Publications
Publications
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- All HBS Web
(1,400)
- Faculty Publications (414)
- January 2018 (Revised April 2021)
- Case
Capital Allocation at HCA
By: W. Carl Kester and Emily R. McComb
In early 2017, HCA Holdings, an investor-owned hospital management company, faced a strategically important capital allocation decision. After the exit of its private equity sponsors in 2016, HCA had to determine how best to allocate its substantial annual free cash... View Details
Keywords: Capital Allocation; Cash Distribution Policy; Dividends; Share Repurchases; Growth Strategy And Execution; Growth Investing; Capital Expenditures; Debt Management; Debt Reduction; Debt Policy; Hospital Management; Investor-owned Hospital Chains; Capital Budgeting; Capital Structure; Cash Flow; Corporate Finance; Decision Choices and Conditions; Health Industry; United States
- January 2018 (Revised June 2018)
- Case
Medtronic: Navigating a Shifting Healthcare Landscape
By: Robert S. Kaplan, Michael E. Porter, Thomas W. Feeley and Alee Hernandez
Medtronic is adapting its strategy to changes in healthcare competition and payments. It has decided to develop new relationships with payers, hospitals, and physicians to become more accountable for patient outcomes and total costs. The case describes new forms of... View Details
- January 2018 (Revised January 2019)
- Case
ZappRx
By: Jeffrey J. Bussgang and Olivia Hull
In October 2015, ZappRx founder Zoe Barry is deciding between two business models for her health technology start-up. Her product, a software application that aims to expedite the prescription fulfillment process for patients with rare diseases, has attracted interest... View Details
- Article
TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear
By: Robert S. Kaplan, Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller and John I. Lowenstein
Purpose
To perform a cost analysis comparison for managing common ocular disorders in an eye emergency department (ED) versus an urgent care setting using a time-driven activity-based cost model (TDABC) to assist physicians and staff in appropriate allocation of... View Details
- December 2017
- Article
Overall Cost Comparison of Gastrointestinal Endoscopic Procedures with Endoscopist- or Anesthesia-Supported Sedation by Activity-Based Costing Techniques
By: Richard A. Helmers, James A. Dilling, Christopher R. Chaffee, Mark V. Larson, Bradly J. Narr, Derek A. Haas and Robert S. Kaplan
Endoscopic/Colonoscopic procedures are done either with gastroenterologist-administered conscious sedation or with anesthesia-administered sedation with propofol. Anesthesia-administered sedation has medical and patient benefits but is more expensive to administer. We... View Details
- Article
Narrow Networks on the Health Insurance Marketplaces: Prevalence, Pricing, and the Cost of Network Breadth
By: Leemore S. Dafny, Igal Hendel, Victoria Marone and Christopher Ody
Anecdotal reports and systematic research highlight the prevalence of narrow-network plans on the Affordable Care Act’s health insurance Marketplaces. At the same time, Marketplace premiums in the period 2014–2016 were much lower than projected by the Congressional... View Details
- August 2017
- Case
CareMore Health System
By: Robert S. Huckman and Brian W. Powers
CareMore Health System—a physician-founded care delivery system and health plan—had developed and refined an innovative care model for at-risk seniors enrolled in Medicare managed care (i.e., Medicare Advantage) plans. CareMore's President, Sachin Jain, and his... View Details
- August 2017
- Supplement
CareMore Health System (B)
By: Robert S. Huckman and Brian W. Powers
This supplement to “CareMore Health System (A)” discusses the company's early experience introducing its managed Medicaid model in the Des Moines, Iowa, market. It also provides an update on the Memphis program discussed in the (A) case. View Details
- July 2017 (Revised July 2019)
- Supplement
"Doctor My Eyes"--The Acquisition of Bausch & Lomb by Warburg Pincus (B)
By: Nori Gerardo Lietz and Ricardo Andrade
The B Case of "Dr. My Eyes" provides the answer as to what happened after the ending fact pattern in Case A and the imminent choices faced by the protagonist in the primary case. At the end of the Case A, Bess Weatherman of Warburg Pincus, must chose one option of two... View Details
- May 11, 2017
- Article
Good Riddance to Big Insurance Mergers
By: Leemore S. Dafny
Federal judges issued preliminary injunctions halting mergers of four of the five largest U.S. health insurers. These decisions provide more precedent to support challenges of mergers between competitors in health care markets—whether payers or providers. View Details
- April 2017
- Supplement
Imprimis (C)
By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel
This case is a supplement to Imprimis (A & B). Set in 2015, it first describes Imprimis’s decision to introduce its own line of compounded eye drop medication called LessDrops. The case then examines the moral dilemma faced by CEO Mark Baum, who was struck by the... View Details
- March 2017
- Article
Variation in the Cost of Care for Primary Total Knee Arthroplasties
By: Derek A. Haas and Robert S. Kaplan
The study examined the cost variation across 29 high-volume U.S. hospitals for delivering a primary total knee arthroplasty without major complicating conditions. Hospital and physician personnel costs were calculated using time-driven activity-based costing.... View Details
- Article
Drivers of the Variation in Prosthetic Implant Purchase Prices for Total Knee and Total Hip Arthroplasties
By: Derek A. Haas, Kevin J Bozic, Anthony M. DiGioia, Zirui Song and Robert S. Kaplan
Previous studies have documented wide variation in health-care spending and prices; however, the causes for the variation in supply purchase prices across providers are not well understood. The purpose of this study was to determine the drivers of variation in... View Details
- January 2017
- Supplement
Terrapin Laboratory: Exercise
By: Joseph B. Fuller and Christopher Payton
In this exercise, we examine the capital requirements of Terrapin Laboratory as they contemplate entering into a new market segment. The company is faced with two potential financing options which have different effects on the ownership structure of the company.... View Details
- 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)
- January 2017 (Revised March 2017)
- Case
SIN Capital and the Fullerton Health IPO
By: Josh Lerner and Ann Leamon
In early 2016, David Sin, founder of the Singapore-based private equity group SIN Capital and chairman of its primary holding, Fullerton Health, was deeply involved in preparations for taking Fullerton public on the Singapore stock exchange. Three years after SIN... View Details
- Article
Managing Healthcare Costs and Value
By: Robert S. Kaplan, Michael E. Porter and Mark L. Frigo
Rising health care costs are a major global challenge. A number of factors contribute to this trend, including aging populations and medical technology. But an underlying and misunderstood source of health care’s escalating costs has been the inability of health care... View Details
- Article
Time-Driven Activity-Based Costing for Surgical Episodes
By: Peter Najjar, Matt Strickland and Robert S. Kaplan
Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services... View Details
- December 2016
- Article
Selective Regulator Decoupling and Organizations' Strategic Responses
By: Jonas Heese, Ranjani Krishnan and Frank Moers
Organizations often respond to institutional pressures by symbolically adopting policies and procedures but decoupling them from actual practice. Literature has examined why organizations decouple from regulatory pressures. In this study, we argue that decoupling... View Details
- Article
Adding Value by Talking More
By: Robert S. Kaplan, Derek A. Haas and Jonathan Warsh
The prevailing fee-for-service payment model has led health care administrators and physician practices to impose severe constraints on the time physicians spend talking, for which they are reimbursed poorly or not at all. New value-based reimbursement models, however,... View Details