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November 2016
Case

QuintilesIMS: Biosimilar Marketing in England

By: John A. Quelch and Emily C. Boudreau

QuintilesIMS was a leading healthcare consulting firm best known for its data and information offerings as well as its market research and management consulting services for life science companies. By 2015, the company was expanding beyond the biopharmaceutical... View Details

Keywords: Health; Pharmaceutical Industry; Biotech; Marketing; Health Care and Treatment; Biotechnology Industry; England

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

Article

Undermining Value-Based Purchasing — Lessons from the Pharmaceutical Industry

By: Leemore S. Dafny, Christopher Ody and Matt Schmitt

The analogy between value-based purchasing in pharmaceuticals and the new frontier of alternative payment models for health care providers is relatively straightforward. Insurers are increasingly demanding steep discounts from providers in exchange for inclusion in... View Details

Keywords: Drug Copayment Coupons; Prescription Drug Policy; Health Care and Treatment; Insurance; Cost; Policy; Pharmaceutical Industry

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2017
Article

The Impact of Training Informal Healthcare Providers in India: A Randomized Controlled Trial

By: Jishnu Das, Abhijit Chowdhury, Reshmaan Hussam and Abhijit Banerjee

Health care providers without formal medical qualifications provide more than 70% of all primary care in rural India. Training these informal providers may be one way to improve the quality of care where few alternatives exist. We report on a randomized controlled... View Details

Keywords: Health Care; India; Business Training; RCT; Health Care and Treatment; Training; Performance Evaluation; Performance Improvement; India

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September 2016 (Revised October 2018)
Case

Springfield Hospital

By: Susanna Gallani and Robert Kaplan

One of the key roles of costing systems is to support the evaluation of performance and facilitate appropriate resource allocations. Through participation in a comparative cost study, management at Springfield Hospital, known for its heavy focus on operational... View Details

Keywords: Time-Driven Activity-Based Costing; Variance Analysis; Activity Based Costing and Management; Health Care and Treatment; Health Industry

September 2016
Article

Communicating Value in Healthcare Using Radar Charts: A Case Study of Prostate Cancer

By: Nikhil G. Thaker, Tariq N. Ali, Michael E. Porter, Thomas W. Feeley, Robert S. Kaplan and Steven J. Frank

Question: Can we create a value-based tool to visualize the outcomes and cost of various treatments that could facilitate patient-centered decision making?

Summary Answer: We developed a standardized value framework by using radar charts to visualize and... View Details

Keywords: Decision Making; Health Care and Treatment; Health Industry

August 2016
Case

VMD Medical Imaging Center

By: Susanna Gallani and Eva Labro

VMD Medical Imaging Center, a local independent provider of medical imaging services, is facing some important challenges. Despite efficiency improvements and cost cutting initiatives carried out over the past few years, their profitability is shrinking; their prices... View Details

Keywords: Costing; Death Spiral; Transfer Pricing; Activity Based Costing and Management; Competitive Strategy; Medical Specialties; Health Industry

2016
Book

Innovation Policy and the Economy, Volume 17

By: Shane Greenstein, Josh Lerner and Scott Stern

The seventeenth volume of the National Bureau of Economic Research’s Innovation Policy and the Economy provides an accessible forum for bringing the work of leading academic researchers to an audience of policymakers and those interested in the interaction... View Details

Keywords: Innovation and Invention; Technological Innovation; Governance; Policy; Economy

Article

Time-Driven Activity-Based Costing in Emergency Medicine

By: Robert S. Kaplan, Brian J. Yun, Anand M. Prabhakar, Jonathan Warsh, John Brennan, Kyle E. Dempsey and Ali S. Raja

Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine... View Details

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

May 16, 2016
Article

Food Safety Economics: The Cost of a Sick Customer

By: Dina Gerdeman and John A. Quelch

Chipotle Mexican Grill’s ongoing struggle to win customers back months after a contaminated food crisis highlights the challenges companies face with keeping food safe.

Chipotle has seen its shares tumble and recently reported its first-ever quarterly loss... View Details

Article

Defining the Value Framework for Prostate Brachytherapy Using Patient-Centered Outcome Metrics and Time-Driven Activity-Based Costing

By: N.G. Thaker, T.J. Pugh, U. Mahmood, S. Choi, T.E. Spinks, N.E. Martin, T.T. Sio, R.J. Kudchadker, R. S. Kaplan, D.A. Kuban, D.A. Swanson, P.F. Orio, M.J. Zelefsky, B.W. Cox, L. Potters, T.A. Buchholz, T.W. Feeley and S.J. Frank

PURPOSE: Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value... View Details

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April 2016 (Revised May 2016)
Case

Hôpital Universitaire de Mirebalais, Partners In Health in Haiti

By: Robert S. Kaplan, Bipin Mistry and Karla Bertrand

The case describes the application of Time-Driven Activity-Based Costing (TDABC) at a new tertiary hospital, operated by Partners in Health in Mirebelais, Haiti. A project team mapped the clinical processes for use in estimating the direct costs of personnel,... View Details

Keywords: Time-Driven Activity-Based Costing; Activity Based Costing and Management; Cost Accounting; Developing Countries and Economies; Health Care and Treatment; Health Industry; Haiti

March 2016 (Revised March 2022)
Teaching Note

Express Scripts: Promoting Prescription Drug Home Delivery (A) and (B)

By: John Beshears

The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. The case associated with this teaching note follows Bob Nease, chief scientist at Express Scripts, as he... View Details

Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Consumer Behavior; Distribution Channels; Health Care and Treatment; Service Industry; Pharmaceutical Industry

Article

Value-based Healthcare: Implications for Thyroid Cancer

By: A.K. Ying, T.W. Feeley and M. E. Porter

Today's delivery of care to thyroid cancer patients is complex, and costly, with uneven outcomes that can be improved. The incidence of thyroid cancer is rising and requires coordinated, multidisciplinary care with high volume centers that is not always available in... View Details

Keywords: Bundled Reimbursement; Healthcare Reform; Integrated Practice Units; Outcomes; Patient-reported Outcomes; Thyroid Cancer; Health Care and Treatment; Cost; Information Technology; Value

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February 2016
Case

Express Scripts: Promoting Prescription Drug Home Delivery (A)

By: John Beshears, Patrick Rooney and Jenny Sanford

The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details

Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Health Care and Treatment; Order Taking and Fulfillment; Compensation and Benefits; Pharmaceutical Industry

February 2016 (Revised March 2022)
Case

Express Scripts: Promoting Prescription Drug Home Delivery (B)

By: John Beshears, Patrick Rooney and Jenny Sanford

The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details

Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Health Care and Treatment; Service Delivery; Decision Choices and Conditions; Order Taking and Fulfillment; Compensation and Benefits

2015
Case

Advanced Leadership Pathways: Mike Critelli and Dossia Service Corporation

By: Rosabeth Moss Kanter and Patricia Bissett Higgins

In 2010, Mark Critelli was a well-seasoned corporate executive who had recently transitioned from being the CEO of a Fortune 500 company to that of a startup called Dossia. As an AL Fellow, he knew that despite believing in Dossia’s mission to empower individuals with... View Details

October 26, 2015
Article

Measuring and Communicating Health Care Value with Charts

By: Robert S. Kaplan, Robin P. Blackstone, Derek A. Haas and Nikhil G. Thaker

The goal of a health care system should be to deliver the most value to patients: the outcomes achieved for treating a medical condition relative to the costs incurred over a complete care cycle. We have found that a radar (spider web) chart is an effective means to... View Details

Keywords: Service Delivery; Value; Health Care and Treatment; Health Industry

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October 22, 2015
Article

The Mayo Clinic Model for Running a Value-Improvement Program

By: Robert S. Kaplan, Derek A. Haas, Richard A. Helmers, March Rucci and Meredith Brady

Applying time-driven activity-based costing (TDABC) in health care cannot be delegated to the finance function. The most successful implementations have had strong executive support, exceptional clinical leaders, and dedicated, multi-disciplinary project teams. The... View Details

Keywords: Service Delivery; Activity Based Costing and Management; Health Care and Treatment; Health Industry

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2017
Working Paper

Discretionary Task Ordering: Queue Management in Radiological Services

By: Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats

Work scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks... View Details

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