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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

September 2020
Article

Medicaid Work Requirements in Arkansas: Two-Year Impacts on Coverage, Employment, and Affordability of Care

By: Benjamin D. Sommers, Lucy Chen, Robert J. Blendon, E. John Orav and Arnold M. Epstein

In June 2018 Arkansas became the first U.S. state to implement work requirements in Medicaid, requiring adults ages 30–49 to work twenty hours a week, participate in “community engagement” activities, or qualify for an exemption to maintain coverage. By April 2019,... View Details

Keywords: Medicaid; Health Care Policy; Health; Health Care and Treatment; Policy; Insurance; Health Industry; Arkansas

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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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February 2012 (Revised August 2014)
Supplement

Poles Apart on PZU (C)

By: Francesca Gino, Vincent Dessain, Karol Misztal and Michael Khayyat

After a decade-long dispute with the Polish State Treasury, in October 2009 the Dutch insurer Eureko agreed to exit PZU in exchange for compensation. Who was the biggest beneficiary of the settlement: Eureko, the Treasury, or PZU itself? View Details

Keywords: Negotiation Process; Insurance; Negotiation Deal; Insurance Industry; Poland

Article

Undermining Value-Based Purchasing — Lessons from the Pharmaceutical Industry

By: Leemore S. Dafny, Christopher Ody and Matt Schmitt

The analogy between value-based purchasing in pharmaceuticals and the new frontier of alternative payment models for health care providers is relatively straightforward. Insurers are increasingly demanding steep discounts from providers in exchange for inclusion in... View Details

Keywords: Drug Copayment Coupons; Prescription Drug Policy; Health Care and Treatment; Insurance; Cost; Policy; Pharmaceutical Industry

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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

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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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

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

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

January 2017
Case

The Six CEOs of Tyco International Ltd.

By: John R. Wells and Gabriel Ellsworth

In September 2016, Johnson Controls, Inc. completed the acquisition of Tyco International PLC, a $9.9 billion business with operating profits of $884 million. The purchase consideration was $14.4 billion. Although the deal was billed as a merger, Ireland-based Tyco... View Details

Keywords: Tyco; Dennis Kozlowski; Edward Breen; Fire Safety; Fire Protection; Security; Packaging; Securities And Exchange Commission; Fraud; Accounting; Accounting Audits; Earnings Management; Financial Statements; Goodwill Accounting; Acquisition; Mergers and Acquisitions; Business Conglomerates; Business Divisions; Business Exit or Shutdown; Business Growth and Maturation; Business Headquarters; Business Model; Business Organization; For-Profit Firms; Restructuring; Crime and Corruption; Engineering; Applied Optics; Chemicals; Construction; Metals and Minerals; Ethics; Finance; Cash Flow; Public Equity; Stock Options; Financing and Loans; Initial Public Offering; Profit; Revenue; Geographic Location; Geographic Scope; Global Range; Globalized Firms and Management; Multinational Firms and Management; Corporate Accountability; Corporate Disclosure; Health Care and Treatment; Business History; Executive Compensation; Selection and Staffing; Courts and Trials; Lawfulness; Lawsuits and Litigation; Business or Company Management; Goals and Objectives; Growth and Development Strategy; Market Entry and Exit; Public Ownership; Problems and Challenges; Strategy; Business Strategy; Competition; Competitive Strategy; Competitive Advantage; Consolidation; Corporate Strategy; Diversification; Expansion; Horizontal Integration; Value; Chemical Industry; Construction Industry; Consumer Products Industry; Electronics Industry; Energy Industry; Industrial Products Industry; Manufacturing Industry; Medical Devices and Supplies Industry; Mining Industry; Pharmaceutical Industry; Semiconductor Industry; Telecommunications Industry; Utilities Industry; Republic of Ireland; Switzerland; Bermuda; United States; New Hampshire

January 1994 (Revised July 1994)
Case

Dell Computer Corporation

By: Peter Tufano

Tina Chen, chief investment officer of a large insurance company, hears accusations by a Kidder Peabody equity research analyst that Dell Computer Corp. might be improperly accounting for what he suspects are large foreign exchange losses resulting from speculation.... View Details

Keywords: International Accounting; Financial Instruments; Ethics; Financial Statements; Computer Industry; United States

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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

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

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

September 2013 (Revised August 2014)
Case

AxSys

By: Regina Herzlinger

AxSys, a Scottish health information exchange firm which can provide connectivity among the Electronic Medical Record systems of different vendors, must decide how best to enter the U.S. market. View Details

2009
Other Unpublished Work

The Pecora Hearings

By: David Moss, Cole Bolton and Eugene Kintgen

In 1932, in the depths of the Great Depression, the Senate Banking Committee began a much-publicized investigation of the nation's financial sector. The hearings, which came to be known as the Pecora hearings after the Banking Committee's lead counsel Ferdinand... View Details

Keywords: Financial History; Financial Crisis; Financial Markets; Governing Rules, Regulations, and Reforms; Government Legislation; Laws and Statutes; Business and Government Relations; Financial Services Industry

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