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All HBS Web
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- Faculty Publications (150)
- Article
Mandate Outcomes Reporting
By: Robert S. Kaplan and Michael E. Porter
Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to...
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Keywords:
Outcomes Reporting;
Outcomes Measurement;
Medicare;
Medicaid;
Health Care and Treatment;
Outcome or Result;
Measurement and Metrics
Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
- Article
Achieving Value in Highly Complex Acute Care: Lessons from the Delivery of Extra Corporeal Life Support
By: Michael Nurok, Jonathan Warsh, Erik Dong, Jeffrey Lopez, Mayumi Kharabi and Robert S. Kaplan
We applied a value (outcomes and cost) analysis to extracorporeal life support (ECLS), a relatively rare but very expensive ICU therapy with highly variable outcomes. To address the outcome component of the value approach, we created guidelines for ECLS delivery; to...
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Nurok, Michael, Jonathan Warsh, Erik Dong, Jeffrey Lopez, Mayumi Kharabi, and Robert S. Kaplan. "Achieving Value in Highly Complex Acute Care: Lessons from the Delivery of Extra Corporeal Life Support." NEJM Catalyst (October 31, 2019).
- Article
Navy Medicine Introduces Value-Based Health Care
By: Alee Hernandez, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III and Michael E. Porter
In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could...
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Hernandez, Alee, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III, and Michael E. Porter. "Navy Medicine Introduces Value-Based Health Care." Health Affairs 38, no. 8 (August 2019): 1393–1400.
- 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...
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Keywords:
Medicare;
Medicaid;
Bundled Payments;
Health Care and Treatment;
Cost Management;
Performance Evaluation;
Outcome or Result
Haas, Derek A., Xiaoran Zhang, Robert S. Kaplan, and Zirui Song. "Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements." JAMA Internal Medicine 179, no. 7 (July 2019): 924–931.
- Article
Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System
By: Regina E. Herzlinger and Bacchus Barua
An analysis of Canada’s single-payer healthcare system shows the dangers of the proposed Medicare for All model. In fact, the Canadian healthcare system is costly and drives poor outcomes when compared to objective performance measures. Alternatively, the Swiss and...
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Keywords:
Healthcare Systems;
Universal Health Coverage;
Health Care and Treatment;
Insurance;
Canada;
Switzerland;
Netherlands
Herzlinger, Regina E., and Bacchus Barua. "Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System." Wall Street Journal (April 17, 2019).
- Article
Populism and the Return of the 'Paranoid Style': Some Evidence and a Simple Model of Demand for Incompetence as Insurance against Elite Betrayal
By: Rafael Di Tella and Julio J. Rotemberg
We present a simple model of populism as the rejection of “disloyal” leaders. We show that adding the assumption that people are worse off when they experience low income as a result of leader betrayal (than when it is the result of bad luck) to a simple voter choice...
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Di Tella, Rafael, and Julio J. Rotemberg. "Populism and the Return of the 'Paranoid Style': Some Evidence and a Simple Model of Demand for Incompetence as Insurance against Elite Betrayal." Journal of Comparative Economics 46, no. 4 (December 2018): 988–1005.
- Article
Defining, Measuring, and Improving Value in Spine Care
By: Robert S. Kaplan and Derek Haas
This chapter discusses how to measure and improve spine care outcomes and costs. Today’s commonly used outcome metrics, such as readmission and complication rates, are actually process and quality metrics. They are not the outcomes, such as improvement in pain and...
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Keywords:
Spine Care;
Outcomes Measurement;
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Cost;
Measurement and Metrics;
Performance Improvement;
Value
Kaplan, Robert S., and Derek Haas. "Defining, Measuring, and Improving Value in Spine Care." Seminars in Spine Surgery 30, no. 2 (June 2018): 80–83.
- Article
Performance Effects of Setting a High Reference Point for Peer‐Performance Comparison
By: Henry Eyring and V.G. Narayanan
We conduct a field experiment, based on a registered report accepted by the Journal of Accounting Research, to test performance effects of setting a high reference point for peer‐performance comparison. Relative to providing the median as a reference point for...
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Keywords:
Relative Performance Evaluation;
Reference Points;
Social Comparison;
Field Experiment;
Performance;
Performance Evaluation;
Education
Eyring, Henry, and V.G. Narayanan. "Performance Effects of Setting a High Reference Point for Peer‐Performance Comparison." Journal of Accounting Research 56, no. 2 (May 2018): 581–615.
- 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...
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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
Kaplan, Robert S., Michael E. Porter, Thomas W. Feeley, and Alee Hernandez. "Medtronic: Navigating a Shifting Healthcare Landscape." Harvard Business School Case 718-471, January 2018. (Revised June 2018.)
- Article
TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear
By: Robert S. Kaplan, Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller and John I. Lowenstein
Purpose
To perform a cost analysis comparison for managing common ocular disorders in an eye emergency department (ED) versus an urgent care setting using a time-driven activity-based cost model (TDABC) to assist physicians and staff in appropriate allocation of...
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Keywords:
Time-driven Activity-based Cost Model;
Emergency Room;
Urgent Care Clinic;
Cost;
Analysis;
Activity Based Costing and Management;
Health Care and Treatment
Kaplan, Robert S., Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller, and John I. Lowenstein. "TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear." Journal of Academic Ophthalmology 10 (2018).
- January 2018
- Article
The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial
By: Leslie K. John, Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein and Kevin Volpp
Purpose: We tested the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally-available weight management program.
Design: A randomized trial tested the impact of employer subsidy: 100%; 80% 50% and a hybrid 50% subsidy... View Details
Design: A randomized trial tested the impact of employer subsidy: 100%; 80% 50% and a hybrid 50% subsidy... View Details
Keywords:
Affordable Care Act (ACA);
Subsidies;
Weight Loss;
Obesity;
Incentives;
Behavioral Economics;
Motivation and Incentives;
Behavior;
Health Disorders;
Health Care and Treatment;
Compensation and Benefits;
United States
John, Leslie K., Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein, and Kevin Volpp. "The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial." American Journal of Health Promotion 32, no. 1 (January 2018): 170–176.
- Article
The IT Transformation Health Care Needs
By: Nikhil R. Sahni, Robert S. Huckman, Anuraag Chigurupati and David M. Cutler
In recent years, health care organizations have made sizable investments in information technology. They’ve used their IT systems to replace paper records with electronic ones and to improve billing processes, thereby boosting revenue. But so far, IT has been of little...
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Keywords:
Health Care and Treatment;
Information Technology;
Performance Improvement;
Business Model
Sahni, Nikhil R., Robert S. Huckman, Anuraag Chigurupati, and David M. Cutler. "The IT Transformation Health Care Needs." Harvard Business Review 95, no. 6 (November–December 2017): 128–136.
- Article
Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT
By: Jonathan G. Rogg, Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang and Benjamin White
Study objectives: Facing increased utilization and subsequent capacity and budget constraints, EDs must better understand bottlenecks and their effect on process flow to improve process efficiency. The primary objective of this study was to identify bottlenecks in...
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Keywords:
Health Care;
Bottleneck;
Health Care and Treatment;
Operations;
Health Industry;
United States
Rogg, Jonathan G., Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang, and Benjamin White. "Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT." American Journal of Emergency Medicine 35, no. 10 (October 2017): 1510–1513.
- September 2017 (Revised February 2023)
- Case
Intermountain Healthcare: Pursuing Precision Medicine
By: Richard G. Hamermesh, Kathy E. Giusti, Robert S. Huckman and Julia Kelley
Headquartered in Salt Lake City, Intermountain Healthcare operates 23 hospitals and hundreds of clinics in Utah and Idaho and provides insurance to approximately 850,000 patients through its insurance arm, SelectHealth. In 2013, Intermountain, known for its commitment...
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Keywords:
Precision Medicine;
Healthcare;
Innovation;
Cancer;
Cancer Research;
Health Care;
Technology;
Health Care and Treatment;
Innovation Leadership;
Disruptive Innovation;
Entrepreneurship;
Decision Choices and Conditions;
Health Industry;
Insurance Industry;
Utah;
United States;
North America
Hamermesh, Richard G., Kathy E. Giusti, Robert S. Huckman, and Julia Kelley. "Intermountain Healthcare: Pursuing Precision Medicine." Harvard Business School Case 818-018, September 2017. (Revised February 2023.)
- September 2017
- Article
Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers
By: Robert S. Kaplan, Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam and Christopher J. Hartnick
Time-driven activity-based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic...
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Keywords:
Time-Driven Activity-Based Costing;
Activity Based Costing and Management;
Health Care and Treatment
Kaplan, Robert S., Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam, and Christopher J. Hartnick. "Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers." The Laryngoscope 127, no. 9 (September 2017).
- August 2017
- Case
CareMore Health System
By: Robert S. Huckman and Brian W. Powers
CareMore Health System—a physician-founded care delivery system and health plan—had developed and refined an innovative care model for at-risk seniors enrolled in Medicare managed care (i.e., Medicare Advantage) plans. CareMore's President, Sachin Jain, and his...
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Keywords:
Health Care Delivery;
Health Insurance;
Medicare;
Medicaid;
Managed Care;
Extensivist;
Social Determinants Of Health;
Health Care and Treatment;
Insurance;
Business Model;
Growth and Development Strategy;
Decision Choices and Conditions;
Health Industry;
United States
Huckman, Robert S., and Brian W. Powers. "CareMore Health System." Harvard Business School Case 618-008, August 2017.
- August 2017
- Article
Relationship Between Labor and Delivery Unit Management Practices and Maternal Outcomes
By: Avery C. Plough, Grace Galwin, Zhonghe Li, Stuart R. Lipsitz, Shehnaz Alidina, Natalie J. Henrich, Lisa R. Hirschhorn, William R. Berry, Atul A. Gawande, Doris Peter, Rory McDonald, Donna L. Caldwell, Janet H. Muri, Debra Bingham, Aaron B. Caughey, Eugene R. Declercq and Neel T. Shah
OBJECTIVE: To define, measure, and characterize key competencies of managing labor and delivery units in the United States and assess the associations between unit management and maternal outcomes.
METHODS: We developed and administered a management measurement...
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Keywords:
Health Care and Treatment;
Management Practices and Processes;
Performance Evaluation;
Outcome or Result;
United States
Plough, Avery C., Grace Galwin, Zhonghe Li, Stuart R. Lipsitz, Shehnaz Alidina, Natalie J. Henrich, Lisa R. Hirschhorn, William R. Berry, Atul A. Gawande, Doris Peter, Rory McDonald, Donna L. Caldwell, Janet H. Muri, Debra Bingham, Aaron B. Caughey, Eugene R. Declercq, and Neel T. Shah. "Relationship Between Labor and Delivery Unit Management Practices and Maternal Outcomes." Obstetrics & Gynecology 130, no. 2 (August 2017): 358–365.
- July 2017 (Revised July 2019)
- Supplement
"Doctor My Eyes"--The Acquisition of Bausch & Lomb by Warburg Pincus (B)
By: Nori Gerardo Lietz and Ricardo Andrade
The B Case of "Dr. My Eyes" provides the answer as to what happened after the ending fact pattern in Case A and the imminent choices faced by the protagonist in the primary case. At the end of the Case A, Bess Weatherman of Warburg Pincus, must chose one option of two...
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Keywords:
Private Equity;
Health Care and Treatment;
Mergers and Acquisitions;
Corporate Governance;
Decision Choices and Conditions;
Outcome or Result;
Health Industry;
Consumer Products Industry;
Pharmaceutical Industry
Lietz, Nori Gerardo, and Ricardo Andrade. "Doctor My Eyes"--The Acquisition of Bausch & Lomb by Warburg Pincus (B). Harvard Business School Supplement 218-029, July 2017. (Revised July 2019.)
- Other Article
My Favorite Slide: The Entrepreneurial Gap Applied to Health Care
By: Robert S. Kaplan and Robert Simons
Value-based health care increases physicians’ accountability for patient outcomes. Many have resisted, claiming that patient outcomes are influenced by many forces outside their control, such as patient’s compliance with post-acute and rehab care. The difference...
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Kaplan, Robert S., and Robert Simons. "My Favorite Slide: The Entrepreneurial Gap Applied to Health Care." NEJM Catalyst (March 8, 2017). (Blog Post.)
- Article
Managing Healthcare Costs and Value
By: Robert S. Kaplan, Michael E. Porter and Mark L. Frigo
Rising health care costs are a major global challenge. A number of factors contribute to this trend, including aging populations and medical technology. But an underlying and misunderstood source of health care’s escalating costs has been the inability of health care...
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Kaplan, Robert S., Michael E. Porter, and Mark L. Frigo. "Managing Healthcare Costs and Value." Strategic Finance 98, no. 7 (January 2017): 24–33.