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      • Faculty Publications  (414)

      Health FinancingRemove Health Financing →

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      • February 2019
      • Article

      Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending

      By: Leemore S. Dafny
      There is limited empirical evidence about the impact of for-profit health insurers on various outcomes. I study the effects of conversions to for-profit status by Blue Cross Blue Shield (BCBS) affiliates in 11 states, spanning 28 geographic markets. I find both the... View Details
      Keywords: Health Insurance; Medical Loss Ratio; Blue Cross; Corporate Governance; Health; Insurance; For-Profit Firms; Insurance Industry; United States
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      Dafny, Leemore S. "Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending." American Economic Journal: Economic Policy 11, no. 1 (February 2019): 222–265.
      • 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; Health Industry; United States
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      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.)
      • November 2018
      • Case

      David Hysong and SHEPHERD Therapeutics

      By: Ananth Raman, John Masko and Aldo Sesia
      In 2016, David Hysong, at age 27, found out he had a rare, incurable cancer. Rather than wait around to die, Hysong, a recent graduate of Harvard Divinity School, decided to launch a biotechnology company called Shepherd Therapeutics to development treatments for his... View Details
      Keywords: Cancer; Therapeutics; Drugs; Health Care and Treatment; Business Startups; Product Development; Financing and Loans; Growth and Development Strategy; Problems and Challenges
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      Raman, Ananth, John Masko, and Aldo Sesia. "David Hysong and SHEPHERD Therapeutics." Harvard Business School Case 619-012, November 2018.
      • Article

      Operational Efficiency and Effective Management in the Catheterization Laboratory

      By: Grant W. Reed, Michael L. Tushman and Samir R. Kapadia
      Operational efficiency is a core business principle in which organizations strive to deliver high-quality goods or services in a cost-effective manner. This concept has become increasingly relevant to cardiac catheterization laboratories, as insurers move away from... View Details
      Keywords: Cath Lab; Catheterization Laboratory; Health Care and Treatment; Performance Efficiency; Management; Performance Productivity; Cost Management; Health Industry
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      Reed, Grant W., Michael L. Tushman, and Samir R. Kapadia. "Operational Efficiency and Effective Management in the Catheterization Laboratory." Journal of the American College of Cardiology 72, no. 20 (November 20, 2018): 2507–2517.
      • 2018
      • Chapter

      The Orphan Drug Act at 35: Observations and an Outlook for the Twenty-First Century

      By: Nicholas Bagley, Benjamin Berger, Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern
      On the 35th anniversary of the adoption of the Orphan Drug Act (ODA), we describe the enormous changes in the markets for therapies for rare diseases that have emerged over recent decades. The most prominent example is the fact that the profit-maximizing price of new... View Details
      Keywords: Health Care and Treatment; Laws and Statutes; Research and Development; Investment; Markets; Monopoly
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      Bagley, Nicholas, Benjamin Berger, Amitabh Chandra, Craig Garthwaite, and Ariel Dora Stern. "The Orphan Drug Act at 35: Observations and an Outlook for the Twenty-First Century." Chap. 4 in Innovation Policy and the Economy, Volume 19, edited by Josh Lerner and Scott Stern, 97–137. University of Chicago Press, 2018.
      • September 2018
      • Case

      The Financial Management of Harvard Business School

      By: C. Fritz Foley and F. Katelynn Boland
      In the spring of 2018, the Senior Associate Dean for Strategic Financial Planning at Harvard Business School considers potential refinements to the School's financial management practices. He faced questions about whether the metrics that had been used to evaluate... View Details
      Keywords: Nonprofit; Financial Management; Nonprofit Organizations; Education Industry; United States
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      Foley, C. Fritz, and F. Katelynn Boland. "The Financial Management of Harvard Business School." Harvard Business School Case 219-036, September 2018.
      • July 2018 (Revised January 2021)
      • Case

      RunKeeper

      By: Shikhar Ghosh and Shweta Bagai
      The case examines the focus of an early stage company and how venture capital can distort a founder’s view. It encompasses issues such as financing, understanding the founders’ definition of success/failure, defining and pivoting a business model, and determining the... View Details
      Keywords: Early Stage Funding; Pivot; Entrepreneurship; Venture Capital; Business Model; Health Industry
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      Ghosh, Shikhar, and Shweta Bagai. "RunKeeper." Harvard Business School Case 819-020, July 2018. (Revised January 2021.)
      • June 2018
      • Supplement

      Amil and the Health Care System in Brazil (B)

      By: Regina Herzlinger, Ana Maria Malik, Ruth Costas and Priscilla Zogbi
      Brazilian Managed Care Organization Amil faces a series of challenges while trying to redefine the terms of its relationship with hospitals and clinics and to implement a new health care model based on primary care and family medicine. View Details
      Keywords: Health Care; Brazil; Managed Care; Innovation; Health Care Industry; Health Care and Treatment; Health; Cost Management; Innovation and Invention; Competitive Strategy; Health Industry; Health Industry; Brazil
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      Herzlinger, Regina, Ana Maria Malik, Ruth Costas, and Priscilla Zogbi. "Amil and the Health Care System in Brazil (B)." Harvard Business School Supplement 318-149, June 2018.
      • Article

      Defining, Measuring, and Improving Value in Spine Care

      By: Robert S. Kaplan and Derek Haas
      This chapter discusses how to measure and improve spine care outcomes and costs. Today’s commonly used outcome metrics, such as readmission and complication rates, are actually process and quality metrics. They are not the outcomes, such as improvement in pain and... View Details
      Keywords: Spine Care; Outcomes Measurement; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Measurement and Metrics; Performance Improvement; Value
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      Kaplan, Robert S., and Derek Haas. "Defining, Measuring, and Improving Value in Spine Care." Seminars in Spine Surgery 30, no. 2 (June 2018): 80–83.
      • May 2018
      • Case

      The Multiple Myeloma Research Foundation's Answer Fund

      By: Richard G. Hamermesh and Matthew G. Preble
      Keywords: Data Analytics; Customer Focus and Relationships; Customer Relationship Management; Cost vs Benefits; Investment Return; Health Care and Treatment; Innovation Leadership; Intellectual Property; Knowledge Sharing; Knowledge Dissemination; Leadership; Leading Change; Resource Allocation; Goals and Objectives; Marketing Communications; Performance; Programs; Projects; Business and Community Relations; Business and Stakeholder Relations; Networks; Partners and Partnerships; Research and Development; Genetics; Behavior; Motivation and Incentives; Social and Collaborative Networks; Nonprofit Organizations; Strategy; Health Industry; Health Industry; Health Industry; United States
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      Hamermesh, Richard G., and Matthew G. Preble. "The Multiple Myeloma Research Foundation's Answer Fund." Harvard Business School Case 818-045, May 2018.
      • May 2018
      • Case

      Kaiser Permanente Colorado: Primary Care Plus

      By: Robert S. Kaplan and Mahek A. Shah
      A geriatrician in Kaiser Permanente’s Colorado region is concerned with the high and growing cost of treating the elderly population. She introduces a new care model, Primary Care Plus, using an interdisciplinary team of a primary care doctor, palliative care... View Details
      Keywords: Primary Health Care; Elderly Patients; Integrated Practice Unit; Interdisciplinary Care; Health Care and Treatment; Age; Cost Management; Performance Improvement; Health Industry; United States; Colorado
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      Kaplan, Robert S., and Mahek A. Shah. "Kaiser Permanente Colorado: Primary Care Plus." Harvard Business School Case 118-053, May 2018.
      • May 2018 (Revised October 2020)
      • Supplement

      La Ribera Health Department (B): Epilogue

      By: Regina E. Herzlinger, Emer Moloney and Daniela Beyersdorfer
      The La Ribera case studies depict an innovative low cost/high quality privately financed hospital model struggling to achieve alignment with the Six Factors. It is reimbursed by the public sector in a Spanish environment whose Consumers, Structure, and Public Policy... View Details
      Keywords: Trends And Opportunities; Government; Government Programs; Acquisition; Business Model; Business Plan; Trends; Opportunities; Government and Politics; Programs; Health Care and Treatment; Situation or Environment; Health Industry; Health Industry; Health Industry; Spain
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      Herzlinger, Regina E., Emer Moloney, and Daniela Beyersdorfer. "La Ribera Health Department (B): Epilogue." Harvard Business School Supplement 318-134, May 2018. (Revised October 2020.)
      • April 2018 (Revised September 2018)
      • Case

      Impact Investing for Cancer

      By: Richard G. Hamermesh and Matthew G. Preble
      It is early 2018, and Emily Park, managing director of impact for the Abreu Family Office, is meeting the next day with Tomás and Maria Abreu to discuss the various ways in which the Abreus can allocate a planned $100 million to make a meaningful difference in cancer... View Details
      Keywords: Impact Investing; Investment; Health Disorders; Philanthropy and Charitable Giving; Decision Choices and Conditions
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      Hamermesh, Richard G., and Matthew G. Preble. "Impact Investing for Cancer." Harvard Business School Case 818-068, April 2018. (Revised September 2018.)
      • March 2018 (Revised January 2019)
      • Case

      Gilead Mexico

      By: Michael Chu and V. Kasturi Rangan
      With a breakthrough cure for Hepatitis C listing in the U.S. at $1,000/pill, Gilead must now solve the issue of making it available to patients across the world, much as it did for its blockbuster HIV/AIDS antiretrovirals. For Erik Musalem, the new general manager of... View Details
      Keywords: Health Care and Treatment; Price; Strategy; Management; Pharmaceutical Industry; Mexico
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      Chu, Michael, and V. Kasturi Rangan. "Gilead Mexico." Harvard Business School Case 318-111, March 2018. (Revised January 2019.)
      • Article

      Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

      By: Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman
      The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with... View Details
      Keywords: Health Care and Treatment; Cost Management; Insurance; Problems and Challenges
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      Tseng, Phillip, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah, and Kevin A. Schulman. "Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System." JAMA, the Journal of the American Medical Association 319, no. 7 (February 20, 2018): 691–697.
      • February 2018 (Revised January 2020)
      • Case

      SoulCycle: The Road Ahead

      By: Ashish Nanda, Eric Van den Steen and Jeffrey Boyar
      Julie Rice and Elizabeth Cutler founded SoulCycle, an indoor cycling studio chain, in 2006 as more than a health club; they wanted it to become a lifestyle brand that would “empower riders in an immersive fitness experience.” By early 2015, SoulCycle had grown to 38... View Details
      Keywords: Fitness; Fitness Industry; Exercise; Cycling; Boutique Fitness; Exit Strategy; Growth; Bicycles; Retail; Pricing; Community; SoulCycle; Vision; Health; Leadership; Strategy; Marketing; Decision Making; Health Industry; United States
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      Nanda, Ashish, Eric Van den Steen, and Jeffrey Boyar. "SoulCycle: The Road Ahead." Harvard Business School Case 718-499, February 2018. (Revised January 2020.)
      • February 2018
      • Case

      Health Savings Accounts: Enabling Consumer Participation

      By: Regina E. Herzlinger and James Wallace
      Health savings accounts (HSAs), a creation of the 2003 Medicare Modernization Act, had become an integral part of the drive toward consumer-driven health care. Coupled with high-deductible health plans, HSAs allowed consumers to directly control a significant part of... View Details
      Keywords: Health Care; Healthcare Costs; Health Insurance; Health Care and Treatment; Cost; Insurance; Innovation and Invention; Health Industry; United States
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      Herzlinger, Regina E., and James Wallace. "Health Savings Accounts: Enabling Consumer Participation." Harvard Business School Case 318-110, February 2018.
      • February 2018
      • Case

      Aetna and the Transformation of Health Care

      By: Rebecca M. Henderson, Russell Eisenstat and Matthew Preble
      Mark Bertolini, chairman and CEO of the health insurer Aetna, faces a number of questions as he seeks to transform Aetna from a classic insurance company into a business that will engage much more deeply with its members around their personal health goals. His strategy... View Details
      Keywords: Health Care and Treatment; Insurance; Transformation; Behavior; Leading Change; Strategy; Health Industry; Health Industry; United States; Connecticut
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      Henderson, Rebecca M., Russell Eisenstat, and Matthew Preble. "Aetna and the Transformation of Health Care." Harvard Business School Case 318-048, February 2018.
      • Article

      The Economic Consequences of Hospital Admissions

      By: Carlos Dobkin, Amy Finkelstein, Raymond Kluender and Matthew Notowidigdo
      We use an event study approach to examine the economic consequences of hospital admissions for adults in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance,... View Details
      Keywords: Personal Finance; Borrowing and Debt; Insurance; Insolvency and Bankruptcy; Health Care and Treatment
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      Dobkin, Carlos, Amy Finkelstein, Raymond Kluender, and Matthew Notowidigdo. "The Economic Consequences of Hospital Admissions." American Economic Review 108, no. 2 (February 2018): 308–352.
      • January 2018 (Revised July 2019)
      • Case

      Big Apple Circus: Time to Fold the Tent?

      By: David G. Fubini and Matthew Wiger
      By 2016, the Big Apple Circus has weathered many storms in its 38 seasons as one of the most well-known New York City nonprofits. Will Weiss, the executive director, has witnessed his share of chaos during four years at Big Apple. After a slight resurgence following... View Details
      Keywords: Turnarounds; Bankruptcy; "Live Entertainment; Art; Crisis Management; Financial Crisis; Organizational Culture; Entertainment; Insolvency and Bankruptcy; Decision Choices and Conditions; Entertainment and Recreation Industry
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      Fubini, David G., and Matthew Wiger. "Big Apple Circus: Time to Fold the Tent?" Harvard Business School Case 418-050, January 2018. (Revised July 2019.)
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