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- 2025
- Working Paper
The Hidden Costs of Working Multiple Jobs: Implications for Spending Behavior and Wellbeing
By: Paige Tsai and Ryan W. Buell
Problem definition: Amidst inflation, rising costs of living, an explosion in remote and gig working opportunities, and an increase in the part-time labor mix in economies around the world, it is becoming evermore commonplace for
people to earn labor income... 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
- 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
- 2024
- Working Paper
Migration, Climate Similarity, and the Consequences of Climate Mismatch
By: Marguerite Obolensky, Marco Tabellini and Charles Taylor
This paper examines the concept of “climate matching” in migration—the idea that migrants seek out destinations with familiar climates. Focusing on the US, we document that temperature distance between origin and destination predicts the distribution of migrants across... View Details
Keywords: Migration; Climate; Immigration; Residency; Weather; Ethnicity; Climate Change; Geographic Location; Policy; United States
- April 2023
- Article
The Real Exchange Rate, Innovation and Productivity
By: Laura Alfaro, Alejandro Cuñat, Harald Fadinger and Yanping Liu
We evaluate manufacturing firms' responses to changes in the real exchange rate (RER) using detailed firm-level data for a large set of countries for the period 2001-2010. We uncover the following stylized facts about regional variation of manufacturing firms'... View Details
- 2024
- Working Paper
What Drives Variation in Investor Portfolios? Estimating the Roles of Beliefs and Risk Preferences
By: Mark Egan, Alexander MacKay and Hanbin Yang
We present an empirical model of portfolio choice that allows for the nonparametric estimation of investors' (subjective) expectations and risk preferences. Utilizing a comprehensive dataset of 401(k) plans from 2009 through 2019, we explore heterogeneity in asset... View Details
- November 2021
- Article
Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing
By: Tyler R. McClintock, David F. Friedlander, Aiden Y. Feng, Mahek A. Shah, Daniel J. Pallin, Steven L. Chang, Angela M. Bader, Thomas W. Feeley, Robert S. Kaplan and George E. Haleblian
Objective. To characterize full cycle of care costs for managing an acute ureteral stone using time-driven activity-based costing.
Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
- Article
The Economic Consequences of Bankruptcy Reform
By: Tal Gross, Raymond Kluender, Feng Liu, Matthew J. Notowidigdo and Jialan Wang
A more generous consumer bankruptcy system provides greater insurance against financial risks but may also raise the cost of credit. We study this trade-off using the 2005 Bankruptcy Abuse Prevention and Consumer Protection Act (BAPCPA), which increased the costs of... View Details
- May 2021
- Article
Value-Based Healthcare in Urology: A Collaborative Review
By: Chanan Reitblat, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh and Boris Gershman
Context:
In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and... View Details
In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and... View Details
- Article
A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018
By: J. Chirenda, B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison and R. S. Kaplan
Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and... View Details
- 2020
- Working Paper
Measuring the Cost of Corporate Water Usage
By: DG Park, George Serafeim and T. Robert Zochowski
We develop a methodology that calculates the impact that organizations have on the environment through their water consumption relating to water stress risk. Using the methodology, we derive estimates for four companies that show how assumptions on the geographic... View Details
- 2020
- Working Paper
Aggregate and Firm-Level Stock Returns During Pandemics, in Real Time
By: Laura Alfaro, Anusha Chari, Andrew Greenland and Peter K. Schott
We show that unexpected changes in the trajectory of COVID-19 infections predict U.S. stock returns, in real time. Parameter estimates indicate that an unanticipated doubling (halving) of projected infections forecasts next-day decreases (increases) in aggregate U.S.... View Details
- 2018
- Working Paper
Corporate Refinancing, Covenants, and the Agency Cost of Debt
By: Daniel Green
How valuable are restrictive debt covenants in reducing the agency costs of debt? I exploit the revealed preference decision to refinance fixed-coupon bonds, which weighs observable interest rate savings against the unobservable costs of a change in restrictive... View Details
Keywords: Covenants; Refinancing; Corporate Bonds; Agency Costs; Debt Policy; Borrowing and Debt; Bonds; Interest Rates
- 2020
- Working Paper
The Real Exchange Rate, Innovation and Productivity
By: Laura Alfaro, Alejandro Cuñat, Harald Fadinger and Yanping Liu
We evaluate manufacturing firms' responses to changes in the real exchange rate (RER) using detailed firm-level data for a large set of countries for the period 2001–2010. We uncover the following stylized facts about regional variation of manufacturing firms'... View Details
- Article
A Field Experiment on Search Costs and the Formation of Scientific Collaborations
By: Kevin Boudreau, Tom Brady, Ina Ganguli, Patrick Gaule, Eva C. Guinan, Anthony Hollenberg and Karim R. Lakhani
We present the results of a field experiment conducted at Harvard Medical School to understand the extent to which search costs affect matching among scientific collaborators. We generated exogenous variation in search costs for pairs of potential collaborators by... View Details
- 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... View Details
- September 2017
- Article
The Real Effects of Capital Controls: Firm-Level Evidence from a Policy Experiment
By: Laura Alfaro, Anusha Chari and Fabio Kanczuk
Emerging-market governments adopted capital control taxes to manage the massive surge in foreign capital inflows in the aftermath of the global financial crisis. Theory suggests that the imposition of capital controls can drive up the cost of capital and curb... View Details
- May 2017
- Article
When Discounts Raise Costs: The Effect of Copay Coupons on Generic Utilization
By: Leemore S. Dafny, Christopher Ody and Matt Schmitt
Branded pharmaceutical manufacturers frequently offer “copay coupons” that insulate consumers from cost sharing, thereby undermining insurers’ ability to influence drug utilization. We study the impact of copay coupons on branded drugs first facing generic entry... View Details
- March 2017
- Article
Variation in the Cost of Care for Primary Total Knee Arthroplasties
By: Derek A. Haas and Robert S. Kaplan
The study examined the cost variation across 29 high-volume U.S. hospitals for delivering a primary total knee arthroplasty without major complicating conditions. Hospital and physician personnel costs were calculated using time-driven activity-based costing.... View Details
- Article
Drivers of the Variation in Prosthetic Implant Purchase Prices for Total Knee and Total Hip Arthroplasties
By: Derek A. Haas, Kevin J Bozic, Anthony M. DiGioia, Zirui Song and Robert S. Kaplan
Previous studies have documented wide variation in health-care spending and prices; however, the causes for the variation in supply purchase prices across providers are not well understood. The purpose of this study was to determine the drivers of variation in... View Details