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      • February 2022
      • Technical Note

      Ethical Analysis: Fairness

      By: Nien-hê Hsieh
      Concerns about fairness can arise across a wide range of contexts. They include the treatment of others, how much things cost, how much workers are paid, the outcome of a decision, and how we assign benefits and burdens across individuals. What counts as fair in a... View Details
      Keywords: Fairness; Management Practices and Processes; Decision Choices and Conditions
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      Hsieh, Nien-hê. "Ethical Analysis: Fairness." Harvard Business School Technical Note 322-097, February 2022.
      • Article

      A 680,000-Person Megastudy of Nudges to Encourage Vaccination in Pharmacies

      By: Katherine L. Milkman, Linnea Gandhi, Mitesh S. Patel, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Jonathan E. Bogard, Ilana Brody, Christopher F. Chabris, Edward Chang, Gretchen B. Chapman, Jennifer E. Dannals, Noah J. Goldstein, Amir Goren, Hal Hershfield, Alex Hirsch, Jillian Hmurovic, Samantha Horn, Dean Karlan, Ariella S. Kristal, Cait Lamberton, Michael N. Meyer, Allison H. Oakes, Maurice E. Schweitzer, Maheen Shermohammed, Jaochim H. Talloen, Caleb Warren, Ashley V. Whillans, Kuldeep N. Yadav, Julian J. Zlatev, Ron Berman, Chalanda N. Evans, Rahul Ladhania, Jens Ludwig, Nina Mazar, Sendhil Mullainathan, Christopher K. Snider, Jann Spiess, Eli Tsukayama, Lyle Ungar, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
      Encouraging vaccination is a pressing policy problem. To assess whether text-based reminders can encourage pharmacy vaccination and what kinds of messages work best, we conducted a megastudy. We randomly assigned 689,693 Walmart pharmacy patients to receive one of 22... View Details
      Keywords: Vaccination; Vaccines; Nudges; Communication Strategy; Communication Technology; Consumer Behavior; Health Care and Treatment
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      Milkman, Katherine L., Linnea Gandhi, Mitesh S. Patel, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Jonathan E. Bogard, Ilana Brody, Christopher F. Chabris, Edward Chang, Gretchen B. Chapman, Jennifer E. Dannals, Noah J. Goldstein, Amir Goren, Hal Hershfield, Alex Hirsch, Jillian Hmurovic, Samantha Horn, Dean Karlan, Ariella S. Kristal, Cait Lamberton, Michael N. Meyer, Allison H. Oakes, Maurice E. Schweitzer, Maheen Shermohammed, Jaochim H. Talloen, Caleb Warren, Ashley V. Whillans, Kuldeep N. Yadav, Julian J. Zlatev, Ron Berman, Chalanda N. Evans, Rahul Ladhania, Jens Ludwig, Nina Mazar, Sendhil Mullainathan, Christopher K. Snider, Jann Spiess, Eli Tsukayama, Lyle Ungar, Christophe Van den Bulte, Kevin G. Volpp, and Angela L. Duckworth. "A 680,000-Person Megastudy of Nudges to Encourage Vaccination in Pharmacies." e2115126119. Proceedings of the National Academy of Sciences 119, no. 6 (February 8, 2022).
      • February 8, 2022
      • Article

      Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions

      By: Alan Yang, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson and Robert S. Kaplan
      In 2017, patients made 145 million visits to emergency departments (EDs), generating $76.3 billion in charges. About a third of ED visits, however, were for conditions that were treatable in lower-resourced settings. We used time-driven activity-based costing (TDABC)... View Details
      Keywords: Time-Driven ABC; Health Care Costs; Activity Based Costing and Management; Health Care and Treatment
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      Yang, Alan, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson, and Robert S. Kaplan. "Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions." NEJM Catalyst (February 8, 2022).
      • Article

      Costs Without Value When Treating Pediatric Behavioral Patients in the ED

      By: Marcella Jewell, Syed S. Shehab, Robert S. Kaplan, Jack Fanton and Joeli Hettler
      Pediatric Emergency Department (ED) visits have greatly increased in recent years. An academic pediatric ED that annually treats about 1,000 behavioral health patients conducted a study to assess the true cost of caring for nonacute behavioral health patients. It... View Details
      Keywords: Costs; Value; Healthcare; Health Care and Treatment; Cost Management
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      Jewell, Marcella, Syed S. Shehab, Robert S. Kaplan, Jack Fanton, and Joeli Hettler. "Costs Without Value When Treating Pediatric Behavioral Patients in the ED." NEJM Catalyst Innovations in Care Delivery 3, no. 2 (February 2022).
      • February 2022 (Revised November 2022)
      • Case

      Nuritas

      By: Mitchell Weiss, Satish Tadikonda, Vincent Dessain and Emer Moloney
      Nora Khaldi had built a technology “to unlock the power of nature” in the service of extending human lifespan and improving health, and now in April 2020 was debating telling her Board of Directors she wanted to put on ice some of her discoveries. Nuritas, the company... View Details
      Keywords: Cash Burn; Cash Flow Analysis; Pharmaceutical Companies; Founder; Artificial Intelligence; AI; Entrepreneurship; Health Testing and Trials; Health Care and Treatment; Decision Making; Market Entry and Exit; AI and Machine Learning; Pharmaceutical Industry
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      Weiss, Mitchell, Satish Tadikonda, Vincent Dessain, and Emer Moloney. "Nuritas." Harvard Business School Case 822-080, February 2022. (Revised November 2022.)
      • 2022
      • Article

      Alleviating Time Poverty Among the Working Poor: A Pre-Registered Longitudinal Field Experiment

      By: A.V. Whillans and Colin West
      Poverty entails more than a scarcity of material resources—it also involves a shortage of time. To examine the causal benefits of reducing time poverty, we conducted a longitudinal feld experiment over six consecutive weeks in an urban slum in Kenya with a sample of... View Details
      Keywords: Time; Subjective Well Being; Administrative Costs; Friction; Poverty; Well-being; Money; Perception; Kenya
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      Whillans, A.V., and Colin West. "Alleviating Time Poverty Among the Working Poor: A Pre-Registered Longitudinal Field Experiment." Art. 719. Scientific Reports 12 (2022).
      • January 2022
      • Case

      Somatus: Value-Based Kidney Care (A)

      By: Ariel D. Stern, Robert S. Huckman and Sarah Mehta
      When Dr. Ikenna Okezie founded Somatus, a value-based kidney care provider, his goal had been nothing short of transforming kidney care delivery in the United States. Rather than relying on dialysis, a costly and intensive treatment for late-stage kidney disease, the... View Details
      Keywords: Business Startups; Disruption; Entrepreneurship; Health; Health Care and Treatment; Health Disorders; Medical Specialties; Innovation and Invention; Disruptive Innovation; Management; Strategy; Business Strategy; Value; Value Creation; Health Industry; United States; Virginia
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      Stern, Ariel D., Robert S. Huckman, and Sarah Mehta. "Somatus: Value-Based Kidney Care (A)." Harvard Business School Case 622-009, January 2022.
      • Article

      Applying Human-Centered Design Principles to Digital Syndromic Surveillance at a Mass Gathering in India: Viewpoint

      By: Ahmed Shaikh, Abhishek Bhatia, Ghanshyam Yadav, Shashwat Hora, Chung Won, Mark Shankar, Aaron Heerboth, Prakash Vemulapalli, Paresh Navalkar, Kunal Oswal, Clay Heaton, Sujata Saunik, Tarun Khanna and Satchit Balsari
      In the wake of the COVID-19 pandemic, digital health tools have been deployed by governments around the world to advance clinical and population health objectives. Few interventions have been successful or have achieved sustainability or scale. In India, government... View Details
      Keywords: Digital Health Tools; Human-centered Design; Health Care and Treatment; Mobile and Wireless Technology; Design; Technology Adoption
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      Shaikh, Ahmed, Abhishek Bhatia, Ghanshyam Yadav, Shashwat Hora, Chung Won, Mark Shankar, Aaron Heerboth, Prakash Vemulapalli, Paresh Navalkar, Kunal Oswal, Clay Heaton, Sujata Saunik, Tarun Khanna, and Satchit Balsari. "Applying Human-Centered Design Principles to Digital Syndromic Surveillance at a Mass Gathering in India: Viewpoint." Journal of Medical Internet Research 24, no. 1 (January 2022).
      • 2022
      • Article

      Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing

      By: Nikhil G. Thaker, Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley and Steven J. Frank
      Integrated quality improvement (QI) and cost reduction strategies can help increase value in cancer care. We applied standard QI and TDABC methods to improve workflow efficiency and reduce costs for MRI-guided prostate brachytherapy. We constructed process maps,... View Details
      Keywords: Brachytherapy; Quality Improvement; Prostate; Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Performance Efficiency; Health Industry
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      Thaker, Nikhil G., Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley, and Steven J. Frank. "Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing." Brachytherapy 21, no. 1 (2022): 49–54.
      • January–February 2022
      • Article

      Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board

      By: Robert S. Kaplan, Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman and Michael-Anne Browne
      The U.S. Military Health System spends about $50 billion annually through its TRICARE health plans to provide care to 9.6 million active duty service members, retirees, and their families. TRICARE, historically, has used the predominant U.S. fee-for-service payment... View Details
      Keywords: Military Health System; Value-based Healthcare; Health Care and Treatment; United States
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      Kaplan, Robert S., Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman, and Michael-Anne Browne. "Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board." Military Medicine 187, nos. 1-2 (January–February 2022): 12–16.
      • Article

      Time-Driven Activity-Based Costing in Breast Cancer Care Delivery

      By: Navraj S. Nagra, Elena Tsangaris, Jessica Means, Michael J. Hassett, Laura S. Dominici, Jennifer R. Bellon, Justin Broyles, Robert S. Kaplan, Thomas W. Feeley and Andrea L. Pusic
      We used time-driven activity-based costing (TDABC) to calculate the complete cost of breast cancer care—initial treatment planning, chemotherapy, radiation therapy, surgical resection and reconstruction, and ancillary services (psychosocial oncology, physical therapy.... View Details
      Keywords: Healthcare; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost
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      Nagra, Navraj S., Elena Tsangaris, Jessica Means, Michael J. Hassett, Laura S. Dominici, Jennifer R. Bellon, Justin Broyles, Robert S. Kaplan, Thomas W. Feeley, and Andrea L. Pusic. "Time-Driven Activity-Based Costing in Breast Cancer Care Delivery." Annals of Surgical Oncology 29, no. 1 (January 2022): 510–521.
      • 2021
      • Working Paper

      Capitalism, Slavery, and the Legacy of Cesare Beccaria

      By: Sophus A. Reinert
      The Milanese Marquis Cesare Beccaria (1738-1794) dedicated his life first to theorizing a more just and equal society grounded in individual rights, anchored in secular political economy rather than in religious dogma, then to realizing this bold vision... View Details
      Keywords: Slavery; Racism; Capitalism; History; Society
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      Reinert, Sophus A. "Capitalism, Slavery, and the Legacy of Cesare Beccaria." Harvard Business School Working Paper, No. 22-034, December 2021. (Revised January 2022.)
      • 2 Dec 2021
      • Interview

      How To Make Healthcare Innovation Happen

      By: Regina E. Herzlinger
      Regina Herzlinger has been called “the godmother of consumer-driven healthcare” because of her groundbreaking scholarly articles and books on the subject. As a professor of business administration at Harvard Business School for nearly 50 years, her focus has supported... View Details
      Keywords: Health Care and Treatment; Innovation and Invention
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      Herzlinger, Regina E. "How To Make Healthcare Innovation Happen." Raise the Line (podcast), Osmosis, December 2, 2021.
      • Article

      A Prescriptive Analytics Framework for Optimal Policy Deployment Using Heterogeneous Treatment Effects

      By: Edward McFowland III, Sandeep Gangarapu, Ravi Bapna and Tianshu Sun
      We define a prescriptive analytics framework that addresses the needs of a constrained decision-maker facing, ex ante, unknown costs and benefits of multiple policy levers. The framework is general in nature and can be deployed in any utility maximizing context, public... View Details
      Keywords: Prescriptive Analytics; Heterogeneous Treatment Effects; Optimization; Observed Rank Utility Condition (OUR); Between-treatment Heterogeneity; Machine Learning; Decision Making; Analysis; Mathematical Methods
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      McFowland III, Edward, Sandeep Gangarapu, Ravi Bapna, and Tianshu Sun. "A Prescriptive Analytics Framework for Optimal Policy Deployment Using Heterogeneous Treatment Effects." MIS Quarterly 45, no. 4 (December 2021): 1807–1832.
      • Article

      Social Technology: An Interdisciplinary Approach to Improving Care for Older Adults

      By: Arthur Kleinman, Hongtu Chen, Sue E. Levkoff, Ann Forsyth, David E. Bloom, Winnie Yip, Tarun Khanna, Conor J. Walsh, David Perry, Ellen W. Seely, Anne S. Kleinman, Yan Zhang, Yuan Wang, Jun Jing, Tianshu Pan, Ning An, Zhenggang Bai, Jiexiu Wang, Qing Liu and Fawwaz Habbal
      Population aging is a defining demographic reality of our era. It is associated with an increase in the societal burden of delivering care to older adults with chronic conditions or frailty. How to integrate global population aging and technology development to help... View Details
      Keywords: Health Care and Treatment; Age; Service Delivery; Information Technology; Collaborative Innovation and Invention
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      Kleinman, Arthur, Hongtu Chen, Sue E. Levkoff, Ann Forsyth, David E. Bloom, Winnie Yip, Tarun Khanna, Conor J. Walsh, David Perry, Ellen W. Seely, Anne S. Kleinman, Yan Zhang, Yuan Wang, Jun Jing, Tianshu Pan, Ning An, Zhenggang Bai, Jiexiu Wang, Qing Liu, and Fawwaz Habbal. "Social Technology: An Interdisciplinary Approach to Improving Care for Older Adults." Art. 729149. Frontiers in Public Health 9 (2021).
      • November–December 2021
      • Article

      Successfully Implementing TDABC in Health-Care Provider Organizations

      By: Susanna Gallani and Gregory Sabin
      This article describes some of the common obstacles that challenge the success of TDABC implementation in health-care provider organizations and suggests potential remedies and preventive measures. View Details
      Keywords: Time-Driven Activity-Based Costing; Implementation; Health Care and Treatment; Activity Based Costing and Management
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      Gallani, Susanna, and Gregory Sabin. "Successfully Implementing TDABC in Health-Care Provider Organizations." Cost Management 35, no. 6 (November–December 2021): 29–33. (Commissioned Article.)
      • Article

      Surgeons and Administrators Co-Creating Value

      By: Michael Nurok, Thoralf Sundt, Robert S. Kaplan and Bruce Gewertz
      Most hospitals have arms-length relationships with physicians, viewing them as people they must ‘‘manage,’’ not as potentially valuable strategic partners. But surgeons make clinical decisions every day that have great influence on both patient outcomes and hospital... View Details
      Keywords: Value-based Health Care; Collaboration; Healthcare Administration; Health Care and Treatment; Management; Strategy; Value Creation
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      Nurok, Michael, Thoralf Sundt, Robert S. Kaplan, and Bruce Gewertz. "Surgeons and Administrators Co-Creating Value." Annals of Surgery 274, no. 6 (December 2021).
      • December 2021
      • Article

      Trade Policy Uncertainty and Stock Returns

      By: Marcelo Bianconi, Federico Esposito and Marco Sammon
      A recent literature has documented large real effects of trade policy uncertainty (TPU) on trade, employment, and investment, but there is little evidence that investors are compensated for bearing such risk. To quantify the risk premium associated with TPU, we exploit... View Details
      Keywords: Trade Policy; Uncertainty; Stock Returns; Risk Premium; Tariff Rates; Portfolio Analysis; Trade; Policy; Risk and Uncertainty; Stocks; Investment Return
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      Bianconi, Marcelo, Federico Esposito, and Marco Sammon. "Trade Policy Uncertainty and Stock Returns." Art. 102492. Journal of International Money and Finance 119 (December 2021).
      • Article

      Transparency as a Solution for the Hospital Capacity Problem

      By: Regina E. Herzlinger
      COVID dramatically clarified a shortcoming in our great healthcare system, but like everything in the world, it has its shortcomings. What we see through the apex of COVID is that many hospitals in hotspot areas cannot provide an adequate supply of beds. Although the... View Details
      Keywords: Hospital Capacity; Health Care and Treatment; Performance Capacity; Planning; Cooperation
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      Herzlinger, Regina E. "Transparency as a Solution for the Hospital Capacity Problem." Ohio State Law Journal 82, no. 5 (December 2021): 787–794.
      • 2021
      • Working Paper

      COVID-19, Government Performance, and Democracy: Survey Experimental Evidence from 12 Countries

      By: Michael Becher, Nicholas Longuet Marx, Vincent Pons, Sylvain Brouard, Martial Foucault, Vincenzo Galasso, Eric Kerrouche, Sandra León Alfonso and Daniel Stegmueller
      Beyond its immediate impact on public health and the economy, the COVID-19 pandemic has put democracy under stress. While a common view is that people should blame the government rather than the political system for bad crisis management, an opposing view is that... View Details
      Keywords: COVID-19 Pandemic; Government Performance; Democracy; Health Pandemics; Government and Politics; Crisis Management; Public Opinion
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      Becher, Michael, Nicholas Longuet Marx, Vincent Pons, Sylvain Brouard, Martial Foucault, Vincenzo Galasso, Eric Kerrouche, Sandra León Alfonso, and Daniel Stegmueller. "COVID-19, Government Performance, and Democracy: Survey Experimental Evidence from 12 Countries." NBER Working Paper Series, No. 29514, November 2021. (Revise and resubmit requested, The Journal of Politics.)
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