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    • All HBS Web  (1,742)
      • Faculty Publications  (290)

      National Health InsuranceRemove National Health Insurance →

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      • August 2012 (Revised December 2023)
      • Background Note

      Note on Health Insurance Coverage, Coding, and Payment

      By: Regina E. Herzlinger and Jo Ellen Slurzberg
      This note explains how health care technology and service innovators receive payment from government insurers, in the U.S. and abroad, and from private insurers. It describes each of the three steps needed to obtain reimbursement: coverage, coding, and payment. It also... View Details
      Keywords: Health Care Delivery; Health Care Costs; Health Insurance; Health Insurance Marketplaces; Health Care and Treatment; Cost; Insurance; Innovation and Invention; Private Sector; Public Sector; Decision Making; Information Technology; Health Industry; Health Industry
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      Herzlinger, Regina E., and Jo Ellen Slurzberg. "Note on Health Insurance Coverage, Coding, and Payment." Harvard Business School Background Note 313-042, August 2012. (Revised December 2023.)
      • August 2012 (Revised January 2013)
      • Case

      Public Health Insurance Exchanges: The Massachusetts Experience

      By: Regina Herzlinger and Jordan Bazinsky
      The CEO of Tufts Health Plan, James Roosevelt, is wondering whether to offer insurance products on the Massachusetts Connector, the first U.S. exchange. He wonders if he should enter these uncharted waters at all. And, if yes, with a broad network or a narrow network... View Details
      Keywords: Health Insurance Exchange; Healthcare Reform; Public Health Insurance Exchange; Decision Making; Market Entry and Exit; Emerging Markets; Health Care and Treatment; Insurance Industry; Insurance Industry; Massachusetts
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      Herzlinger, Regina, and Jordan Bazinsky. "Public Health Insurance Exchanges: The Massachusetts Experience." Harvard Business School Case 313-043, August 2012. (Revised January 2013.)
      • July 2012
      • Case

      Transatlantic Holdings, Inc. - The Belle of the Ball

      By: Clayton S. Rose and Aldo Sesia
      In November of 2011 Transatlantic Holdings, Inc., a global property and casualty reinsurance company, announced it had agreed to sell itself to Alleghany Corporation, ending "the most frenzied takeover battle" of 2011, which involved competitors, Warren Buffett's... View Details
      Keywords: Mergers & Acquisitions; Finance; Insurance And Reinsurance; Governance; Insurance; Mergers and Acquisitions; Strategy; Valuation; Insurance Industry; Insurance Industry; United States; Bermuda; Switzerland
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      Rose, Clayton S., and Aldo Sesia. "Transatlantic Holdings, Inc. - The Belle of the Ball." Harvard Business School Case 313-017, July 2012.
      • Blog Post

      Why Economic Conservatives Should Support the Individual Mandate in Health Care

      By: Regina E. Herzlinger

      Although many conservatives are gnashing their teeth about the Supreme Court's upholding the individual mandate, had it not been upheld, their worst nightmares would have occurred: government would have required hundreds of billions in additional taxes to pay for... View Details

      Keywords: Health Care; Health Care Industry; Health Insurance; Health; Health Care and Treatment; Health Industry
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      Herzlinger, Regina E. "Why Economic Conservatives Should Support the Individual Mandate in Health Care." Huffington Post, The Blog (June 29, 2012). http://www.huffingtonpost.com/regina-e-herzlinger/health-insurance-market-mandate_b_1637762.html.
      • April 2012
      • Article

      Paying a Premium on Your Premium? Consolidation in the U.S. Health Insurance Industry

      By: Leemore S. Dafny, Mark Duggan and Subramaniam Ramanarayanan
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      Dafny, Leemore S., Mark Duggan, and Subramaniam Ramanarayanan. "Paying a Premium on Your Premium? Consolidation in the U.S. Health Insurance Industry." American Economic Review 102, no. 2 (April 2012): 1161–1185.
      • April 2012
      • Article

      Change Agents, Networks, and Institutions: A Contingency Theory of Organizational Change

      By: Julie Battilana and Tiziana Casciaro
      We develop a contingency theory for how structural closure in a network, defined as the extent to which an actor's network contacts are connected to one another, affects the initiation and adoption of change in organizations. Using longitudinal survey data supplemented... View Details
      Keywords: Networks; Theory; Organizations; Change
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      Battilana, Julie, and Tiziana Casciaro. "Change Agents, Networks, and Institutions: A Contingency Theory of Organizational Change." Academy of Management Journal 55, no. 2 (April 2012).
      • October 2012
      • Article

      The Impact of Tort Reform on Employer-Sponsored Health Insurance Premiums

      By: Ronen Avraham, Leemore S. Dafny and Max Schanzenbach
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      Avraham, Ronen, Leemore S. Dafny, and Max Schanzenbach. "The Impact of Tort Reform on Employer-Sponsored Health Insurance Premiums." Journal of Law, Economics & Organization 28, no. 4 (October 2012): 657–686.
      • March 2012
      • Article

      Fixing What's Wrong with U. S. Politics

      By: David A. Moss
      In America today there's a growing sense that the political system is broken and that its ineffectiveness is a major threat to U.S. competitiveness. Why do so many think the political system is not working? Research shows that in Congress, Republicans and Democrats are... View Details
      Keywords: Government and Politics; System; Conflict Management; Performance Productivity; Policy; Public Administration Industry; United States
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      Moss, David A. "Fixing What's Wrong with U. S. Politics." Harvard Business Review 90, no. 3 (March 2012).
      • February 2012 (Revised June 2013)
      • Case

      Moving to Universal Coverage: Health Care Reform in Massachusetts

      By: Michael E. Porter and Jennifer F Baron
      State health care reform in Massachusetts has involved a phased process, focusing first on coverage expansion and then turning to delivery system innovation and cost containment. In 2006, the state adopted an individual mandate to obtain health care coverage which,... View Details
      Keywords: Health Care and Treatment; Business and Government Relations; Insurance; Massachusetts
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      Porter, Michael E., and Jennifer F Baron. "Moving to Universal Coverage: Health Care Reform in Massachusetts." Harvard Business School Case 712-466, February 2012. (Revised June 2013.)
      • 2012
      • Other Book

      Redefining German Health Care: Moving to a Value-Based System

      By: Michael E. Porter and Clemens Guth
      The German health care system is on a collision course with budget realities. Costs are high and rising, and quality problems are becoming ever more apparent. Decades of reforms have produced little change to these troubling trends. Why has Germany failed to solve... View Details
      Keywords: Health
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      Porter, Michael E., and Clemens Guth. Redefining German Health Care: Moving to a Value-Based System. Heidelberg: Springer, 2012.
      • December 2011 (Revised December 2011)
      • Case

      Cancer Treatment Centers of America: Scaling the Mother Standard of Care

      By: Rosabeth Moss Kanter and Matthew Bird
      The CEO of a private and growing national network of specialty care hospitals focusing on advanced-stage and complex cancer treatments reflected on the firm's past phase of growth before meeting with the company's Chairman and founder to discuss how to further scale... View Details
      Keywords: Health Care and Treatment; Business Growth and Maturation; Medical Specialties; Service Delivery; Innovation and Invention; Health Industry
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      Kanter, Rosabeth Moss, and Matthew Bird. "Cancer Treatment Centers of America: Scaling the Mother Standard of Care." Harvard Business School Case 312-073, December 2011. (Revised December 2011.)
      • December 2011
      • Article

      Data Impediments to Empirical Work on Health Insurance Markets

      By: Leemore S. Dafny, David Dranove, Frank Limbrock and Fiona Scott Morton
      We compare four datasets that researchers might use to study competition in the health insurance industry. We show that the two datasets most commonly used to estimate market concentration differ considerably from each other (both in levels and in changes over time),... View Details
      Keywords: Competition; Analytics and Data Science; Market Participation; Insurance Industry
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      Dafny, Leemore S., David Dranove, Frank Limbrock, and Fiona Scott Morton. "Data Impediments to Empirical Work on Health Insurance Markets." B.E. Journal of Economic Analysis & Policy 11, no. 2 (December 2011).
      • September 2011
      • Supplement

      Narayana Hrudayalaya Heart Hospital

      By: Tarun Khanna and Tanya Bijlani
      Narayana Hrudayalaya (NH) is one of the world's busiest heart hospitals, where surgeons perform 30-35 complex cardiac surgeries daily. With an average cost of $1,800 per surgery, the hospital treats patients at affordable prices, and does not turn away even the poorest... View Details
      Keywords: Buildings and Facilities; Experience and Expertise; Cost Management; Insurance; Health Care and Treatment; Resource Allocation; Time Management; Emerging Markets; Infrastructure; Cooperative Ownership; Quality; Social Enterprise; Health Industry; Karnataka
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      Khanna, Tarun, and Tanya Bijlani. "Narayana Hrudayalaya Heart Hospital." Harvard Business School Multimedia/Video Supplement 712-802, September 2011.
      • September 2011 (Revised January 2012)
      • Case

      Telemonitoring at Visiting Nurse Health System

      By: F. Warren McFarlan, Mark Keil and Mala Kaul
      The Telemonitoring at Visiting Nurse Health System case presents one home healthcare organization's efforts to use telemonitoring to improve the quality of care provided to at-risk patients who were discharged from hospitals and needed home care. After two years of... View Details
      Keywords: Capital Budgeting; Cost vs Benefits; Risk Management; Technology Adoption; Technological Innovation; Organizational Change and Adaptation; Competitive Strategy; Health Industry; Health Industry
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      McFarlan, F. Warren, Mark Keil, and Mala Kaul. "Telemonitoring at Visiting Nurse Health System." Harvard Business School Case 112-030, September 2011. (Revised January 2012.)
      • August 2011 (Revised July 2014)
      • Case

      Amil and the Health Care System in Brazil

      By: Regina E. Herzlinger and Ricardo Reisen de Pinho
      Dr. Edson Bueno created Amil, Brazil's largest health insurer. Unlike many others, it is vertically integrated. Dr. Bueno has two opportunities for growth. Which, if any, should he pursue? View Details
      Keywords: Health Care and Treatment; Innovation and Invention; Opportunities; Insurance; Vertical Integration; Insurance Industry; Brazil
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      Herzlinger, Regina E., and Ricardo Reisen de Pinho. "Amil and the Health Care System in Brazil." Harvard Business School Case 312-029, August 2011. (Revised July 2014.)
      • July 2011
      • Article

      Kidney Paired Donation

      By: C. Bradley Wallis, Kannan P. Samy, Alvin E. Roth and Michael A. Rees
      Kidney paired donation (KPD) was first suggested in 1986, but it was not until 2000 when the first paired donation transplant was performed in the U.S. In the past decade, KPD has become the fastest growing source of transplantable kidneys, overcoming the barrier faced... View Details
      Keywords: Philanthropy and Charitable Giving; Health Care and Treatment; Growth and Development Strategy; Success; Problems and Challenges; Programs; System; United States
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      Wallis, C. Bradley, Kannan P. Samy, Alvin E. Roth, and Michael A. Rees. "Kidney Paired Donation." Nephrology, Dialysis, Transplantation 26, no. 7 (July 2011): 2091–2099.
      • July – August 2011
      • Article

      The Enabling Role of Social Position in Diverging from the Institutional Status Quo: Evidence from the U.K. National Health Service

      By: Julie Battilana
      This study examines the relationship between social position, both within the field and within the organization, and the likelihood of individual actors initiating organizational changes that diverge from the institutional status quo. I explore this relationship using... View Details
      Keywords: Status and Position; Transformation; Organizational Change and Adaptation; Projects; Leading Change; Managerial Roles; Relationships; Power and Influence; Health Industry; United Kingdom
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      Battilana, Julie. "The Enabling Role of Social Position in Diverging from the Institutional Status Quo: Evidence from the U.K. National Health Service." Organization Science 22, no. 4 (July–August 2011): 817–834.
      • 11 May 2011
      • Other Presentation

      Clinical Registries: The Opportunity for the Nation

      By: Michael E. Porter
      Clinical Registries: The Opportunity for the Nation View Details
      Keywords: Health; United States
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      Porter, Michael E. "Clinical Registries: The Opportunity for the Nation." National Leadership Meeting, Centers for Medicare & Medicaid Services, May 11, 2011.
      • March 2011 (Revised March 2011)
      • Case

      Horizon Blue Cross Blue Shield of New Jersey - Managing in the Shadow of Health Care Reform

      By: Felix Oberholzer-Gee, Raffaella Sadun and Richard G. Hamermesh
      Per the Patient Protection and Affordable Care Act (PPACA), which President Obama signed in 2010, states would be required to create state-wide health insurance marketplaces - the Health Benefit Exchanges (HBEs) - in which individuals and small employers could choose... View Details
      Keywords: Insurance; Health Care and Treatment; Governing Rules, Regulations, and Reforms; Emerging Markets; Risk and Uncertainty; Health Industry; Health Industry; New Jersey
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      Oberholzer-Gee, Felix, Raffaella Sadun, and Richard G. Hamermesh. "Horizon Blue Cross Blue Shield of New Jersey - Managing in the Shadow of Health Care Reform." Harvard Business School Case 711-403, March 2011. (Revised March 2011.)
      • 2010
      • Chapter

      Consumer-Driven Universal Health Care is the Best Solution

      By: Regina E. Herzlinger
      The best way to achieve universal health insurance coverage is to implement a consumer-controlled system rather than a government-controlled system. View Details
      Keywords: Health Care and Treatment; Insurance; Customers; System
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      Herzlinger, Regina E. "Consumer-Driven Universal Health Care is the Best Solution." In Current Controversies: Health Care, edited by Noel Merino. Farmington Hills, MI: Greenhaven Press, 2010.
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