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May 1998 (Revised September 1999)
Background Note

Note on Managed Care

By: Richard M.J. Bohmer

Presents an overview of managed care. Describes the relationship between provider and insurance companies, examines the implications for consumers, and discusses financial arrangements and operational characteristics commonly observed in the industry. Also provides a... View Details

Keywords: Customers; Insurance; Health Care and Treatment; Service Operations; Relationships; Insurance Industry

February 2010 (Revised March 2012)
Case

U.S. Healthcare Reform: International Perspectives

By: Arthur A. Daemmrich and Elia Cameron

The national economic implications of rising healthcare costs were poorly understood, even as the United States, Germany, and the United Kingdom instituted reforms in early 2010. Presenting opportunities for cross-national policy learning, this case describes the... View Details

Keywords: Macroeconomics; Insurance; Governing Rules, Regulations, and Reforms; Health Care and Treatment; Laws and Statutes; Business and Government Relations; Health Industry; Health Industry; Germany; United Kingdom; United States

18 Apr 2024
Lecture

Innovation Opportunities Created by COVID-19 Can Help: And How to Make Them Happen

By: Regina E. Herzlinger

The crush of patients created by COVID enabled the creation of sites for care outside the traditional hospital, such as retail pharmacies, ambulatory surgery centers, urgent care centers, telemedicine, and wireless sensors. Public policy mirrored these changes by... View Details

Keywords: Policy; Health Pandemics; Health Care and Treatment; Innovation and Invention; Health Industry; Health Industry

November 2020
Teaching Note

DayTwo: Going to Market with Gut Microbiome

By: Ayelet Israeli

Teaching Note for HBS Case No. 519-010. DayTwo is a young Israeli startup that applies research on the gut microbiome and machine learning algorithms to deliver personalized nutritional recommendations to its users in order to minimize blood sugar spikes after meals.... View Details

February 2010 (Revised February 2021)
Case

The Vitality Group: Paying for Self-Care

By: Regina E. Herzlinger

Vitality is part of a $2 billion start-up South African and U.K. health insurance firm. It has achieved excellent results in rewarding people for promoting their health. It is now contemplating how to enter the U.S. market. View Details

Keywords: Market Entry and Exit; Insurance Industry; South Africa; United Kingdom; United States

March 1994 (Revised December 2014)
Case

Humana, Inc.: Managing in a Changing Industry

By: Stuart Gilson

Intensifying competition and change in the U.S. health care industry force a large integrated health-care provider to reassess its strategy of operating both hospitals and health insurance plans (HMOs). In an attempt to increase its stock price and operating... View Details

Keywords: Business Strategy; Restructuring; Change Management; Financial Management; Health Industry

Teaching Interest

Overview

By: Regina E. Herzlinger

Course Requirements

Students are required to prepare a business plan, which employs the framework of this course, to explore an entrepreneurial opportunity in health care, and to evaluate their classmates' plans.

Career Focus

For... View Details

Keywords: Healthcare; Healthcare Industry; Healthcare Innovation; Healthcare Costs; Healthcare Operations; Healthcare Organizations; Healthcare Startups; Healthcare Technology; Healthcare Ventures

December 12, 2023
Article

Prices for Common Services at Quaternary vs Nonquaternary Hospitals

By: Brandon W. Yan, Maximilian J. Pany and Leemore S. Dafny

Using commercial health insurance claims data from 2017-2019, we assessed whether quaternary hospitals charged higher prices for common, unspecialized services also offered by nonquaternary hospitals. We found quaternary-hospital price premiums of 8.2 percent, on... View Details

Keywords: Price; Health Care and Treatment; Insurance; Markets; Health Industry

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October 2022 (Revised August 2024)
Case

Cigna-Express Scripts: Can a Vertical Merger Rescue an Industry Under Attack?

By: Leemore Dafny

In Fall 2019, Cigna Corporation – a global health services company with a significant presence in the U.S. employer-sponsored health insurance market - was digesting its $54 billion acquisition of Express Scripts, Inc. (ESI), a pharmacy benefit manager (PBM)... View Details

Keywords: Mergers and Acquisitions; Business Model; Vertical Integration; Insurance Industry

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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2019
Chapter

Behavioral Economics and Health-Care Markets

By: Amitabh Chandra, Benjamin Handel and Joshua Schwartzstein

This chapter summarizes research in behavioral health economics, focusing on insurance markets and product markets in health care. We argue that the prevalence of choice difficulties and biases leading to mistakes in these markets establish a special place for them in... View Details

Keywords: Behavioral Economics; Consumer Behavior; Economics; Health Care and Treatment; Insurance; Markets

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05 Jun 2012
First Look

First Look: June 5

bond market. Specifically, we show evidence for reaching for yield among insurance companies, the largest institutional holders of corporate bonds. Insurance companies have capital requirements tied to the... View Details

Keywords: Sean Silverthorne

Research Summary

Behavioral Hazard and Public Policy

By: Joshua R. Schwartzstein

It is well recognized that people overuse low-value medical care due to moral hazard—because copays are lower than costs. Now Professor Schwartzstein has introduced the concept of “behavioral hazard” to explain the opposite: people underuse high-value care because... View Details

June 2005 (Revised August 2011)
Case

Narayana Hrudayalaya Heart Hospital: Cardiac Care for the Poor (A)

By: Tarun Khanna, V. Kasturi Rangan and Merlina Manocaran

Describes the mission, vision, and strategy of a team of entrepreneurs headed by a charismatic heart surgeon who founded a heart hospital in Bangalore, India. The purpose of the hospital was to offer health care for the masses. This tertiary care hospital performed... View Details

Keywords: Social Entrepreneurship; Health Care and Treatment; Goals and Objectives; Social Marketing; Mission and Purpose; Strategic Planning; Social Enterprise; Welfare; Health Industry; Health Industry; Bangalore

31 Jul 2018
First Look

New Research and Ideas, July 31, 2018

Shankar MD, Suptendra N. Sarbadhikari PhD, Barbara Bierer, Kenneth D. Mandl MD, Sanjay Mehendale MD, MPH, and Tarun Khanna Abstract—In February 2018, the Government of India announced a massive public health View Details

Keywords: Dina Gerdeman

27 Aug 2013
First Look

First Look: August 27

https://www.hbs.edu/faculty/Pages/item.aspx?num=45271 August 2013 Journal of Health Economics Consumers' Misunderstanding of Health Insurance By: Loewenstein, George, Joelle Y.... View Details

Keywords: Sean Silverthorne

April 2020
Supplement

Luvo (B)

By: José B. Alvarez and Natalie Kindred

This case, a follow on to HBS No. 517-049 "Luvo," provides a brief look at changes that have occurred at Luvo, now called Performance Kitchen, since the timing of the first case (mid-2016). Set in January 2020, “Luvo (B)” touches on developments such as the company's... View Details

Keywords: Consumer Behavior; Health; Health Care and Treatment; Nutrition; Food; Strategy; Product Positioning; Product Marketing; Food and Beverage Industry; Agriculture and Agribusiness Industry; Consumer Products Industry; Retail Industry; United States; Canada

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; Insurance Industry; Massachusetts

March 2010 (Revised April 2014)
Case

American Well: The Doctor Will E-See You Now

By: Elie Ofek and Ron Laufer

What is next for healthcare IT provider American Well, whose innovative Online Care technology allows physicians to deliver care to patients online in real time? Using American Well's platform, patients with non-emergency health concerns can communicate with physicians... View Details

Keywords: Entrepreneurship; Health Care and Treatment; Technological Innovation; Growth and Development Strategy; Market Entry and Exit; Service Delivery; Online Technology; Health Industry

December 2009 (Revised May 2012)
Case

Koo Foundation Sun Yat-Sen Cancer Center: Breast Cancer Care in Taiwan

By: Michael E. Porter, Jennifer F Baron and C. Jason Wang

Taiwan's Koo Foundation Sun Yat-Sen Cancer Center has developed an integrated, team-based care delivery model for breast cancer care that is being expanded to other cancer types in 2009. A decade earlier, President and CEO Dr. Andrew Huang and the Center had worked... View Details

Keywords: Health Care and Treatment; Medical Specialties; Service Delivery; Outcome or Result; Performance Effectiveness; Quality; Integration; Health Industry; Health Industry; Taiwan

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