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(91)
- News (16)
- Research (57)
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- 04 Feb 2019
- News
The PCAOB as Third-party Payer
- 01 Mar 2018
- News
New Marketplace Survey: Payers and Providers Remain Far Apart
- 27 Feb 2017
- News
Achieving Universal Coverage Without Turning to a Single Payer
- 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... View Details
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.)
- January 2019 (Revised June 2019)
- Technical Note
U.S. Commercial Health Insurance Industry
By: Susanna Gallani, Mary Witkowski and Harry B. Wolberg
This note describes the role of commercial payers in the U.S. healthcare industry. We begin with a review of the historical evolution of commercial payers and their role in the market, from the beginning to the Affordable Care Act and beyond. Every wave of reforms in... View Details
Keywords: Health Care and Treatment; Insurance; Governing Rules, Regulations, and Reforms; Organizational Change and Adaptation; Health Industry; Insurance Industry; United States
Gallani, Susanna, Mary Witkowski, and Harry B. Wolberg. "U.S. Commercial Health Insurance Industry." Harvard Business School Technical Note 119-064, January 2019. (Revised June 2019.)
- May 11, 2017
- Article
Good Riddance to Big Insurance Mergers
By: Leemore S. Dafny
Federal judges issued preliminary injunctions halting mergers of four of the five largest U.S. health insurers. These decisions provide more precedent to support challenges of mergers between competitors in health care markets—whether payers or providers. View Details
Keywords: Mergers and Acquisitions; Insurance; Health Care and Treatment; Health Industry; Insurance Industry
Dafny, Leemore S. "Good Riddance to Big Insurance Mergers." New England Journal of Medicine 376, no. 19 (May 11, 2017): 1804–1806.
- 15 Mar 2021
- Working Paper Summaries
The Health Costs of Cost-Sharing
Bohan Li
Bohan is a doctoral student in Health Policy Management. She graduated from the University of Pennsylvania in 2018 with a double major in Chemistry and Economics. Post-graduation, Bohan spent 4 years as a management consultant advising both payers and providers,... View Details
- Article
A Simple Solution to a Very Old Problem
By: Hoff Stauffer and Jurgen Weiss
The article addresses the problem of fixed cost recovery via variable electricity rates creating disincentives for utilities to engage in energy efficiency. The article provides one solution, which is to decouple fixed cost recovery from sales volumes, with the help of... View Details
Stauffer, Hoff, and Jurgen Weiss. "A Simple Solution to a Very Old Problem." Electricity Journal 19, no. 4 (May 2006): 56–59.
- 12 Jul 2011
- News
La crise de la dette américaine en sept questions
- 06 Jun 2018
- Video
David Mou, Blavatnik Fellow 2018-2019
- October 2023
- Article
What Does the Inflation Reduction Act Mean for Patients and Physicians?
By: Amitabh Chandra and Benedic Ippolito
The debate around prescription drug measures in the recently passed U.S. Inflation Reduction Act (IRA), which limit some patients’ out-of-pocket costs, has not fully addressed their effect on physicians and patients via their effect on payers. Reducing patients’ costs... View Details
Chandra, Amitabh, and Benedic Ippolito. "What Does the Inflation Reduction Act Mean for Patients and Physicians?" NEJM Catalyst Innovations in Care Delivery 4, no. 10 (October 2023).
- June 2004
- Article
A Catering Theory of Dividends
By: Malcolm Baker and Jeffrey Wurgler
We propose that the decision to pay dividends is driven by prevailing investor demand for dividend payers. Managers cater to investors by paying dividends when investors put a stock price premium on payers, and by not paying when investors prefer nonpayers. To test... View Details
Keywords: Dividends; Catering; Financial Instruments; Investment Return; Business and Shareholder Relations
Baker, Malcolm, and Jeffrey Wurgler. "A Catering Theory of Dividends." Journal of Finance 59, no. 3 (June 2004): 1125–1165.
- December 2016
- Article
Health Care Needs Real Competition
By: Leemore S. Dafny and Thomas H. Lee
The U.S. health care system is inefficient, unreliable, and crushingly expensive. There is no shortage of proposed solutions, but central to the best of them is the idea that health care needs more competition. In other sectors, competition improves quality and... View Details
Dafny, Leemore S., and Thomas H. Lee. "Health Care Needs Real Competition." Harvard Business Review 94, no. 12 (December 2016): 76–87.
- Article
Supporting Value-Based Health Care—Aligning Financial and Legal Accountability
By: Mark M. Zaki, Anupam B. Jena and Amitabh Chandra
U.S. health care payment and delivery-system reforms have focused on improving care by making organizations accountable for outcomes, quality, and costs. Payers have supported the implementation of accountable care organizations (ACOs), bundled-payment models, and... View Details
Zaki, Mark M., Anupam B. Jena, and Amitabh Chandra. "Supporting Value-Based Health Care—Aligning Financial and Legal Accountability." New England Journal of Medicine 385, no. 11 (September 9, 2021): 965–967.
- Article
Using the Balanced Scorecard for Successful Health Care M&A Integration
By: Robert S. Kaplan
The failure of merged organizations to achieve stated goals is commonplace. In health care, the challenge is exacerbated by the industry’s third-party payer system and multiple stakeholders, especially the physicians in the merging entities. This article describes how... View Details
Kaplan, Robert S. "Using the Balanced Scorecard for Successful Health Care M&A Integration." NEJM Catalyst (May 21, 2020).
- April 2008 (Revised May 2008)
- Case
Commonwealth Care Alliance: Elderly and Disabled Care
By: Michael E. Porter and Jennifer F Baron
Individuals enrolled in both Medicare and Medicaid, known as dual eligibles, are among the highest-cost beneficiaries in the US. Commonwealth Care Alliance, a small nonprofit insurer and care delivery system in Massachusetts, operated under a public demonstration... View Details
Keywords: Programs; Public Sector; Alliances; Policy; Age; Service Delivery; Value; Health Care and Treatment; Welfare; Insurance Industry; Health Industry; Massachusetts
Porter, Michael E., and Jennifer F Baron. "Commonwealth Care Alliance: Elderly and Disabled Care." Harvard Business School Case 708-502, April 2008. (Revised May 2008.)
- November 2007 (Revised January 2010)
- Case
ThedaCare: System Strategy
By: Michael E. Porter and Sachin H. Jain
Over the 1980s and 1990s, America's changing health care payer environment resulted in mergers of numerous community hospitals into hospital systems. Based in Appleton, Wisconsin, ThedaCare stood out among community hospital systems in its pursuit of service... View Details
Keywords: Value Creation; Health Care and Treatment; Problems and Challenges; Innovation and Invention; Health Industry; Wisconsin
Porter, Michael E., and Sachin H. Jain. "ThedaCare: System Strategy." Harvard Business School Case 708-424, November 2007. (Revised January 2010.)
- Article
Time-Driven Activity-Based Costing for Surgical Episodes
By: Peter Najjar, Matt Strickland and Robert S. Kaplan
Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services... View Details
Keywords: Surgery; Time-Driven Activity-Based Costing; Bundled Payments; Health Care and Treatment; Cost Management
Najjar, Peter, Matt Strickland, and Robert S. Kaplan. "Time-Driven Activity-Based Costing for Surgical Episodes." JAMA Surgery 152, no. 1 (January 2017): 96–97.