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      • 2021
      • Working Paper

      The Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes

      By: Arlen Guarin, Christian Posso, Estefania Saravia and Jorge Tamayo
      Identifying the effect of physicians’ skills on health outcomes is a challenging task due to the nonrandom sorting between physicians and hospitals. We overcome this challenge by exploiting a Colombian government program that randomly assigned 2,126 physicians to 618... View Details
      Keywords: Physicians' Health Skills; Health Birth Outcomes; Birthing Outcomes; Experimental Evidence; Health Care and Treatment; Competency and Skills; Outcome or Result; Health Industry; Colombia
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      Guarin, Arlen, Christian Posso, Estefania Saravia, and Jorge Tamayo. "The Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes." Harvard Business School Working Paper, No. 22-015, February 2021. (R&R American Economic Journal.)
      • Article

      Supporting Value-Based Health Care—Aligning Financial and Legal Accountability

      By: Mark M. Zaki, Anupam B. Jena and Amitabh Chandra
      U.S. health care payment and delivery-system reforms have focused on improving care by making organizations accountable for outcomes, quality, and costs. Payers have supported the implementation of accountable care organizations (ACOs), bundled-payment models, and... View Details
      Keywords: Value-based Health Care; Accountability; Health Care and Treatment; United States
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      Zaki, Mark M., Anupam B. Jena, and Amitabh Chandra. "Supporting Value-Based Health Care—Aligning Financial and Legal Accountability." New England Journal of Medicine 385, no. 11 (September 9, 2021): 965–967.
      • Article

      A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal

      By: Jiayin Xue, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg and Kevin Schulman
      U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital... View Details
      Keywords: Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Health Industry; India; Nepal; United States
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      Xue, Jiayin, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg, and Kevin Schulman. "A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal." NEJM Catalyst Innovations in Care Delivery 2, no. 9 (September 2021).
      • 2021
      • Working Paper

      Detecting Anomalous Patterns of Care Using Health Insurance Claims

      By: Sriram Somanchi, Edward McFowland III and Daniel B. Neill
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      Somanchi, Sriram, Edward McFowland III, and Daniel B. Neill. "Detecting Anomalous Patterns of Care Using Health Insurance Claims." Working Paper, 2021. (In Preparation.)
      • September 2021
      • Article

      Kidney Exchange: An Operations Perspective

      By: Itai Ashlagi and Alvin E. Roth
      Many patients in need of a kidney transplant have a willing but incompatible (or poorly matched) living donor. Kidney exchange programs arrange exchanges among such patient-donor pairs, in cycles and chains of exchange, so each patient receives a compatible kidney.... View Details
      Keywords: Kidney Exchange Programs; Matching; Health Disorders; Health Care and Treatment; Programs; Design
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      Ashlagi, Itai, and Alvin E. Roth. "Kidney Exchange: An Operations Perspective." Management Science 67, no. 9 (September 2021): 5455–5478.
      • Article

      Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected

      By: Maximilian J. Pany, Michael E. Chernew and Leemore S. Dafny
      Concern about high hospital prices for commercially insured patients has motivated several proposals to regulate these prices. Such proposals often limit regulations to highly concentrated hospital markets. Using a large sample of 2017 US commercial insurance claims,... View Details
      Keywords: Health Care Providers; Hospitals; Insurance Market Regulation; Price Regulation; Markets; Health Care and Treatment; Cost; Quality; Insurance; Price; Governing Rules, Regulations, and Reforms
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      Pany, Maximilian J., Michael E. Chernew, and Leemore S. Dafny. "Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected." Health Affairs 40, no. 9 (September 2021): 1386–1394.
      • August 2021
      • Case

      Livongo: Scaling a Purpose-Driven Organization in Healthcare

      By: Ranjay Gulati, Aseem Shukla and Reva Nohria
      When seasoned entrepreneur Glen Tullman founded the chronic health care startup Livongo in 2014, it was personal. His son lived with diabetes, and Tullman knew firsthand how taxing it could be to manage such an unrelenting disease. Livongo set out to empower people... View Details
      Keywords: Healthcare Industry; Scaling; Telehealth; Health Care and Treatment; Small Business; Internet and the Web; Customer Focus and Relationships; Growth and Development Strategy; Opportunities; Mergers and Acquisitions; Health Industry
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      Gulati, Ranjay, Aseem Shukla, and Reva Nohria. "Livongo: Scaling a Purpose-Driven Organization in Healthcare." Harvard Business School Case 422-017, August 2021.
      • Summer 2021
      • Article

      Predictable Country-level Bias in the Reporting of COVID-19 Deaths

      By: Botir Kobilov, Ethan Rouen and George Serafeim
      We examine whether a country’s management of the COVID-19 pandemic relate to the downward biasing of the number of reported deaths from COVID-19. Using deviations from historical averages of the total number of monthly deaths within a country, we find that the... View Details
      Keywords: COVID-19; Deaths; Reporting; Incentives; Government Policy; Health Pandemics; Health Care and Treatment; Country; Crisis Management; Outcome or Result; Reports; Policy
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      Kobilov, Botir, Ethan Rouen, and George Serafeim. "Predictable Country-level Bias in the Reporting of COVID-19 Deaths." Journal of Government and Economics 2 (Summer 2021).
      • August 2021 (Revised February 2023)
      • Case

      Fair Park Covid-19 Mass Vaccination Site (A)

      By: Willy Shih
      This case is an opportunity to apply the methods of the Toyota Production System (TPS) to the analysis of an everyday service application: administering Covid-19 vaccines. It describes the start-up of a drive-up Covid-19 mass vaccination site at the Texas State Fair... View Details
      Keywords: Operations Improvement; Operations And Processes; Toyota Production System; COVID-19 Pandemic; Operations; Service Operations; Health Pandemics; Problems and Challenges; Goals and Objectives; Measurement and Metrics; Health Care and Treatment; Health Industry; United States; Texas
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      Shih, Willy. "Fair Park Covid-19 Mass Vaccination Site (A)." Harvard Business School Case 622-003, August 2021. (Revised February 2023.)
      • August 2021
      • Teaching Note

      IBM Watson at MD Anderson Cancer Center

      By: Shane Greenstein and Mel Martin
      Teaching Note for HBS Case No. 621-022. View Details
      Keywords: Decision Making; Technological Innovation; Innovation Strategy; Knowledge Management; Knowledge Use and Leverage; Operations; Failure; Information Technology; Applications and Software; Health Care and Treatment; Product Development; Health Industry; Health Industry; Health Industry; United States; Houston; Texas
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      Greenstein, Shane, and Mel Martin. "IBM Watson at MD Anderson Cancer Center." Harvard Business School Teaching Note 622-020, August 2021.
      • July 2021 (Revised July 2022)
      • Case

      Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care

      By: Robert S. Kaplan, Navraj S. Nagra and Syed S. Shehab
      Dr. Andrea Pusic, breast cancer reconstruction surgeon, wants to extend outcomes measurement beyond traditional surgical metrics of infections, complications, and survival rates. The case describes her development of a new mobile phone app, which collects patients’... View Details
      Keywords: Health Care and Treatment; Outcome or Result; Cost Management; Activity Based Costing and Management; Mobile and Wireless Technology; Health Testing and Trials; Surveys; Health Industry; Boston
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      Kaplan, Robert S., Navraj S. Nagra, and Syed S. Shehab. "Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care." Harvard Business School Case 122-010, July 2021. (Revised July 2022.)
      • July 2021
      • Article

      Making Medications Stick: Improving Medication Adherence by Highlighting the Personal Health Costs of Non-compliance

      By: Jon M. Jachimowicz, Joe J. Gladstone, Dan Berry, Charlotte L. Kirkdale, Tracey Thornley and Adam D. Galinsky
      Poor compliance of prescription medication is an ongoing public health crisis. Nearly half of patients do not take their medication as prescribed, harming their own health while also increasing public health care costs. Despite these detrimental consequences, prior... View Details
      Keywords: Prescription Drugs; Medication Adherence; Personal Health Costs; Health; Behavior; Motivation and Incentives; Communication Strategy
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      Jachimowicz, Jon M., Joe J. Gladstone, Dan Berry, Charlotte L. Kirkdale, Tracey Thornley, and Adam D. Galinsky. "Making Medications Stick: Improving Medication Adherence by Highlighting the Personal Health Costs of Non-compliance." Behavioural Public Policy 5, no. 3 (July 2021): 396–416.
      • July 2021
      • Article

      Medical Debt in the U.S., 2009–2020

      By: Raymond Kluender, Neale Mahoney, Francis Wong and Wesley Yin
      Importance: Medical debt is an increasing concern in the US, yet there is limited understanding of the amount and distribution of medical debt, and its association with health care policies.

      Objective: To measure the amount of medical debt nationally and by... View Details
      Keywords: Debt; Borrowing and Debt; Health Care and Treatment; United States
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      Kluender, Raymond, Neale Mahoney, Francis Wong, and Wesley Yin. "Medical Debt in the U.S., 2009–2020." JAMA, the Journal of the American Medical Association 326, no. 3 (July 2021): 250–256.
      • 2024
      • Working Paper

      Fecal Microbiota Transplants —Too Simple to be Safe? Case Histories of Transformational Advances

      By: Amar Bhide and Srikant M. Datar
      By 2013, after many decades of very slow development and adoption, Fecal Microbiota Transplantation procedures were attracting widespread attention. This case history chronicles the: 1) pioneering fecal transplants performed in the 20th century; 2) development of the... View Details
      Keywords: Health Care and Treatment; Innovation and Invention; Governing Rules, Regulations, and Reforms
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      Bhide, Amar, and Srikant M. Datar. "Fecal Microbiota Transplants —Too Simple to be Safe? Case Histories of Transformational Advances." Harvard Business School Working Paper, No. 21-132, June 2021. (Revised May 2024.)
      • June 15, 2021
      • Article

      Cutting the Gordian Knot of Employee Health Care Benefits and Costs: A Corporate Model Built on Employee Choice

      By: Regina E. Herzlinger and Barak D. Richman
      President Joe Biden’s promise to give every American access to affordable health insurance is well-intentioned, but his plan’s policy elements—a public option, a permanent expanded tax credit—require congressional approval and would expend significant political and... View Details
      Keywords: Health Insurance; Health Insurance Marketplaces; Health Care Delivery; Health Care Financing; Health Care Industry; Health Care and Treatment; Insurance; Service Delivery; Cost Management; Health Industry; United States
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      Herzlinger, Regina E., and Barak D. Richman. "Cutting the Gordian Knot of Employee Health Care Benefits and Costs: A Corporate Model Built on Employee Choice." Health Affairs Blog (June 15, 2021).
      • June 11, 2021
      • Article

      Addressing Demographic Disparities in Clinical Trials

      By: Kathy Giusti, Richard G. Hamermesh and Mark Krasnow
      Disparities in health care are not just limited to the delivery of care. They also exist in the way that clinical trials are structured. Women, people of color, and the elderly often are not adequately represented. This article offers three strategies for addressing... View Details
      Keywords: Health Testing and Trials; Demographics
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      Giusti, Kathy, Richard G. Hamermesh, and Mark Krasnow. "Addressing Demographic Disparities in Clinical Trials." Harvard Business Review Digital Articles (June 11, 2021).
      • June 10, 2021
      • Article

      Preparing Hospitals for the Next Pandemic

      By: Regina E. Herzlinger and Barak D. Richman
      The COVID-19 epidemic response has shown that the U.S. is blessed with heroic physicians and other health care providers, researchers, and facilities. But it has also revealed a health care system that was woefully unprepared for the surge of pandemic patients. In the... View Details
      Keywords: Hospital; Hospital Management; Hospitals—administration; Health Care; Health Care Industry; Health Care Investment; Health Care Operations; Health Pandemics; Health Care and Treatment; Operations; Performance Improvement; Investment; Health Industry; United States
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      Herzlinger, Regina E., and Barak D. Richman. "Preparing Hospitals for the Next Pandemic." Harvard Business Review Digital Articles (June 10, 2021).
      • Article

      The Covid-19 Pandemic Should Not Delay Actions to Prevent Anticompetitive Consolidation in U.S. Health Care Markets

      By: Leemore S. Dafny
      This article describes potential regulatory and legislative reforms to assist antitrust enforcement agencies in halting anticompetitive acquisitions and practices, and preserving and promoting competition in health care markets. View Details
      Keywords: Health Care and Treatment; Markets; Competition; Governing Rules, Regulations, and Reforms
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      Dafny, Leemore S. "The Covid-19 Pandemic Should Not Delay Actions to Prevent Anticompetitive Consolidation in U.S. Health Care Markets." Promarket (June 10, 2021).
      • Article

      The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit

      By: Junaid Nabi and Robert S. Kaplan
      The Centers of Medicare and Medicaid Services (CMS) recently announced that it will be removing more... View Details
      Keywords: Ambulatory Care; Payment Policy; Health Care and Treatment; Governing Rules, Regulations, and Reforms
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      Nabi, Junaid, and Robert S. Kaplan. "The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit." Health Affairs Blog (June 2, 2021).
      • June 2021
      • Article

      Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative

      By: Casey J. Allen, Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala and Matthew H.G. Katz
      We used national administrative data to assess multiple domains of value associated with enhanced recovery pathways for patients undergoing pancreatic surgery. Value metrics included in-hospital mortality, complication rates, length of stay (LOS), 30-day readmission... View Details
      Keywords: Value-based Health Care; Health Care and Treatment; Analytics and Data Science; Outcome or Result; Measurement and Metrics; Performance Improvement
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      Allen, Casey J., Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala, and Matthew H.G. Katz. "Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative." Journal of Surgical Research 262 (June 2021): 115–120.
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