Publications
Publications
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- All HBS Web
(1,491)
- Faculty Publications (273)
- January 19, 2024
- Article
Value-Based Health Care Can Transform the Treatment of Patients with Substance Use Disorder
By: Robert S. Kaplan and Sarah E. Wakeman
U.S. overdose deaths currently exceed 100,000 per year. New facilities, known as bridge clinics, are broadening access to high-quality care by offering outpatient substance use disorder (SUD) treatment with few access barriers. But many of the critical services offered... View Details
- January 2024
- Article
A Cost Model for a Low Threshold Clinic Treating Opioid Use Disorder
By: Sarah E. Wakeman, Elizabeth Powell, Syed Shehab, Grace Herman, Laura Kehoe and Robert S. Kaplan
The US fee-for-service payment system under-reimburses clinics offering access to comprehensive treatments for opioid use disorder (OUD). The funding shortfall limits a clinic’s ability to expand and improve access, especially for socially marginalized patients with... View Details
- January 2024
- Article
Cost of Exempting Sole Orphan Drugs from Medicare Negotiation
By: Matthew Vogel, Olivia Zhao, William B. Feldman, Amitabh Chandra, Aaron S. Kesselheim and Benjamin N. Rome
Importance: The Inflation Reduction Act (IRA) requires Medicare to negotiate prices for some high-spending drugs but exempts drugs approved solely for the treatment of a single rare disease.
Objective: To estimate Medicare spending and global... View Details
Objective: To estimate Medicare spending and global... View Details
- 2023
- Working Paper
Are Hospital Quality Indicators Causal?
By: Amitabh Chandra, Maurice Dalton and Douglas O. Staiger
Hospitals play a key role in patient outcomes and spending, but efforts to improve their quality are hindered because we do not know whether hospital quality indicators are causal or biased. We evaluate the validity of commonly used quality indicators, such as... View Details
- October 2023
- Article
Health System Perspective on Cost for Delivering a Decision Aid for Prostate Cancer Using Time-Driven Activity-Based Costing
By: David R. Ho, Robert S. Kaplan, Jonathan Bergman, David F. Penson, Benjamin Waterman, Kristin C. Williams, Jefersson Villatoro, Lorna Kwan and Christopher S. Saigal
Previsit decision aids (DAs) have been shown to improve decisional quality. But the cost to deploy a DA has not been previously estimated. We interviewed or observed relevant personnel at three institutions that had implemented DA programs for men with prostate cancer.... View Details
- September–October 2023
- Article
Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using Time-Driven Activity-Based Costing Method: A Single Center Study
By: Aamir Ali, Jordana Phillips, Damir Ljuboja, Syed S. Shehab, Etta D. Pisano, Robert S. Kaplan and Ammar Sarwar
We use time-driven activity-based costing (TDABC) to measure the cost of performing breast imaging using different modalities: full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), contrast-enhanced mammography (CEM), US and MRI exams, and... View Details
- September 2023
- Article
The Health Costs of Dirty Energy: Evidence from the Capacity Market in Colombia
By: Achyuta Adhvaryu, Theresa Molina, Anant Nyshadham, Jorge Tamayo and Nicholas Torres
The health effects of “dirty” (fossil fuel driven) energy production are difficult to measure accurately due to the endogeneity of fuel choice. We exploit an electricity policy in Colombia that generates a price-based trigger for the use of thermal energy sources.... View Details
- October 2023
- Article
What Does the Inflation Reduction Act Mean for Patients and Physicians?
By: Amitabh Chandra and Benedic Ippolito
The debate around prescription drug measures in the recently passed U.S. Inflation Reduction Act (IRA), which limit some patients’ out-of-pocket costs, has not fully addressed their effect on physicians and patients via their effect on payers. Reducing patients’ costs... View Details
- July–August 2023
- Article
Investing in Growth Through Uncertainty
By: Ranjay Gulati
When faced with disruptions and downturns, many leaders and companies instinctively focus on cutting costs to maintain profitability. But some identify opportunities and then take thoughtful action to emerge from crisis even stronger. That means not only planning for... View Details
- April 2023 (Revised January 2024)
- Background Note
Note on Healthcare in Ghana
By: Regina E. Herzlinger and Ben Creo
This note provides an overview of the healthcare system in Ghana. It discusses the public and private sector as well as traditional medical practice. It also discusses the country’s pharmaceutical industry. It is recommended as a companion to Professor Regina... View Details
Keywords: Africa; Pharmaceutical Companies; Pharmacy Benefit Manager; Health Care; Health Care Costs; Health Care Delivery; Health Care Entrepreneurship; Telehealth; Health Equity; Governing Rules, Regulations, and Reforms; Health Care and Treatment; Business and Government Relations; Health Industry; Health Industry; Ghana
- 2023
- Article
Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital
By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk
The COVID-19 pandemic raised awareness of the need to better understand where and how patient-level costs are incurred in health care organizations. This study used time-driven activity-based costing to estimate COVID-19 patient-level hospital costs in a Brazilian... View Details
- February 2023
- Article
A Different Framework to Achieve Universal Coverage in the U.S.
By: Katherine Baicker, Amitabh Chandra and Mark Shepard
This JAMA Forum discusses alternative ways to achieve universal coverage in the US such as administrative simplification in the Affordable Care Act plans to increase enrollment, having a basic policy that would be available to everyone, and options for supplemental... View Details
- January 2023
- Case
Crow Holdings Development: Mass Timber Construction
By: John D. Macomber, Robert Hernandez and Kyle MertensMeyer
Jim McCaffery and Cody Armbrister of Crow Holdings Development evaluate the pros and cons of committing to mass timber construction instead of conventional concrete or steel for a new 260,000 SF multi-story office building in Texas. Benefits include substantially... View Details
Keywords: Real Estate Development; Architecture; Air Quality; Health ＆ Wellness; Office Property; Sustainability; Carbon Abatement; Natural Environment; Environmental Accounting; Green Buildings; Design; Construction; Cost vs Benefits; Environmental Sustainability; Construction Industry; Real Estate Industry; Texas
- January–February 2023
- Article
Data-Driven COVID-19 Vaccine Development for Janssen
By: Dimitris Bertsimas, Michael Lingzhi Li, Xinggang Liu, Jennings Xu and Najat Khan
The COVID-19 pandemic has spurred extensive vaccine research worldwide. One crucial part of vaccine development is the phase III clinical trial that assesses the vaccine for safety and efficacy in the prevention of COVID-19. In this work, we enumerate the first... View Details
- December 2022
- Article
Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition
By: Anna Paula Beck da Silva Etges, Richard D. Urman, Anne Geubelle, Robert Kaplan and Carisi Anne Polanczyk
This communication announces the International Cost Standard Set Program. Its goal is to establish global standardized frameworks for measuring the costs of treating specific clinical conditions. A scientific committee, including 16 international healthcare cost... View Details
- October 2022 (Revised September 2024)
- Case
mPharma: Scaling Access to Affordable Primary Care in Africa
By: Regina E. Herzlinger and Ben Creo
mPharma hopes to scale up to create the largest pan-African healthcare company ever to provide much-needed primary care in retail pharmacies; a reliable, fairly priced supply of drugs; and micro-insurance for drugs. They must prioritize launching a telemedicine... View Details
Keywords: Africa; Pharmaceutical Companies; Pharmacy Benefit Manager; Health Care; Health Care And Treatment; Health Care Costs; Health Care Delivery; Health Care Entrepreneurship; Telehealth; Health Equity; Corporate Strategy; Social Entrepreneurship; Equity; Growth and Development Strategy; Expansion; Product Launch; Customer Value and Value Chain; Social Enterprise; Multinational Firms and Management; Health Industry; Health Industry; Africa
- June 2022
- Article
A New Initiative to Track HIV Resource Allocation and Costs
By: Ryan McBain, AK Nandakumar, Michael Ruffner, Carlyn Mann, Mai Hijazi, Susanna Baker, Linden Morrison, Kalipso Chalkidou, Shufang Zhang, Iris Semini, Fern Terris-Prestholt, Steven Forsythe, Sarah Byakika, Joshua Musinguzi and Robert S. Kaplan
In early 2020, several global health institutions – including the Global Fund to Fight AIDS, Tuberculosis and Malaria; Joint United Nations Program on HIV/AIDS (UNAIDS); United States Agency for International Development; and Office of the Global AIDS Coordinator at... View Details
- October 2022
- Article
It’s Not Just the Prices: Time-Driven Activity-Based Costing for Initiation of Veno-Venous Extracorporeal Membrane Oxygenation at Three International Sites—A Case Review
By: Michael Nurok, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes and Robert S. Kaplan
The United States spends more for intensive care units (ICUs) than do other high-income countries. We used time-driven activity-based costing (TDABC) to analyze ICU costs for initiation of extracorporeal membrane oxygenation (ECMO) for respiratory failure to estimate... View Details
- September 2022
- Article
Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia
By: Chen Wei, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak and Paul C. Zei
Cardiac SBRT is a novel way of treating refractory ventricular tachycardia (VT) that may be less costly than catheter ablation, owing to its noninvasive, outpatient nature. We applied time-driven activity-based costing to both procedures. The direct and total... View Details
- September 2022
- Article
Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities
By: Leemore Dafny, Christopher Ody and Teresa Rokos
The federal Anti-Kickback Statute prohibits biopharmaceutical manufacturers from directly covering Medicare enrollees’ out-of-pocket spending for the drugs they manufacture, but manufacturers may donate to independent patient assistance charities and earmark donations... View Details