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- May 2025
- Case
Dell Med: Transforming Care Delivery & Payment
By: Robert S. Kaplan, David N. Bernstein and Mary L. Witkowski
Health care in the U.S. and globally continues to undergo massive transformation, surging towards a system that rewards value for patients. However, widespread adoption of value-based health care remains a challenge. This case study focuses on the care delivery... View Details
- February 2025
- Article
Innovations in Evaluating Ambulatory Costs of Cystic Fibrosis Care: A Comparative Study Across Multidisciplinary Care Centers in Ireland and the United States
By: Emma Brady, Ryan C. Perkins, Kate Cullen, Gregory S. Sawicki, Robert S. Kaplan and Gerardine Doyle
Lead clinicians at two large pediatric cystic fibrosis (CF) centers in the United States and Ireland measured and compared their ambulatory care costs. The clinicians selected three strata of patients (0–11 months, 1–5 years, and 6–17 years of age). Process maps were... View Details
- September 26, 2024
- Article
A Better Way to Measure Social Impact
By: Robert S. Kaplan and Constance Spitzer
All impact investors report the financial returns from their funds and investments, and many provide metrics on intended social outcomes, such as numbers of individuals served, or quality jobs created. But investors do not supply metrics about their impacts on... View Details
- July–August 2024
- Article
Disclosing Downstream Emissions
By: Robert S. Kaplan and Karthik Ramanna
An increasing number of companies are using the E-liability carbon-accounting method as an important tool for tracking progress toward reducing global emissions in their supply chains. The system does not require formal accounting for downstream emissions—those... View Details
- July 2024
- Article
Mass General Brigham’s Patient-Reported Outcomes Measurement System: A Decade of Learnings
By: Jason B. Liu, Robert S. Kaplan, David W. Bates, Mario O. Edelen, Rachel C. Sisodia and Andrea L. Pusic
This article describes the strategies that leaders at the Mass General Brigham (MGB) health system have used in launching a standardized patient-reported outcome measure (PROM) collection program in 2012, a major step in the value-based transformation of health care.... View Details
- May 2024
- Article
True Costs of Uterine Artery Embolization: Time-Driven Activity-Based Costing in Interventional Radiology Over a 3-Year Period
By: Julia C. Bulman, Nicole H. Kim, Robert S. Kaplan, Sarah Schroeppel DeBacker, Olga R. Brook and Ammar Sarwar
The study used time-driven activity-based costing (TDABC) to estimate the costs to perform uterine artery embolization (UAE). Utilization times for patients undergoing outpatient UAE for fibroids or adenomyosis were captured from electronic health record timestamps and... View Details
- April 2024
- Teaching Note
Harvard University and Urban Mining Industries: Decarbonizing the Supply Chain
By: Shirley Lu and Robert S. Kaplan
Teaching Note for HBS Case No. 123-076. View Details
- March 2024
- Article
Establishing the Foundation for Carbon Trading Markets
By: Robert S. Kaplan, Karthik Ramanna and Marc Roston
Poor measurement practices and inadequate controls have led to extensive trading of carbon offset instruments that do not materially reduce the supply of atmospheric GHG. We introduce five carbon offset accounting principles, built from fundamental financial-accounting... View Details
- 2024
- Working Paper
Principles and Content for Downstream Emissions Disclosures
By: Robert S. Kaplan and Karthik Ramanna
In a previous paper, we proposed the E-liability carbon accounting algorithm for companies to measure and subsequently reduce their own and their suppliers’ emissions. Some investors and stakeholders, however, want companies to also be accountable for downstream... View Details
- January 19, 2024
- Article
Value-Based Health Care Can Transform the Treatment of Patients with Substance Use Disorder
By: Robert S. Kaplan and Sarah E. Wakeman
U.S. overdose deaths currently exceed 100,000 per year. New facilities, known as bridge clinics, are broadening access to high-quality care by offering outpatient substance use disorder (SUD) treatment with few access barriers. But many of the critical services offered... View Details
- 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
- 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
- September–October 2023
- Article
Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using Time-Driven Activity-Based Costing Method: A Single Center Study
By: Aamir Ali, Jordana Phillips, Damir Ljuboja, Syed S. Shehab, Etta D. Pisano, Robert S. Kaplan and Ammar Sarwar
We use time-driven activity-based costing (TDABC) to measure the cost of performing breast imaging using different modalities: full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), contrast-enhanced mammography (CEM), US and MRI exams, and... View Details
- Article
Update on E-liability Accounting
By: Robert Kaplan, Karthik Ramanna and Piyush Jha
Since publication of the original E-liability carbon accounting paper (HBR, Nov 2021), we created the E-liability Institute to help companies, governments, and nonprofits implement the method. The Institute’s mission is to test and validate the method, and develop... View Details
- August 2023
- Teaching Note
Vanderbilt: Transforming an Academic Health Care Delivery System, 2020
By: Michael E. Porter, Robert S. Kaplan, Mary L. Witkowski and David N. Bernstein
Teaching Note for HBS Case No. 724-373. View Details
- August 2023
- Case
Vanderbilt: Transforming an Academic Health Care Delivery System, 2020
By: Michael E. Porter, Robert S. Kaplan, Mary L. Witkowski and David N. Bernstein
- July–August 2023
- Article
Accounting for Carbon Offsets
By: Robert S. Kaplan, Karthik Ramanna and Marc Roston
Markets for carbon trading function poorly, and many traded offsets do not actually perform as promised. Without robust protocols for monitoring offsets and in the absence of proper accounting mechanisms, market-based approaches to reducing atmospheric GHG will be... View Details
- May 2023 (Revised June 2023)
- Case
Harvard University and Urban Mining Industries: Decarbonizing the Supply Chain
By: Shirley Lu and Robert S. Kaplan
The case describes Harvard University’s consideration to decarbonize its supply chain by replacing cement with a low-carbon substitute called Pozzotive®. Developed and produced by Urban Mining Industries, Pozzotive® is a ground-glass material made with post-consumer... View Details