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  • August 2015 (Revised August 2015)
  • Case

Hoag Orthopedic Institute

By: Robert S. Kaplan and Jonathan Warsh
Two groups of orthopedic surgeons form a joint venture with a community hospital to establish Hoag Orthopedic Institute, a for-profit hospital and two ambulatory service centers. By controlling and integrating all aspects of the patients' medical treatment, the... View Details
Keywords: Outcomes Measurement; Bundled Payment; Health Care; Activity-based Costing And Management; Measurement and Metrics; Activity Based Costing and Management; Competitive Strategy; Medical Specialties; Health Care and Treatment; Outcome or Result; Health Industry
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Kaplan, Robert S., and Jonathan Warsh. "Hoag Orthopedic Institute." Harvard Business School Case 115-023, August 2015. (Revised August 2015.)
  • January 2017 (Revised October 2023)
  • Case

Classtivity: Payal's Pirouette

By: Jeffrey J. Bussgang and Olivia Hull
A few months after launching a new fitness technology product, the small staff of New York startup Classtivity gathers on a Saturday in April 2013 to take stock. With one successful pivot under its belt, Classtivity is finally generating revenue and enthusiasm among... View Details
Keywords: Product Pivot; Boutique Fitness; Fitness Industry; Market Sizing; Consumer Technology; Bundling; Subscription Model; Two-sided Marketplace; ClassPass; Entrepreneurship; Venture Capital; Business Startups; Transition; Customer Focus and Relationships; Technological Innovation; Organizational Change and Adaptation; Customer Value and Value Chain; Marketing Strategy; Failure; Business Strategy; Health Industry; Health Industry; New York (city, NY)
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Bussgang, Jeffrey J., and Olivia Hull. "Classtivity: Payal's Pirouette." Harvard Business School Case 817-002, January 2017. (Revised October 2023.)
  • March 2019
  • Case

DayTwo: Going to Market with Gut Microbiome

By: Ayelet Israeli and David Lane
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. After a first year of trial rollout in... View Details
Keywords: Start-up Growth; Startup; Positioning; Targeting; Go To Market Strategy; B2B2C; B2B Vs. B2C; Health & Wellness; AI; Machine Learning; Female Ceo; Female Protagonist; Science-based; Science And Technology Studies; Ecommerce; Applications; DTC; Direct To Consumer Marketing; US Health Care; "USA,"; Innovation; Pricing; Business Growth; Segmentation; Distribution Channels; Growth and Development Strategy; Business Startups; Science-Based Business; Health; Innovation and Invention; Marketing; Information Technology; Business Growth and Maturation; E-commerce; Applications and Software; Health Industry; Health Industry; Health Industry; Health Industry; Health Industry; Israel; United States
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Israeli, Ayelet, and David Lane. "DayTwo: Going to Market with Gut Microbiome." Harvard Business School Case 519-010, March 2019.
  • 2016
  • Working Paper

Immigrant Entrepreneurs and the Social Safety Net

By: Gareth Olds
This paper explores the role of public health insurance in small business ownership among immigrants, a group with high rates of entrepreneurship. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 created a five-year “waiting period” for legal... View Details
Keywords: Insurance; Entrepreneurship; Welfare or Wellbeing; Immigration
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Olds, Gareth. "Immigrant Entrepreneurs and the Social Safety Net." Harvard Business School Working Paper, No. 16-142, June 2016.
  • 14 Jul 2006
  • Op-Ed

The Case for Consumer-Driven Medicaid

The Medicaid program provides a much needed health insurance safety net for 52 million of our nation's poor and medically needy, but its price tag threatens the financial stability of the states, growing 9.5... View Details
Keywords: by Regina E. Herzlinger
  • August 2003 (Revised April 2005)
  • Case

Old Tex College

By: Regina E. Herzlinger and Ray Herschman
Requires student to choose among the following health insurance options for employers: number of plans offered, managed care and consumer-driven options, and self-funding vs. full insurance. Teaching purpose: To Understand the design of health insurance. Includes color... View Details
Keywords: Insurance; Health; Health Care and Treatment; Compensation and Benefits; Employees
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Herzlinger, Regina E., and Ray Herschman. "Old Tex College." Harvard Business School Case 304-014, August 2003. (Revised April 2005.)
  • February 2022 (Revised April 2022)
  • Case

CVS Health: Prescription for Transformation

By: Rosabeth Moss Kanter and Tuna Cem Hayirli
In 2021, new CEO Karen Lynch (named the most powerful woman in business) considered the next transformation phase for CVS Health (a Fortune 5 corporate giant. The 2018 acquisition of Aetna insurance brought her to the company as part of its long evolution from a... View Details
Keywords: COVID; Caregiving; Healthcare; Access; Change; Retail; Health; Health Care and Treatment; Organizational Change and Adaptation; Transformation; Health Industry; Health Industry
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Kanter, Rosabeth Moss, and Tuna Cem Hayirli. "CVS Health: Prescription for Transformation." Harvard Business School Case 322-091, February 2022. (Revised April 2022.)
  • September 2017
  • Editorial

Helping Patients with Cancer Navigate Narrow Networks

By: Stephen M. Schleicher, Emeline M. Aviki and Thomas W. Feeley
The Affordable Care Act of 2010 (ACA) was designed primarily to improve patient access to affordable health care. The access-expanding provisions of the ACA included federal- and state-based health insurance exchanges with minimum coverage requirements and preexisting... View Details
Keywords: Health Care and Treatment; Insurance; Problems and Challenges; United States
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Schleicher, Stephen M., Emeline M. Aviki, and Thomas W. Feeley. "Helping Patients with Cancer Navigate Narrow Networks." Journal of Clinical Oncology 35, no. 27 (September 2017): 3095–3096.
  • 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
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Bohmer, Richard M.J. "Note on Managed Care." Harvard Business School Background Note 698-060, May 1998. (Revised September 1999.)
  • 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
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Daemmrich, Arthur A., and Elia Cameron. "U.S. Healthcare Reform: International Perspectives." Harvard Business School Case 710-040, February 2010. (Revised March 2012.)
  • July 2003 (Revised August 2003)
  • Case

Global Healthcare Exchange

By: Lynda M. Applegate and Jamie Ladge
Founded in March 2000 at the height of the dot-com bubble, Global Healthcare Exchange (GHX) was one of 90 online marketplaces in the health care industry. The company's founders were among the largest suppliers in the industry, including Johnson & Johnson, GE Medical,... View Details
Keywords: Mergers and Acquisitions; Entrepreneurship; Price; Leadership; Growth and Development Strategy; Supply and Industry; Organizational Design; Expansion; Internet and the Web; Valuation; Health Industry
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Applegate, Lynda M., and Jamie Ladge. "Global Healthcare Exchange." Harvard Business School Case 804-002, July 2003. (Revised August 2003.)
  • 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
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"Innovation Opportunities Created by COVID-19 Can Help: And How to Make Them Happen." Fortnightly of Chicago, April 18, 2024.
  • 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
  • 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
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Herzlinger, Regina E. "The Vitality Group: Paying for Self-Care." Harvard Business School Case 310-071, February 2010. (Revised February 2021.)
  • 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
Keywords: Start-up Growth; Startup; Positioning; Targeting; Go To Market Strategy; B2B Vs. B2C; B2B2C; Health & Wellness; AI; Machine Learning; Female Ceo; Female Protagonist; Science-based; Science And Technology Studies; Ecommerce; Applications; DTC; Direct To Consumer Marketing; US Health Care; "USA,"; Innovation; Pricing; Business Growth; Segmentation; Distribution Channels; Growth and Development Strategy; Business Startups; Science-Based Business; Health; Innovation and Invention; Marketing; Information Technology; Business Growth and Maturation; E-commerce; Applications and Software; Health Industry; Health Industry; Health Industry; Health Industry; Health Industry; Israel; United States
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Israeli, Ayelet. "DayTwo: Going to Market with Gut Microbiome." Harvard Business School Teaching Note 521-052, November 2020.
  • 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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Yan, Brandon W., Maximilian J. Pany, and Leemore S. Dafny. "Prices for Common Services at Quaternary vs Nonquaternary Hospitals." JAMA, the Journal of the American Medical Association 330, no. 22 (December 12, 2023): 2211–2213.
  • 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
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Gilson, Stuart. "Humana, Inc.: Managing in a Changing Industry." Harvard Business School Case 294-062, March 1994. (Revised December 2014.)
  • 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.
  • 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
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Dafny, Leemore. "Cigna-Express Scripts: Can a Vertical Merger Rescue an Industry Under Attack?" Harvard Business School Case 323-038, October 2022. (Revised August 2024.)
  • 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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Chandra, Amitabh, Benjamin Handel, and Joshua Schwartzstein. "Behavioral Economics and Health-Care Markets." Chap. 6 in Handbook of Behavioral Economics: Foundations and Applications 2, edited by B. Douglas Bernheim, Stefano DellaVigna, and David Laibson, 459–502. Amsterdam: Elsevier/North-Holland, 2019.
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