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Publications

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    • All HBS Web  (246)
      • Faculty Publications  (52)

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      • Article

      Assessing the Value of Pediatric Aerodigestive Care

      By: Robert S. Kaplan, Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher and Evan Propst
      Leaders at six hospitals conducted a research study to assess and compare the health outcomes and costs of pediatric aerodigestive care. Four of the hospitals delivered care with an integrated practice unit (IPU) while two delivered care traditionally, with isolated... View Details
      Keywords: Time-Driven Activity-Based Costing; Value-based Health Care; Integrated Practice Unit; Health Care and Treatment; Cost Management; Performance Improvement
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      Kaplan, Robert S., Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher, and Evan Propst. "Assessing the Value of Pediatric Aerodigestive Care." NEJM Catalyst Innovations in Care Delivery 1, no. 4 (July–August 2020).
      • Article

      Navy Medicine Introduces Value-Based Health Care

      By: Alee Hernandez, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III and Michael E. Porter
      In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could... View Details
      Keywords: Military Health System; Health Care and Treatment; Cost Management; Projects
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      Hernandez, Alee, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III, and Michael E. Porter. "Navy Medicine Introduces Value-Based Health Care." Health Affairs 38, no. 8 (August 2019): 1393–1400.
      • Article

      Effect of Different Financial Incentive Structures on Promoting Physical Activity Among Adults: A Randomized Clinical Trial

      By: Chethan Bachireddy, Andrew Joung, Leslie K. John, Francesca Gino, Bradford Tuckfield, Luca Foschini and Katherine L. Milkman
      Importance: Few adults engage in recommended levels of physical activity. Financial incentives can promote physical activity, but little is known about how their structure influences their effectiveness; for example, whether incentives are more effective if they are... View Details
      Keywords: Physical Activity; Financial Incentives; Motivation and Incentives; Money
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      Bachireddy, Chethan, Andrew Joung, Leslie K. John, Francesca Gino, Bradford Tuckfield, Luca Foschini, and Katherine L. Milkman. "Effect of Different Financial Incentive Structures on Promoting Physical Activity Among Adults: A Randomized Clinical Trial." JAMA Network Open 2, no. 8 (August 2019): 1–13.
      • July 2019
      • Article

      Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements

      By: Derek A. Haas, Xiaoran Zhang, Robert S. Kaplan and Zirui Song
      In 2016, the Centers for Medicare & Medicaid Services (CMS) launched its first mandatory bundled payment program, the Comprehensive Care for Joint Replacement (CJR) model, by randomizing metropolitan statistical areas (MSAs) into the payment model. The paper analyzed... View Details
      Keywords: Medicare; Medicaid; Bundled Payments; Health Care and Treatment; Cost Management; Performance Evaluation; Outcome or Result
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      Haas, Derek A., Xiaoran Zhang, Robert S. Kaplan, and Zirui Song. "Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements." JAMA Internal Medicine 179, no. 7 (July 2019): 924–931.
      • 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
      Keywords: Time-driven Activity-based Cost Model; Emergency Room; Urgent Care Clinic; Cost; Analysis; Activity Based Costing and Management; Health Care and Treatment
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      Kaplan, Robert S., Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller, and John I. Lowenstein. "TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear." Journal of Academic Ophthalmology 10 (2018).
      • Article

      The IT Transformation Health Care Needs

      By: Nikhil R. Sahni, Robert S. Huckman, Anuraag Chigurupati and David M. Cutler
      In recent years, health care organizations have made sizable investments in information technology. They’ve used their IT systems to replace paper records with electronic ones and to improve billing processes, thereby boosting revenue. But so far, IT has been of little... View Details
      Keywords: Health Care and Treatment; Information Technology; Performance Improvement; Business Model
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      Sahni, Nikhil R., Robert S. Huckman, Anuraag Chigurupati, and David M. Cutler. "The IT Transformation Health Care Needs." Harvard Business Review 95, no. 6 (November–December 2017): 128–136.
      • September 2017 (Revised February 2023)
      • Case

      Intermountain Healthcare: Pursuing Precision Medicine

      By: Richard G. Hamermesh, Kathy E. Giusti, Robert S. Huckman and Julia Kelley
      Headquartered in Salt Lake City, Intermountain Healthcare operates 23 hospitals and hundreds of clinics in Utah and Idaho and provides insurance to approximately 850,000 patients through its insurance arm, SelectHealth. In 2013, Intermountain, known for its commitment... View Details
      Keywords: Precision Medicine; Healthcare; Innovation; Cancer; Cancer Research; Health Care; Technology; Health Care and Treatment; Innovation Leadership; Disruptive Innovation; Entrepreneurship; Decision Choices and Conditions; Health Industry; Insurance Industry; Utah; United States; North America
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      Hamermesh, Richard G., Kathy E. Giusti, Robert S. Huckman, and Julia Kelley. "Intermountain Healthcare: Pursuing Precision Medicine." Harvard Business School Case 818-018, September 2017. (Revised February 2023.)
      • 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).
      • July 31, 2017
      • Article

      A Commitment Contract to Achieve Virologic Suppression in Poorly Adherent Patients with HIV/AIDS

      By: Marcella Alsan, John Beshears, Wendy S. Armstrong, James J. Choi, Brigitte C. Madrian, Minh Ly T. Nguyen, Carlos Del Rio, David Laibson and Vincent C. Marconi
      Objective: Assess whether a commitment contract informed by behavioral economics leads to persistent virologic suppression among HIV-positive patients with poor antiretroviral therapy (ART) adherence. Design: Single-center pilot randomized clinical trial and a... View Details
      Keywords: Adherence; Antiretroviral Therapy; Behavioral Economics; Commitment Contract; Financial Incentives; HIV-1 Virologic Suppression; Health Disorders; Motivation and Incentives
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      Alsan, Marcella, John Beshears, Wendy S. Armstrong, James J. Choi, Brigitte C. Madrian, Minh Ly T. Nguyen, Carlos Del Rio, David Laibson, and Vincent C. Marconi. "A Commitment Contract to Achieve Virologic Suppression in Poorly Adherent Patients with HIV/AIDS." AIDS 31, no. 12 (July 31, 2017): 1765–1769.
      • 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.
      • June 2016
      • Article

      When Doctors Go to Business School: Career Choices of Physician-MBAs

      By: Damir Ljuboja, Brian W. Powers, Benjamin Robbins, Robert S. Huckman, Krishna Yeshwant and Sachin Jain
      There has been substantial growth in the number of physicians pursuing Master of Business Administration (MBA) degrees over the past decade, but there is continuing debate over the utility of these programs and the career outcomes of their graduates. The authors... View Details
      Keywords: Medical Education; MD; MBA; Physicians; Executive Education; Training; Personal Development and Career; Health Care and Treatment; Health Industry; United States
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      Ljuboja, Damir, Brian W. Powers, Benjamin Robbins, Robert S. Huckman, Krishna Yeshwant, and Sachin Jain. "When Doctors Go to Business School: Career Choices of Physician-MBAs." American Journal of Managed Care 22, no. 6 (June 2016): e196–e198.
      • Article

      Defining the Value Framework for Prostate Brachytherapy Using Patient-Centered Outcome Metrics and Time-Driven Activity-Based Costing

      By: N.G. Thaker, T.J. Pugh, U. Mahmood, S. Choi, T.E. Spinks, N.E. Martin, T.T. Sio, R.J. Kudchadker, R. S. Kaplan, D.A. Kuban, D.A. Swanson, P.F. Orio, M.J. Zelefsky, B.W. Cox, L. Potters, T.A. Buchholz, T.W. Feeley and S.J. Frank
      PURPOSE: Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value... View Details
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      Thaker, N.G., T.J. Pugh, U. Mahmood, S. Choi, T.E. Spinks, N.E. Martin, T.T. Sio, R.J. Kudchadker, R. S. Kaplan, D.A. Kuban, D.A. Swanson, P.F. Orio, M.J. Zelefsky, B.W. Cox, L. Potters, T.A. Buchholz, T.W. Feeley, and S.J. Frank. "Defining the Value Framework for Prostate Brachytherapy Using Patient-Centered Outcome Metrics and Time-Driven Activity-Based Costing." Brachytherapy 15, no. 3 (May 2016): 274–282.
      • August 2015
      • Article

      Hospital Board and Management Practices Are Strongly Related to Hospital Performance on Clinical Quality Metrics

      By: Thomas C Tsai, Ashish K. Jha, Atul A. Gawande, Robert S. Huckman, Nicholas Bloom and Raffaella Sadun
      National policies to improve health care quality have largely focused on clinical provider outcomes and, more recently, payment reform. Yet the association between hospital leadership and quality, although crucial to driving quality improvement, has not been explored... View Details
      Keywords: Hospitals; Quality; Governing and Advisory Boards; Management Practices and Processes; Service Delivery; Health Care and Treatment; Health Industry
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      Tsai, Thomas C., Ashish K. Jha, Atul A. Gawande, Robert S. Huckman, Nicholas Bloom, and Raffaella Sadun. "Hospital Board and Management Practices Are Strongly Related to Hospital Performance on Clinical Quality Metrics." Health Affairs 34, no. 8 (August 2015): 1304–1311.
      • June 2015 (Revised May 2017)
      • Teaching Note

      Philips Healthcare: Marketing the HealthSuite Digital Platform

      By: John A. Quelch
      Keywords: Healthcare; Experiential Quality; Conformance Quality; Clinical Outcomes; Cost Efficiency; Quality; Performance; Health Care and Treatment
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      Quelch, John A. "Philips Healthcare: Marketing the HealthSuite Digital Platform." Harvard Business School Teaching Note 515-113, June 2015. (Revised May 2017.)
      • April 2015
      • Case

      Carolinas HealthCare System: Consumer Analytics

      By: John A. Quelch and Margaret L. Rodriguez
      In 2014, Dr. Michael Dulin, chief clinical officer for analytics and outcomes research and head of the Dickson Advanced Analytics (DA2) group at Carolinas HealthCare System (CHS), successfully unified all analytics talent and resources into one group over a three year... View Details
      Keywords: Consumer Segmentation; Big Data; Management Information Systems; Hospital Management; Health Care and Treatment; Marketing; Segmentation; Analytics and Data Science; Information Management; Information Technology; Health; Health Industry; United States
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      Quelch, John A., and Margaret L. Rodriguez. "Carolinas HealthCare System: Consumer Analytics." Harvard Business School Case 515-060, April 2015.
      • Article

      How Not to Cut Health Care Costs

      By: Robert S. Kaplan and Derek A. Haas
      Health care providers in much of the world are trying to respond to the tremendous pressure to reduce costs—but evidence suggests that many of their attempts are counterproductive, raising costs and sometimes decreasing the quality of care. Using evidence from field... View Details
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      Kaplan, Robert S., and Derek A. Haas. "How Not to Cut Health Care Costs." Harvard Business Review 92, no. 11 (November 2014): 116–122.
      • Article

      Patterns of Failure after Involved Field Radiation Therapy for Pediatric and Young Adult Hodgkin Lymphoma

      By: Minh-Phuong Huynh-Le, Amanda J. Walker, Scott Duke Kominers, Ido Paz-Priel, Moody D. Wharam and Stephanie A. Terezakis
      Involved field radiation therapy (IFRT) is integral in curative therapy for Hodgkin lymphoma (HL), although primarily used in patients with intermediate/high‐risk HL. We present failure patterns and clinical outcomes in a cohort of pediatric and young adult patients... View Details
      Keywords: Hematology/oncology; Hodgkin Lymphoma; Involved Field Radiation Therapy; Health Disorders; Health Care and Treatment
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      Huynh-Le, Minh-Phuong, Amanda J. Walker, Scott Duke Kominers, Ido Paz-Priel, Moody D. Wharam, and Stephanie A. Terezakis. "Patterns of Failure after Involved Field Radiation Therapy for Pediatric and Young Adult Hodgkin Lymphoma." Pediatric Blood & Cancer 61, no. 7 (July 2014).
      • June 2014 (Revised February 2017)
      • Case

      Kathy Giusti and the Multiple Myeloma Research Foundation

      By: Richard G. Hamermesh, Joshua D. Margolis and Matthew G. Preble
      What do you do when your rising professional career is cut short by an unexpected cancer diagnosis? Kathy Giusti shifted careers, built a new organization that transformed how cancer research is done, and now faces the challenge of sustaining the organization and its... View Details
      Keywords: Philanthropy; Philanthropy Funding; Entrepreneurship; Health Care; Management Styles; Personalized Medicine; Health Care Outcomes; Cancer; Cancer Care In The U.S.; Personal Care; Leadership; Leading Change; Social Entrepreneurship; Philanthropy and Charitable Giving; Health Care and Treatment; Leadership Style; Management Style; Management Skills; Growth and Development Strategy; Business Strategy; Health; Health Industry; United States; Canada; Spain
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      Hamermesh, Richard G., Joshua D. Margolis, and Matthew G. Preble. "Kathy Giusti and the Multiple Myeloma Research Foundation." Harvard Business School Case 814-026, June 2014. (Revised February 2017.)
      • Article

      Better Accounting Transforms Health Care Delivery

      By: Robert S. Kaplan and Mary L. Witkowski
      The paper describes the theory and preliminary results for an action research program that explores the implications from better measurements of health care outcomes and costs. After summarizing Porter's outcome taxonomy (Porter 2010), we illustrate how to use process... View Details
      Keywords: Activity Based Costing and Management; Research; Health Care and Treatment; Health Industry
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      Kaplan, Robert S., and Mary L. Witkowski. "Better Accounting Transforms Health Care Delivery." Accounting Horizons 28, no. 2 (June 2014): 365–383.
      • June 2014
      • Article

      Improving Value with TDABC

      By: Robert S. Kaplan
      The article discusses the benefits of time-driven activity-based costing (TDABC) combined with outcomes measurement for healthcare organizations. Topics covered include improving resource efficiency, optimizing care over the complete care cycle, and planning and... View Details
      Keywords: Goals and Objectives; Activity Based Costing and Management; Health Care and Treatment; Health Industry
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      Kaplan, Robert S. "Improving Value with TDABC." hfm (Healthcare Financial Management) 68, no. 6 (June 2014): 76–83.
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