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  • All HBS Web  (842)
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    • News  (244)
    • Research  (472)
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  • November 2013
  • Teaching Note

Choosing Health Insurance Coverage under the Affordable Care Act (ACA)

By: Robert C. Pozen, Katherine Brooks and Iwan Djanali
Keywords: Health Care; Health Care Industry; Health Care and Treatment; Health Industry
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Pozen, Robert C., Katherine Brooks, and Iwan Djanali. "Choosing Health Insurance Coverage under the Affordable Care Act (ACA)." Harvard Business School Teaching Note 314-025, November 2013.
  • January 2019 (Revised June 2019)
  • Technical Note

U.S. Commercial Health Insurance Industry

By: Susanna Gallani, Mary Witkowski and Harry B. Wolberg
This note describes the role of commercial payers in the U.S. healthcare industry. We begin with a review of the historical evolution of commercial payers and their role in the market, from the beginning to the Affordable Care Act and beyond. Every wave of reforms in... View Details
Keywords: Health Care and Treatment; Insurance; Governing Rules, Regulations, and Reforms; Organizational Change and Adaptation; Health Industry; Health Industry; United States
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Gallani, Susanna, Mary Witkowski, and Harry B. Wolberg. "U.S. Commercial Health Insurance Industry." Harvard Business School Technical Note 119-064, January 2019. (Revised June 2019.)
  • October 2014
  • Article

Are Health Insurance Markets Competitive?

By: Leemore S. Dafny
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Dafny, Leemore S. "Are Health Insurance Markets Competitive?" American Economic Review 100, no. 4 (September 2010): 1399–1431.
  • August 2017
  • Case

CareMore Health System

By: Robert S. Huckman and Brian W. Powers
CareMore Health System—a physician-founded care delivery system and health plan—had developed and refined an innovative care model for at-risk seniors enrolled in Medicare managed care (i.e., Medicare Advantage) plans. CareMore's President, Sachin Jain, and his... View Details
Keywords: Health Care Delivery; Health Insurance; Medicare; Medicaid; Managed Care; Extensivist; Social Determinants Of Health; Health Care and Treatment; Insurance; Business Model; Growth and Development Strategy; Decision Choices and Conditions; Health Industry; United States
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Huckman, Robert S., and Brian W. Powers. "CareMore Health System." Harvard Business School Case 618-008, August 2017.
  • 1981
  • Case

Town of Holden Health Insurance Procurement

By: Dutch Leonard
Keywords: Health; Local Range; Insurance; Financial Management
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Leonard, Dutch. "Town of Holden Health Insurance Procurement." 1981. (financial management.)
  • February 2016 (Revised May 2016)
  • Case

Employee Health

By: John A. Quelch and Emily C. Boudreau
Keywords: Health Care; Empoylee Wellness Programs; Health Insurance; Mental Health; Corporate Culture; Employee Compensation; Health; Corporate Strategy; Europe; Asia; North America
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Quelch, John A., and Emily C. Boudreau. "Employee Health." Harvard Business School Case 516-074, February 2016. (Revised May 2016.)
  • August 2017
  • Supplement

CareMore Health System (B)

By: Robert S. Huckman and Brian W. Powers
This supplement to “CareMore Health System (A)” discusses the company's early experience introducing its managed Medicaid model in the Des Moines, Iowa, market. It also provides an update on the Memphis program discussed in the (A) case. View Details
Keywords: Health Care Delivery; Health Insurance; Medicare; Medicaid; Managed Care; Extensivist; Social Determinants Of Health; Health Care and Treatment; Insurance; Business Model; Growth and Development Strategy; Health Industry; United States
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Huckman, Robert S., and Brian W. Powers. "CareMore Health System (B)." Harvard Business School Supplement 618-009, August 2017.
  • Blog Post

Health Care Transparency: The Fox Is Guarding the Chicken Coop in Washington Again

By: Regina E. Herzlinger

Now that more people can shop directly for their own health insurance under the Affordable Care Act, they have been transformed from potential patients to consumers, and like any other consumers of goods or services, they want to know if what they're buying is any... View Details

Keywords: Transparency; Health Care; Health Insurance; Health Care and Treatment; Health Industry
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Herzlinger, Regina E. "Health Care Transparency: The Fox Is Guarding the Chicken Coop in Washington Again." Huffington Post, The Blog (March 24, 2014). http://www.huffingtonpost.com/regina-e-herzlinger/health-care-transparency_b_5022531.html.
  • 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).
  • June 24, 2016
  • Article

Health Insurance Mergers Put Consumers Last

By: John A. Quelch
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Quelch, John A. "Health Insurance Mergers Put Consumers Last." The Hill (June 24, 2016). (Opinion.)
  • 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.
  • 17 Sep 2020
  • Research & Ideas

Many Small-Business Employees May Be Close to Losing Health Insurance

and health insurance marketplaces. Applicants eligible for zero-premium plans could be enrolled by default, with the option to make changes. “There could be smoother, common processes,” Dafny says. “And... View Details
Keywords: by Rachel Layne; Health
  • Article

Asset Accumulation and Labor Force Participation of Disability Insurance Applicants

By: Pian Shu
This paper provides empirical evidence of the existence of forward-looking asset-accumulation behavior among disability-insurance applicants, previously examined only in the theoretical literature. Using panel data from the RAND Health and Retirement Study, I show that... View Details
Keywords: Disability Insurance; Asset Accumulation; Labor Force Participation; Assets; Behavior; Employment; Insurance; Insurance Industry; United States
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Shu, Pian. "Asset Accumulation and Labor Force Participation of Disability Insurance Applicants." Journal of Public Economics 129 (September 2015): 26–40.
  • Article

What Could Amazon's Approach to Health Care Look Like?

By: Robert S. Huckman
Keywords: Health Care; Amazon; Health Insurance; Information Technology; United States
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Huckman, Robert S. "What Could Amazon's Approach to Health Care Look Like?" Harvard Business Review (website) (February 6, 2018).
  • 2013
  • Working Paper

Asset Accumulation and Labor Force Participation of Disability Insurance Applicants

By: Pian Shu
Using panel data from the RAND Health and Retirement Study, I show that rejected applicants for Social Security Disability Insurance (SSDI) possess significantly more assets immediately prior to their application and exhibit lower labor force attachment than accepted... View Details
Keywords: Disability Insurance; Asset Accumulation; Labor Force Participation; Assets; Behavior; Employment; Insurance; Insurance Industry; United States
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Shu, Pian. "Asset Accumulation and Labor Force Participation of Disability Insurance Applicants." Harvard Business School Working Paper, No. 14-008, July 2013.
  • 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).
  • 2020
  • Working Paper

Cutting the Gordian Knot of Employee Health Care Benefits and Costs: A Corporate Model Built on Employee Choice

By: Regina E. Herzlinger and Barak D. Richman
The U.S. employer-based health insurance tax exclusion created a system of employer-sponsored insurance (ESI) with limited insurance choices and transparency that may lock employed households into health plans that are costlier or different from those they prefer to... View Details
Keywords: After-tax Income; Consumer-driven Health Care; Health Care Costs; Health Insurance; Income Inequality; Tax Policy; Health Care and Treatment; Cost; Insurance; Employees; Income; Taxation; Policy; United States
Citation
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Herzlinger, Regina E., and Barak D. Richman. "Cutting the Gordian Knot of Employee Health Care Benefits and Costs: A Corporate Model Built on Employee Choice." Duke Law School Public Law & Legal Theory Series, No. 2020-4, December 2019. (Revised January 2021.)
  • April 2022
  • Article

AI Insurance: How Liability Insurance Can Drive the Responsible Adoption of Artificial Intelligence in Health Care

By: Ariel Dora Stern, Avi Goldfarb, Timo Minssen and W. Nicholson Price II
Despite enthusiasm about the potential to apply artificial intelligence (AI) to medicine and health care delivery, adoption remains tepid, even for the most compelling technologies. In this article, the authors focus on one set of challenges to AI adoption: those... View Details
Keywords: Artificial Intelligence; Medicine; Health Care and Treatment; Legal Liability; Insurance; Technology Adoption; AI and Machine Learning
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Stern, Ariel Dora, Avi Goldfarb, Timo Minssen, and W. Nicholson Price II. "AI Insurance: How Liability Insurance Can Drive the Responsible Adoption of Artificial Intelligence in Health Care." NEJM Catalyst Innovations in Care Delivery 3, no. 4 (April 2022).
  • September 2013 (Revised August 2014)
  • Case

Ping An Health (PAH): Towards a Comprehensive Private Health Insurance Market in China

By: Regina E. Herzlinger and Da Liu
Citation
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Herzlinger, Regina E., and Da Liu. "Ping An Health (PAH): Towards a Comprehensive Private Health Insurance Market in China." Harvard Business School Case 314-042, September 2013. (Revised August 2014.)
  • 2021
  • Working Paper

Detecting Anomalous Patterns of Care Using Health Insurance Claims

By: Sriram Somanchi, Edward McFowland III and Daniel B. Neill
Citation
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Somanchi, Sriram, Edward McFowland III, and Daniel B. Neill. "Detecting Anomalous Patterns of Care Using Health Insurance Claims." Working Paper, 2021. (In Preparation.)
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