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      • Faculty Publications  (478)

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      • 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
      Keywords: Health Care and Treatment; Insurance; Cost; United States
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      Dafny, Leemore S., Igal Hendel, Victoria Marone, and Christopher Ody. "Narrow Networks on the Health Insurance Marketplaces: Prevalence, Pricing, and the Cost of Network Breadth." Health Affairs 36, no. 9 (September 2017).
      • September 2017
      • Article

      Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers

      By: Robert S. Kaplan, Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam and Christopher J. Hartnick
      Time-driven activity-based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic... View Details
      Keywords: Time-Driven Activity-Based Costing; Activity Based Costing and Management; Health Care and Treatment
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      Kaplan, Robert S., Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam, and Christopher J. Hartnick. "Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers." The Laryngoscope 127, no. 9 (September 2017).
      • August 2017
      • Case

      Infection Control at Massachusetts General Hospital (Abridged)

      By: Robert S. Huckman and Nikolaos Trichakis
      The case explores the challenges facing Massachusetts General Hospital concerning the adoption of a new infection control policy, which promises to improve operational performance, patient safety, and profitability. The new policy requires coordination between... View Details
      Keywords: Safety; Organizational Change and Adaptation; Integration; Health Care and Treatment; Policy; Health Industry; Boston
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      Huckman, Robert S., and Nikolaos Trichakis. "Infection Control at Massachusetts General Hospital (Abridged)." Harvard Business School Case 618-018, August 2017.
      • August 2017 (Revised November 2021)
      • Case

      Ryan Greene at Rainier Wearables

      By: Shikhar Ghosh, Thomas R. Eisenmann and Christopher Payton
      This case provides a platform for discussing mental health and depression in entrepreneurship. Why do entrepreneurs have more mental health issues than other professions? What can an entrepreneur do if they face a situation where their mental well-being is being... View Details
      Keywords: Mental Health; Depression; Entrepreneurship; Well-being; Personal Development and Career
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      Ghosh, Shikhar, Thomas R. Eisenmann, and Christopher Payton. "Ryan Greene at Rainier Wearables." Harvard Business School Case 818-047, August 2017. (Revised November 2021.)
      • August 2017
      • Article

      Should Governments Invest More in Nudging?

      By: Shlomo Benartzi, John Beshears, Katherine L. Milkman, Cass R. Sunstein, Richard H. Thaler, Maya Shankar, Will Tucker-Ray, William J. Congdon and Steven Galing
      Governments are increasingly adopting behavioral science techniques for changing individual behavior in pursuit of policy objectives. The types of “nudge” interventions that governments are now adopting alter people’s decisions without coercion or significant changes... View Details
      Keywords: Nudge; Nudge Unit; Choice Architecture; Behavioral Science; Behavioral Economics; Savings; Pension Plan; Education; College Enrollment; Energy; Electricity Usage; Preventive Health; Influenza Vaccination; Flu Shot; Open Materials; Behavior; Governance; Economics; Policy; Power and Influence
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      Benartzi, Shlomo, John Beshears, Katherine L. Milkman, Cass R. Sunstein, Richard H. Thaler, Maya Shankar, Will Tucker-Ray, William J. Congdon, and Steven Galing. "Should Governments Invest More in Nudging?" Psychological Science 28, no. 8 (August 2017): 1041–1055.
      • June 2017 (Revised October 2017)
      • Case

      Becton Dickinson: Innovation and Growth (A)

      By: Raffaella Sadun, Michael Beer and James Weber
      In late 2015, CEO Vince Forlenza was reviewing Becton Dickinson’s transformation efforts designed to enable the company to innovate and grow in a changing environment. Becton Dickinson had been a successful medical device company for over 100 years. In recent years,... View Details
      Keywords: Transformation; Change Management; Innovation Leadership; Mergers and Acquisitions; Organizational Change and Adaptation; Organizational Culture; Organizational Design; Strategy; Growth and Development Strategy; Health Industry; Health Industry; Health Industry; United States
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      Sadun, Raffaella, Michael Beer, and James Weber. "Becton Dickinson: Innovation and Growth (A)." Harvard Business School Case 717-419, June 2017. (Revised October 2017.)
      • May 2017
      • Supplement

      Boston Children's Hospital Process Map Video

      By: Robert S. Kaplan and Mary Witkowski
      The 13 minute video simulates a discussion among orthopedic surgeons and cast room technicians about the processes and resources used when applying long leg casts for patients. The video should be used when teaching Boston Children’s Hospital (Abridged) case, #914-407,... View Details
      Keywords: Activity Based Costing; Healthcare Costing; Process Maps; Activity Based Costing and Management; Health Care and Treatment
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      Kaplan, Robert S., and Mary Witkowski. "Boston Children's Hospital Process Map Video." Harvard Business School Multimedia/Video Supplement 117-703, May 2017.
      • April 2017
      • Supplement

      Imprimis (B)

      By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel
      This case is a supplement to Imprimis (A). It describes the company’s decision to enter into the pharmaceutical compounding business in 2013–2014. Imprimis purchased a compounded ophthalmological medication called Dropless Therapy, which was injected into patients’... View Details
      Keywords: Healthcare; Drug Compounding; Drug Development; Pharmaceuticals; Small Business; Decision-making, Business Model; Mark Baum; Imprimis; Decision Making; Strategy; Health Care and Treatment; Policy; Pharmaceutical Industry; United States
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      Casadesus-Masanell, Ramon, Karen Elterman, and Marc Appel. "Imprimis (B)." Harvard Business School Supplement 717-496, April 2017.
      • 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
      Keywords: Health Care and Treatment; Cost; Moral Sensibility; Competitive Strategy; Decision Choices and Conditions; Pharmaceutical Industry; United States
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      Casadesus-Masanell, Ramon, Karen Elterman, and Marc Appel. "Imprimis (C)." Harvard Business School Supplement 717-497, April 2017.
      • 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
      Keywords: Cost Management; Performance Productivity; Health Care and Treatment; Health Industry
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      Haas, Derek A., and Robert S. Kaplan. "Variation in the Cost of Care for Primary Total Knee Arthroplasties." Arthroplasty Today 3, no. 1 (March 2017): 33–37.
      • Article

      Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center

      By: Robert S. Kaplan, Yoshimi Anzai, Marta E. Heilbrun, Derek Haas, Luca Boi, Kirk Moshre, Satoshi Minoshima and Vivian S. Lee
      The lack of understanding the true costs (not charges) of delivering health care services poses tremendous challenges in the containment of health care costs. In this study, we applied an established cost accounting method, time-driven activity-based costing (TDABC),... View Details
      Keywords: Healthcare Costs; Medical Imaging; Computed Tomography; Activity-Based Costing; Cost Accounting; Activity Based Costing and Management; Health Care and Treatment; Performance Efficiency; Health Industry
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      Kaplan, Robert S., Yoshimi Anzai, Marta E. Heilbrun, Derek Haas, Luca Boi, Kirk Moshre, Satoshi Minoshima, and Vivian S. Lee. "Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center." Academic Radiology 24, no. 2 (February 2017): 200–208.
      • 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
      Keywords: Costing; Cost Variation; Total Knee Arthroplasty; Total Hip Arthroplasty; Prosthetic Implant Cost; Health Care and Treatment; Cost Management; Health Industry; Health Industry
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      Haas, Derek A., Kevin J Bozic, Anthony M. DiGioia, Zirui Song, and Robert S. Kaplan. "Drivers of the Variation in Prosthetic Implant Purchase Prices for Total Knee and Total Hip Arthroplasties." Journal of Arthroplasty 32, no. 2 (February 2017): 347–350.
      • January 2017
      • Supplement

      Intrapreneurship at DaVita HealthCare Partners: Cash Flow Tool

      By: Joseph B. Fuller and Christopher Payton
      DaVita Healthcare Partners Inc. (DaVita) is one of the U.S.'s leading dialysis providers, a process whereby persons with end-stage renal disease (ESRD) are connected to a machine that performs the functions of a healthy kidney. Kent Thiry, DaVita's CEO, has expanded... View Details
      Keywords: Intrapreneurship; Entrepreneurial Organizations; Startup Management; Startup; Strategic Positioning; Corporate Entrepreneurship; Corporate Strategy; Business Startups; Strategic Planning; Competitive Strategy; Health Industry; United States
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      Fuller, Joseph B., and Christopher Payton. "Intrapreneurship at DaVita HealthCare Partners: Cash Flow Tool." Harvard Business School Spreadsheet Supplement 317-703, January 2017.
      • 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
      Keywords: Health Care and Treatment; Cost; Cost Management; Cost Accounting; Health Industry
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      Kaplan, Robert S., Michael E. Porter, and Mark L. Frigo. "Managing Healthcare Costs and Value." Strategic Finance 98, no. 7 (January 2017): 24–33.
      • 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
      Keywords: Surgery; Time-Driven Activity-Based Costing; Bundled Payments; Health Care and Treatment; Cost Management
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      Najjar, Peter, Matt Strickland, and Robert S. Kaplan. "Time-Driven Activity-Based Costing for Surgical Episodes." JAMA Surgery 152, no. 1 (January 2017): 96–97.
      • Article

      One Obstacle to Curing Cancer: Patient Data Isn't Shared

      By: Richard G. Hamermesh and Kathy Giusti
      Precision Medicine requires large datasets to identify the mutations that lead to various cancers. Currently, genomic information is hoarded in fragmented silos within numerous academic medical centers, pharmaceutical companies, and some disease-based foundations. For... View Details
      Keywords: Healthcare; Technological And Scientific Innovation; Cancer Care In The U.S.; Cancer Treatment; Precision Medicine; Personalized Medicine; Data Sharing; Technological Innovation; Analytics and Data Science; Health Disorders; Medical Specialties; Research and Development; Customization and Personalization; Health Industry; United States
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      Hamermesh, Richard G., and Kathy Giusti. "One Obstacle to Curing Cancer: Patient Data Isn't Shared." Harvard Business Review (website) (November 28, 2016).
      • 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
      Keywords: Value Creation; Cost Management; Health Care and Treatment; Customer Focus and Relationships; Health Industry
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      Kaplan, Robert S., Derek A. Haas, and Jonathan Warsh. "Adding Value by Talking More." New England Journal of Medicine 375, no. 20 (November 17, 2016): 1918–1920.
      • November 2016
      • Case

      QuintilesIMS: Biosimilar Marketing in England

      By: John A. Quelch and Emily C. Boudreau
      QuintilesIMS was a leading healthcare consulting firm best known for its data and information offerings as well as its market research and management consulting services for life science companies. By 2015, the company was expanding beyond the biopharmaceutical... View Details
      Keywords: Health; Pharmaceutical Industry; Biotech; Marketing; Health Care and Treatment; Biotechnology Industry; England
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      Quelch, John A., and Emily C. Boudreau. "QuintilesIMS: Biosimilar Marketing in England." Harvard Business School Case 517-054, November 2016.
      • October 2016 (Revised March 2019)
      • Case

      Carrum Health: Scaling Bundled Payments

      By: Robert S. Huckman and Sarah Mehta
      Founded in 2014, Carrum Health helped self-insured employers located in three markets (San Diego, California; Seattle, Washington; and San Francisco, California) save money on their employees’ planned surgeries. It did so by contracting directly with top-quality... View Details
      Keywords: Health Financing; Health Insurance; Value-based Healthcare Reimbursements; Bundled Payments; Innovation; Scale; Health; Health Care and Treatment; Cost Management; Growth and Development Strategy; Decision Choices and Conditions; Health Industry; California; San Francisco; San Diego; Seattle
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      Huckman, Robert S., and Sarah Mehta. "Carrum Health: Scaling Bundled Payments." Harvard Business School Case 617-017, October 2016. (Revised March 2019.)
      • 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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      Dafny, Leemore S., Christopher Ody, and Matt Schmitt. "Undermining Value-Based Purchasing — Lessons from the Pharmaceutical Industry." New England Journal of Medicine 375, no. 21 (November 24, 2016): 2013–2015.
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