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(97)
- News (16)
- Research (57)
- Events (1)
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- 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
- 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.
- 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.
- 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).
- 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.
- 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
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.)
- 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.
- March 2011
- Article
What Do Dividends Tell Us About Earnings Quality
By: Douglas Skinner and Eugene F. Soltes
Over the past 30 years, there have been significant changes in the distribution of earnings (cross-sectional variation has increased, with increasing left skewness) as well as in corporate payout policy, with many fewer firms paying dividends and the emergence of stock... View Details
Keywords: Distribution; Business Earnings; Change; Policy; Stocks; Investment Return; Performance Consistency; Quality
Skinner, Douglas, and Eugene F. Soltes. "What Do Dividends Tell Us About Earnings Quality." Review of Accounting Studies 16, no. 1 (March 2011).
- 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.
- August 2012 (Revised December 2023)
- Background Note
Note on Health Insurance Coverage, Coding, and Payment
By: Regina E. Herzlinger and Jo Ellen Slurzberg
This note explains how health care technology and service innovators receive payment from government insurers, in the U.S. and abroad, and from private insurers. It describes each of the three steps needed to obtain reimbursement: coverage, coding, and payment. It also... View Details
- November 2016 (Revised April 2017)
- Case
Hygeia Group: Delivering Quality Care in Nigeria
By: Robert F. Higgins and Ifedayo O. Kuye
Fola Laoye is the Group Managing Director of Hygeia Group, a Nigerian healthcare insurer and provider, and she is deciding on the optimal strategy to grow the provider arm of her business. Hygeia Group was founded in the 1980s by her physician parents, and although... View Details
Keywords: Healthcare; Healthcare Industry; Hospitals; Nigeria; Health Care and Treatment; Growth and Development Strategy; Health Industry; Nigeria
Higgins, Robert F., and Ifedayo O. Kuye. "Hygeia Group: Delivering Quality Care in Nigeria." Harvard Business School Case 817-088, November 2016. (Revised April 2017.)
- Article
Better Accounting Transforms Health Care Delivery
By: Robert S. Kaplan and Mary L. Witkowski
The paper describes the theory and preliminary results for an action research program that explores the implications from better measurements of health care outcomes and costs. After summarizing Porter's outcome taxonomy (Porter 2010), we illustrate how to use process... View Details
Keywords: Activity Based Costing and Management; Research; Health Care and Treatment; Health Industry
Kaplan, Robert S., and Mary L. Witkowski. "Better Accounting Transforms Health Care Delivery." Accounting Horizons 28, no. 2 (June 2014): 365–383.
- January 2023
- Case
Thomas Buberl: Refounding AXA
By: Hubert Joly, Mihir Desai and Amram Migdal
In 2022, AXA and its CEO Thomas Buberl faced new types of challenges, including systemic risks such as climate change, geopolitical instability, public health crises, and social tensions caused by economic risks. AXA was one of the world’s largest insurers. Since... View Details
Keywords: Change; Change Management; Transformation; Transition; Trends; Environmental Management; Climate Change; Ethics; Values and Beliefs; Finance; Insurance; Management; Management Succession; Risk Management; Organizations; Corporate Social Responsibility and Impact; Mission and Purpose; Organizational Change and Adaptation; Planning; Strategic Planning; Risk and Uncertainty; Society; Human Needs; Social Issues; Strategy; Adaptation; Business Strategy; Corporate Strategy; Insurance Industry; Europe; France; Paris
Joly, Hubert, Mihir Desai, and Amram Migdal. "Thomas Buberl: Refounding AXA." Harvard Business School Case 523-059, January 2023.
- September 2011
- Article
How to Solve the Cost Crisis in Health Care
By: Robert S. Kaplan and Michael E. Porter
Existing health care costing systems have serious flaws that make it impossible to measure costs accurately at the individual patient and medical condition level. This gap has severely limited meaningful cost reduction throughout the system. The paper describes a new... View Details
Keywords: Cost; Health Care and Treatment; Measurement and Metrics; Service Delivery; Outcome or Result; Quality; Health Industry
Kaplan, Robert S., and Michael E. Porter. "How to Solve the Cost Crisis in Health Care." Harvard Business Review 89, no. 9 (September 2011): 47–64.
- August 2010 (Revised March 2012)
- Case
The UCLA Medical Center: Kidney Transplantation
By: Michael E. Porter, Jennifer F Baron, Jacob Mathew Chacko and Robin Jian Tang
In 2010, organ transplantation remained among the few sets of medical conditions in the U.S. for which bundled payments were a dominant reimbursement model, and for which patient health outcomes were universally measured and reported. In 1986, UCLA Medical Center was... View Details
Keywords: Insurance; Health Care and Treatment; Health Disorders; Measurement and Metrics; Outcome or Result; Competitive Strategy; Integration; Health Industry; California
Porter, Michael E., Jennifer F Baron, Jacob Mathew Chacko, and Robin Jian Tang. "The UCLA Medical Center: Kidney Transplantation." Harvard Business School Case 711-410, August 2010. (Revised March 2012.)