regina E. Herzlinger and James Wallace
The United States has serious health care problems: More than 27 million uninsured people, costs that are growing faster than income, and a staggering $37 trillion of unfunded liabilities in the Medicare program. Perhaps most alarming: The US ranks lowest among...
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Keywords:
Healthcare;
Public Option;
Medicare;
Health Care and Treatment;
Insurance;
Cost Management;
Problems and Challenges;
United States
Herzlinger, Regina E., and James Wallace. "Medicare for All or Public Option: Can Either Heal Health Care?" Harvard Business School Working Knowledge (January 2, 2020).
- 2020
- Working Paper
Cutting the Gordian Knot of Employee Health Care Benefits and Costs: A Corporate Model Built on Employee Choice
By: Regina E. Herzlinger and Barak D. Richman
The U.S. employer-based health insurance tax exclusion created a system of employer-sponsored insurance (ESI) with limited insurance choices and transparency that may lock employed households into health plans that are costlier or different from those they prefer to...
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Keywords:
After-tax Income;
Consumer-driven Health Care;
Health Care Costs;
Health Insurance;
Income Inequality;
Tax Policy;
Health Care and Treatment;
Cost;
Insurance;
Employees;
Income;
Taxation;
Policy;
United States
Herzlinger, Regina E., and Barak D. Richman. "Cutting the Gordian Knot of Employee Health Care Benefits and Costs: A Corporate Model Built on Employee Choice." Duke Law School Public Law & Legal Theory Series, No. 2020-4, December 2019. (Revised January 2021.)
- November 2019 (Revised December 2019)
- Case
Martini Klinik: Prostate Cancer Care 2019
By: Michael E. Porter, Jens Deerberg-Wittram and Thomas W. Feeley
Since its establishment in 2005, Hamburg’s Martini Klinik had single mindedly focused on prostate cancer care with a commitment to measure long-term health outcomes for every patient. A wholly owned subsidiary of the University Hospital Hamburg, Martini Klinik was a...
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Keywords:
Health Care;
Michael Porter;
Jens Deerberg-Wittram;
Clifford Marks;
Prostate Cancer;
Health Care Policy;
Value Agenda;
Integrated Practice Units;
Outcomes Measurement;
Health Care and Treatment;
Value;
Health Disorders;
Insurance;
Medical Specialties;
Outcome or Result;
Measurement and Metrics;
Business Processes;
Insurance Industry;
Health Industry;
Germany
Porter, Michael E., Jens Deerberg-Wittram, and Thomas W. Feeley. "Martini Klinik: Prostate Cancer Care 2019." Harvard Business School Case 720-359, November 2019. (Revised December 2019.)
- November 9, 2019
- Article
Effect of Revealing Authors' Conflicts of Interests in Peer Review: Randomized Controlled Trial
By: Leslie K. John, George Loewenstein, Andrew Marder and Michael Callaham
Objective: To assess the impact of disclosing authors’ conflict of interest declarations to peer reviewers at a medical journal.
Design: Randomised controlled trial.
Setting: The study was conducted within the manuscript review process at the... View Details
Design: Randomised controlled trial.
Setting: The study was conducted within the manuscript review process at the... View Details
Keywords:
Conflicts Of Interest;
Peer Review;
Randomized Controlled Trial;
Scientific Publication;
Conflict of Interests;
Journals and Magazines;
Science
John, Leslie K., George Loewenstein, Andrew Marder, and Michael Callaham. "Effect of Revealing Authors' Conflicts of Interests in Peer Review: Randomized Controlled Trial." BMJ: British Medical Journal 367, no. 8221 (November 9, 2019).
- June 2019
- Teaching Note
Zebra Medical Vision
By: Shane Greenstein and Sarah Gulick
Teaching note is meant to accompany Zebra Medical Vision case, which offers a look at a company’s decisions as a small startup competing with other startups and major technology companies. It also demonstrates the challenges faced by a machine learning company working...
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- 2019
- Article
Time-Driven Activity-Based Cost Analysis for Outpatient Anticoagulation Therapy: Direct Costs in a Primary Care Setting with Optimal Performance
By: Robert S. Kaplan, Rohit A. Bobade, Richard A. Helmers, Thomas M. Jaeger, Laura J. Odell and Derek A. Haas
Objectives: To determine how overall cost of anticoagulation therapy for warfarin compares with that of Novel Oral Anticoagulants (NOACs). Also, to demonstrate a scientific, comprehensive, and an analytical approach to estimate direct costs involved in monitoring and...
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Keywords:
Time-Driven Activity-Based Costing;
Activity Based Costing and Management;
Health Care and Treatment;
Analysis
Kaplan, Robert S., Rohit A. Bobade, Richard A. Helmers, Thomas M. Jaeger, Laura J. Odell, and Derek A. Haas. "Time-Driven Activity-Based Cost Analysis for Outpatient Anticoagulation Therapy: Direct Costs in a Primary Care Setting with Optimal Performance." Journal of Medical Economics 22, no. 5 (2019): 471–477.
- April 2019
- Case
Barber Cardiosystems
By: Ranjay Gulati and Paul S. Myers
Barber Cardiosystems, based in Melbourne, Australia, designs and manufactures therapeutic devices used for treatment of coronary conditions. Over four decades, it has grown to be among the top 200 medical device companies in the world. It competes against much larger...
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Keywords:
Organizational Behavior;
Strategic Alignment;
Cost Management;
Performance Productivity;
Organizational Culture;
Motivation and Incentives;
Organizational Design;
Strategy;
Leadership;
Medical Devices and Supplies Industry;
Australia
Gulati, Ranjay, and Paul S. Myers. "Barber Cardiosystems." Harvard Business School Brief Case 919-505, April 2019.
- March 2019 (Revised April 2021)
- Case
The DivaCup: Navigating Distribution and Growth
By: Ayelet Israeli
When the mother-daughter founders of DivaCup set out with a mission to disrupt the menstrual care industry with an innovative product form, they initially struggled to gain legitimacy and convince retailers to carry their unique product. Fifteen years later, the...
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Keywords:
Female;
Female Ceo;
Female Entrepreneur;
Female Protagonist;
Health & Wellness;
Healthcare;
Price Policies;
Minimum Advertised Price;
Differentiation;
Positioning;
Growth;
Health;
Health Care and Treatment;
Price;
Disruption;
Distribution;
Distribution Channels;
Competitive Strategy;
Competition;
Growth Management;
Mission and Purpose;
Product Development;
Product Marketing;
Product Launch;
Product Positioning;
Advertising;
Business Startups;
Internet and the Web;
Entrepreneurship;
Social Entrepreneurship;
Social Issues;
Social Enterprise;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Canada;
United States;
United Kingdom
Israeli, Ayelet. "The DivaCup: Navigating Distribution and Growth." Harvard Business School Case 519-055, March 2019. (Revised April 2021.)
- March 2019
- Article
A Time-Driven Activity-Based Costing Analysis of Emergency Department Scribes
By: Robert S. Kaplan, Heather A. Heaton, David M. Nestler, William J. Barry, Richard A. Helmers, Mustafa Y. Sir, Deepi G. Goyal, Derek A. Haas and Annie T. Sadosty
Objectives: To apply time-driven activity-based costing (TDABC) methodology to determine emergency medicine physician documentation costs with and without scribes.
Methods: Two research assistants shadowed attending physicians for a total of 64 hours in the... View Details
Methods: Two research assistants shadowed attending physicians for a total of 64 hours in the... View Details
Kaplan, Robert S., Heather A. Heaton, David M. Nestler, William J. Barry, Richard A. Helmers, Mustafa Y. Sir, Deepi G. Goyal, Derek A. Haas, and Annie T. Sadosty. "A Time-Driven Activity-Based Costing Analysis of Emergency Department Scribes." Mayo Clinic Proceedings: Innovations, Quality & Outcomes 3, no. 1 (March 2019): 30–34.
- 2019
- Chapter
Behavioral Economics and Health-Care Markets
By: Amitabh Chandra, Benjamin Handel and Joshua Schwartzstein
This chapter summarizes research in behavioral health economics, focusing on insurance markets and product markets in health care. We argue that the prevalence of choice difficulties and biases leading to mistakes in these markets establish a special place for them in...
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Keywords:
Behavioral Economics;
Consumer Behavior;
Economics;
Health Care and Treatment;
Insurance;
Markets
Chandra, Amitabh, Benjamin Handel, and Joshua Schwartzstein. "Behavioral Economics and Health-Care Markets." Chap. 6 in Handbook of Behavioral Economics: Foundations and Applications 2, edited by B. Douglas Bernheim, Stefano DellaVigna, and David Laibson, 459–502. Amsterdam: Elsevier/North-Holland, 2019.
- October 2018 (Revised August 2019)
- Case
Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?
By: Leemore Dafny
In July 2017, CEO Kevin Tabb of Boston's Beth Israel Deaconess Medical Center announced his plan to consolidate 11 Massachusetts hospitals under a common management structure. These hospitals collectively generated $5 billion in patient revenue and 25% of...
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Keywords:
Beth Israel Deaconess;
Lahey;
Partners;
Health Care;
Hospitals;
Payers;
Providers;
Anti-trust;
Health Care Regulation;
Mergers and Acquisitions;
Health Care and Treatment;
Market Design;
Duopoly and Oligopoly;
Negotiation;
Consolidation;
Competition;
Health Industry;
Massachusetts;
Boston
Dafny, Leemore. "Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?" Harvard Business School Case 319-026, October 2018. (Revised August 2019.)
- September 2018 (Revised December 2019)
- Case
Zebra Medical Vision
By: Shane Greenstein and Sarah Gulick
An Israeli startup founded in 2014, Zebra Medical Vision developed algorithms that produced diagnoses from X-rays, mammograms, and CT-scans. The algorithms used deep learning and digitized radiology scans to create software that could assist doctors in making...
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Keywords:
Radiology;
Machine Learning;
X-ray;
CT Scan;
Medical Technology;
Probability;
FDA 510(k);
Diagnosis;
Business Startups;
Health Care and Treatment;
Information Technology;
Applications and Software;
Competitive Strategy;
Product Development;
Commercialization;
Decision Choices and Conditions;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Medical Devices and Supplies Industry;
Israel
Greenstein, Shane, and Sarah Gulick. "Zebra Medical Vision." Harvard Business School Case 619-014, September 2018. (Revised December 2019.)
- March 2018
- Supplement
Improving Access at VA
By: Ryan W. Buell and Robert S. Huckman
In 2015, the Department of Veterans Affairs (VA) ran the largest healthcare system in the United States, with over 1,700 sites of care that served nearly 9 million veterans. One year earlier, a scandal had erupted over a cover-up of the excessive wait times veterans...
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Keywords:
Service Operations;
Service Delivery;
Social Issues;
Health Care and Treatment;
Government Administration;
Performance Improvement;
Public Administration Industry;
Health Industry;
United States
Buell, Ryan W., and Robert S. Huckman. "Improving Access at VA." Harvard Business School Multimedia/Video Supplement 618-709, March 2018.
- March 2018 (Revised February 2020)
- Teaching Note
Improving Access at VA
By: Ryan W. Buell and Robert S. Huckman
In 2015, the Department of Veterans Affairs (VA) ran the largest healthcare system in the United States, with over 1,700 sites of care that served nearly 9 million veterans. One year earlier, a scandal had erupted over a cover-up of the excessive wait times veterans...
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- March 2018
- Case
University Hospitals Cleveland Medical Center: Managing Capacity in Neurology
By: Joel Goh, Robert S. Huckman and Nikhil Sahni
In December 2014, Dr. Anthony Furlan, chair of the Department of Neurology at University Hospitals Cleveland Medical Center (UH), faced a mandate from the hospital’s executive leadership team. Specifically, all UH departments were directed to take steps within six...
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Keywords:
Health Care;
Hospitals;
Capacity Planning;
Scheduling;
Health Care and Treatment;
Service Operations;
Performance Capacity;
Health Industry;
North America;
United States;
Ohio;
Cleveland
Goh, Joel, Robert S. Huckman, and Nikhil Sahni. "University Hospitals Cleveland Medical Center: Managing Capacity in Neurology." Harvard Business School Case 618-062, March 2018.