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- November 2012 (Revised January 2013)
- Case
Companion Diagnostics: Uncertainties for Approval and Reimbursement
By: Richard G. Hamermesh, Norman C. Selby and Phillip Andrews
The FDA approvals of novel therapeutics were seen as signs in the personalized medicine community of real progress in the growth of personalized medicine. The FDA's approval of such drugs, along with companion diagnostics, suggested a shift in thinking and regulatory... View Details
Keywords: Models Of Reimbursement; Personalized Medicine; Regulation; Healthcare Reform; Health Care and Treatment; Health Industry; United States
Hamermesh, Richard G., Norman C. Selby, and Phillip Andrews. "Companion Diagnostics: Uncertainties for Approval and Reimbursement." Harvard Business School Case 813-037, November 2012. (Revised January 2013.)
- November 25, 2015
- Article
Developing Bundled Reimbursement for Cancer Care
By: Thomas Feeley, Tracy E. Spinks and Alexis Guzman
This case study describes the development of a bundled reimbursement pilot for head and neck cancer patients treated at the University of Texas MD Anderson Cancer Center. The study describes the steps involved and the challenges to new alternative payment models in... View Details
Feeley, Thomas, Tracy E. Spinks, and Alexis Guzman. "Developing Bundled Reimbursement for Cancer Care." NEJM Catalyst (November 25, 2015).
- 9 Jan 2013
- Other Presentation
Value-Based Health Care Delivery: Reimbursement
Keywords: Health
Porter, Michael E. "Value-Based Health Care Delivery: Reimbursement." Institute for Strategy and Competitiveness, Boston, MA, January 9, 2013.
- 11 Jan 2012
- Other Presentation
Value-Based Health Care Delivery: Reimbursement
Keywords: Health
Porter, Michael E. "Value-Based Health Care Delivery: Reimbursement." Institute for Strategy and Competitiveness, Boston, MA, January 11, 2012.
- 5 Jan 2012
- Other Presentation
Value-Based Health Care Delivery: Outcomes Measurement and Reimbursement
Keywords: Health
Porter, Michael E. "Value-Based Health Care Delivery: Outcomes Measurement and Reimbursement." Institute for Strategy and Competitiveness, Boston, MA, January 5, 2012.
- 2023
- Article
Digital Health Reimbursement Strategies of 8 European Countries and Israel: Scoping Review and Policy Mapping
By: Robin van Kessel, Divya Srivastava, Ilias Kyriopoulos, Giovanni Monti, David Novillo-Ortiz, Ran Milman, Wojciech Wilhelm Zhang-Czabanowski, Greta Nasi, Ariel Dora Stern, George Wharton and Elias Mossialos
Background: The adoption of digital health care within health systems is determined by various factors, including pricing and reimbursement. The reimbursement landscape for digital health in Europe remains underresearched. Although various emergency reimbursement... View Details
Keywords: Technology Adoption; Health Care and Treatment; Cross-Cultural and Cross-Border Issues; Price; Health Industry; Europe; Israel
van Kessel, Robin, Divya Srivastava, Ilias Kyriopoulos, Giovanni Monti, David Novillo-Ortiz, Ran Milman, Wojciech Wilhelm Zhang-Czabanowski, Greta Nasi, Ariel Dora Stern, George Wharton, and Elias Mossialos. "Digital Health Reimbursement Strategies of 8 European Countries and Israel: Scoping Review and Policy Mapping." e49003. JMIR mHealth and uHealth 11 (2023).
- August 2012 (Revised January 2013)
- Module Note
Note on Pharmaceutical Reimbursement in the U.S.
By: Regina Herzlinger and Drew Cronin-Fine
- May 1994 (Revised February 2021)
- Background Note
Note on Reimbursement of Health Care Providers: Case-Based and Capitation Payment
By: Regina E. Herzlinger and Tom Nagle
Explains how managed care organizations use capitation as a payment method for providers. View Details
Keywords: Managed Care; Capitation; Health Care and Treatment; Insurance; Accounting; Financial Management; Health Industry; Insurance Industry
Herzlinger, Regina E., and Tom Nagle. "Note on Reimbursement of Health Care Providers: Case-Based and Capitation Payment." Harvard Business School Background Note 194-141, May 1994. (Revised February 2021.)
- Article
Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries
By: Sara Gerke, Ariel D. Stern and Timo Minssen
Reimbursement is a key challenge for many new digital health solutions, whose importance and value have been highlighted and expanded by the current COVID-19 pandemic. Germany’s new Digital Healthcare Act (Digitale–Versorgung–Gesetz or DVG) entitles all individuals... View Details
Keywords: COVID-19; Reimbursement; Digital Health Reforms; Health Pandemics; Health Care and Treatment; Internet and the Web; Governing Rules, Regulations, and Reforms; Germany
Gerke, Sara, Ariel D. Stern, and Timo Minssen. "Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries." Art. 94. npj Digital Medicine 3 (2020).
- November 8, 2018
- Article
Transitioning Payment Models: Fee-for-Service to Value-Based Care
By: Thomas W. Feeley and Namita Seth Mohta
In a survey of the NEJM Catalyst Insights Council in July 2018, 42% of respondents say they think value-based reimbursement models will be the primary revenue model for U.S. health care. Indeed, this transition is already happening. Respondents report that a quarter of... View Details
Keywords: Payment Methods; Value-based Healthcare Reimbursements; Health Care and Treatment; Value; Transformation
Feeley, Thomas W., and Namita Seth Mohta. "Transitioning Payment Models: Fee-for-Service to Value-Based Care." NEJM Catalyst (November 8, 2018).
- September 2022
- Article
Trends in Remote Patient Monitoring Use in Traditional Medicare
By: Mitchell Tang, Carter Nakamoto, Ariel Dora Stern and Ateev Mehrotra
Remote patient monitoring (RPM), the collection by patients of physiological measurements that are automatically sent to their health care practitioners, has been touted as a promising tool for improving chronic disease management. Interest in RPM has grown because of... View Details
Tang, Mitchell, Carter Nakamoto, Ariel Dora Stern, and Ateev Mehrotra. "Trends in Remote Patient Monitoring Use in Traditional Medicare." JAMA Internal Medicine 182, no. 9 (September 2022): 1005–1006.
- June 30, 2020
- Article
Bipartisan Tax-Free Solution to Health Care Financing: Coupling HRAs With a Public Option
By: Regina E. Herzlinger, Richard Boxer and James Wallace
A combination of health insurance initiatives by the presumptive 2020 Democratic and Republican presidential nominees could expand health care coverage and significantly reduce costs, without raising taxes. Along the way, the combination could revitalize private... View Details
Keywords: Health Care Financing; Public Option; Health Reimbursement Arrangement (HRA); Health Care and Treatment; Insurance; Cost Management
Herzlinger, Regina E., Richard Boxer, and James Wallace. "Bipartisan Tax-Free Solution to Health Care Financing: Coupling HRAs With a Public Option." Health Affairs Blog (June 30, 2020).
- 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
Huckman, Robert S., and Sarah Mehta. "Carrum Health: Scaling Bundled Payments." Harvard Business School Case 617-017, October 2016. (Revised March 2019.)
- 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
Ying, A.K., T.W. Feeley, and M. E. Porter. "Value-based Healthcare: Implications for Thyroid Cancer." International Journal of Endocrine Oncology 3, no. 2 (May 2016): 115–129. (e-Pub 4/2016.)
- 2013
- Working Paper
International Health Economics
By: Mark Egan and Tomas J. Philipson
Perhaps because health care is a local service sector, health economists have paid little attention to international linkages between domestic health care economies. However, the growth in domestic health care sectors is often attributed to medical innovations whose... View Details
Egan, Mark, and Tomas J. Philipson. "International Health Economics." NBER Working Paper Series, No. 19280, August 2013.
- October 2013
- Case
FasterCures: Removing Barriers to Treatments
By: Richard G. Hamermesh and James Weber
In mid-2013, as FasterCures celebrated its 10th anniversary as a center of the Milken Institute, Executive Director Margaret Anderson thought about what the organization should do to ensure it had even more impact in its next 10 years. FasterCures was a non-profit... View Details
Keywords: Health Care; Health Care Industry; Health Care Policy; Health Services; Healthcare; Healthcare Reform; Healthcare Ventures; Nonprofit; Non-profit Management; Not-for-profit; Incubator; Accelerator; Venture Philanthropy; Medical Services; Medical Solutions; Medical Research; Medical Treatment; Clinical Trials; Drug Reimbursement; Early Stage; Early Stage Research Funding; Early Stage Funding; Milken Institute; Michael Milken; David Baltimore; Partnering For Cures; National Institutes Of Health; Cancer Care In The U.S.; Cancer Care Services; Policy-making; Health Care and Treatment; Health; Health Testing and Trials; Entrepreneurship; Social Entrepreneurship; Nonprofit Organizations; Policy; Health Industry; United States; District of Columbia
Hamermesh, Richard G., and James Weber. "FasterCures: Removing Barriers to Treatments." Harvard Business School Case 814-003, October 2013.
- 2015
- Working Paper
How Should We Pay for Health Care?
By: Michael E. Porter and Robert S. Kaplan
Improving the way we pay for health care must be a central component in health care reform. Payment reform must link provider reimbursement and accountability to improving patient value: better health outcomes delivered at lower cost. Today’s deeply flawed... View Details
Porter, Michael E., and Robert S. Kaplan. "How Should We Pay for Health Care?" Harvard Business School Working Paper, No. 15-041, December 2014. (Revised February 2015.)
- Article
Adding Value by Talking More
By: Robert S. Kaplan, Derek A. Haas and Jonathan Warsh
The prevailing fee-for-service payment model has led health care administrators and physician practices to impose severe constraints on the time physicians spend talking, for which they are reimbursed poorly or not at all. New value-based reimbursement models, however,... View Details
Keywords: Value Creation; Cost Management; Health Care and Treatment; Customer Focus and Relationships; Health Industry
Kaplan, Robert S., Derek A. Haas, and Jonathan Warsh. "Adding Value by Talking More." New England Journal of Medicine 375, no. 20 (November 17, 2016): 1918–1920.
- June 1999 (Revised May 2001)
- Case
CardioThoracic Systems
CardioThoracic Systems, a company that has developed a new system for performing heart surgery on a beating heart, is facing marketing challenges. Discusses the numerous reasons for the system's low penetration (including existing techniques, surgeon resistance, and a... View Details
Keywords: Problems and Challenges; Technological Innovation; Situation or Environment; Marketing Strategy; Sales; Health Care and Treatment; Technology Industry; Health Industry; Medical Devices and Supplies Industry; United States
Roberts, Michael J., and Diana S. Gardner. "CardioThoracic Systems." Harvard Business School Case 899-281, June 1999. (Revised May 2001.)
- September 8, 2020
- Article
Allocation of COVID-19 Relief Funding to Disproportionately Black Counties
By: Pragya Kakani, Amitabh Chandra and Sendhil Mullainathan
This study describes correlations between the dollar amount of relief funding authorized by the US Congress to fund prevention, diagnosis, and treatment of coronavirus disease 2019 (COVID-19) and to reimburse health care entities for lost revenues, and county-level... View Details
Kakani, Pragya, Amitabh Chandra, and Sendhil Mullainathan. "Allocation of COVID-19 Relief Funding to Disproportionately Black Counties." JAMA, the Journal of the American Medical Association 324, no. 10 (September 8, 2020): 1000–1003.