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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; Health Industry; Massachusetts

November 2012 (Revised January 2013)
Case

Companion Diagnostics: Uncertainties for Approval and Reimbursement

By: Richard G. Hamermesh, Norman C. Selby and Phillip Andrews

The FDA approvals of novel therapeutics were seen as signs in the personalized medicine community of real progress in the growth of personalized medicine. The FDA's approval of such drugs, along with companion diagnostics, suggested a shift in thinking and regulatory... View Details

Keywords: Models Of Reimbursement; Personalized Medicine; Regulation; Healthcare Reform; Health Care and Treatment; Health Industry; United States

February 2021
Case

New England Baptist Hospital: Getting Paid for Value

By: Robert S. Kaplan, Mary Witkowski, Toby E. Emanuel and Syed S. Shehab

New England Baptist Hospital (NEBH), a national leader in adult orthopedic care, has the lowest rate of complications and 30-day readmissions in New England, but gets paid 30% less for its surgeries than nearby institutions. NEBH introduces, with several large... View Details

Keywords: Healthcare; Healthcare Spending; Healthcare Innovation; Healthcare Industry; Health Care Outcomes; Health Care Delivery; Health Care Reform; Bundled Payments; Health Care and Treatment; Spending; Innovation and Invention; Value Creation; Strategy; Health Industry; North America

Article

Value-based Healthcare: Implications for Thyroid Cancer

By: A.K. Ying, T.W. Feeley and M. E. Porter

Today's delivery of care to thyroid cancer patients is complex, and costly, with uneven outcomes that can be improved. The incidence of thyroid cancer is rising and requires coordinated, multidisciplinary care with high volume centers that is not always available in... View Details

Keywords: Bundled Reimbursement; Healthcare Reform; Integrated Practice Units; Outcomes; Patient-reported Outcomes; Thyroid Cancer; Health Care and Treatment; Cost; Information Technology; Value

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Article

Ten Year Sunset Rule for Healthcare Regulation Is a Nonstarter and Discouragement to Post-COVID-19 Investment

By: Regina E. Herzlinger and Eugene Schneller

U.S. healthcare delivery has not benefitted from the same productivity growth as many other service industries, such as bricks and mortar retailing, a loss that has gravely diminished cost control and access. Regulatory capture, which creates barriers to venture... View Details

Keywords: Health Care; COVID-19; Regulation; Health Care and Treatment; Health Pandemics; Governing Rules, Regulations, and Reforms; Investment

September 2016
Case

Health Leads: Reaching for Impact (A)

By: V. Kasturi Rangan and Sarah Appleby

Explores strategies to achieve system-level impact for a nonprofit focused on addressing patients' basic social needs through healthcare institutions. Founded in 1996 with a volunteer-staffed help desk at Boston Medical Center connecting low-income patients with basic... View Details

Keywords: Scaling Social Impact; Nonprofit; Healthcare; Health Care Outcomes; Health Care Reform; Health Care Delivery; Scaling Social Enterprise; Social Enterprise; Health; Nonprofit Organizations; Health Care and Treatment; Health Industry; United States

July 2019
Article

The Impact of Price Regulation on the Availability of New Drugs in Germany

By: Ariel Dora Stern, Felicitas Pietrulla, Annika Herr, Aaron S. Kesselheim and Ameet Sarpatwari

The 2011 German Pharmaceutical Market Restructuring Act (“AMNOG”) subjected branded, non-rare disease drugs to price regulation based on an assessment of their clinical benefit. Assessment outcomes range from “major added benefit” to “less benefit than the appropriate... View Details

Keywords: Regulation; Pharmaceuticals; Healthcare; Health Care and Treatment; Price; Governing Rules, Regulations, and Reforms; Pharmaceutical Industry; Germany

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May 25, 2004
Article

Specialization and Its Discontents: The Pernicious Impact of Regulations Against Specialization and Physician Ownership on the U.S. Healthcare System

By: Regina E. Herzlinger

Keywords: Health Care and Treatment; Ownership; Governing Rules, Regulations, and Reforms; Health Industry; United States

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July 2019
Article

Challenges and Opportunities in Software-Driven Medical Devices

By: William J. Gordon and Ariel Dora Stern

The safety and security of medical devices driven by software, the software-development processes, and the need for data collection and privacy, all offer challenges and opportunities for device regulation and clinical care. View Details

Keywords: Medical Devices; Healthcare; Health Care; Health Care and Treatment; Applications and Software; Governing Rules, Regulations, and Reforms; Medical Devices and Supplies Industry

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September 2016
Case

Health Leads: Reaching for Impact (Abridged)

By: V. Kasturi Rangan and Sarah Appleby

A nonprofit in the healthcare arena explores strategies to achieve system-level impact. Founded in 1996 with a volunteer-staffed help desk at Boston Medical Center connecting low-income patients with basic resources like heating assistance, job training, and childcare... View Details

Keywords: Scaling Social Enterprise; Scaling Social Impact; Health Care Delivery; Health Care Outcomes; Health Care Reform; Nonprofit; Nonprofit Scaling; Social Enterprise; Health Care and Treatment; Nonprofit Organizations; Growth and Development Strategy; Health Industry; United States

January 2011 (Revised September 2011)
Case

Caterpillar, Inc. (A)

By: David F. Hawkins

2010 Healthcare Reform Act eliminates Medicare Part D subsidy and Caterpillar recognizes a $100 million change. View Details

Keywords: Information Infrastructure; Governing Rules, Regulations, and Reforms; Employment; Cost vs Benefits; Forecasting and Prediction; Change Management; Asset Management; Financial Strategy; Activity Based Costing and Management; Business or Company Management; Technology Industry; Manufacturing Industry; United States

Research Summary

Overview

We are studying the practical application of Michael Porter's value-based strategy to reform health care by examining best practices of integrated practice units, outcome measurement, cost measurement, value-based payment, episode based payment, regionalization of... View Details

Keywords: Health Care; Health Care Outcomes; Healthcare IT; Health Care Quality; Health Economics; Value Agenda; Information Technology; Mobile App; Big Data; Electronic Health Records; Pers; Value Creation; Information Technology Industry; United States

October 2013
Case

FasterCures: Removing Barriers to Treatments

By: Richard G. Hamermesh and James Weber

In mid-2013, as FasterCures celebrated its 10th anniversary as a center of the Milken Institute, Executive Director Margaret Anderson thought about what the organization should do to ensure it had even more impact in its next 10 years. FasterCures was a non-profit... View Details

02 Mar 2007
What Do You Think?

What Is the Government’s Role in US Health Care?

Summing Up This month's exchange of ideas regarding U.S. healthcare reform ranged far and wide. Some of us were interested primarily in the issue of cost escalation and how to contain it. Others addressed... View Details

Keywords: by Jim Heskett; Health

Article

Comparative Costs of Advanced Proton and Photon Radiation Therapies: Lessons from Time-driven Activity-based Costing in Head and Neck Cancer

By: Nikhil G. Thaker, Steven J. Frank and Thomas W. Feeley

Time-driven activity-based costing (TDABC) is an innovative costing tool in healthcare that can be used to directly compare the true cost of competing technologies over the full care cycle. Rather than only comparing therapeutic effectiveness over a limited number of... View Details

Keywords: Head And Neck Cancer; IMRT; Proton Therapy; Time-Driven ABC; Information Technology; Activity Based Costing and Management; Medical Specialties

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; Insurance Industry; United States

April 2021
Article

Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models

By: Susanna Gallani, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar and Frank Opelka

Modern medicine is undergoing a transformation that involves innovative surgical approaches, increased medical treatment options, clinical care pathways that require collaboration beyond hospital walls, and health data captured by electronic health records and other... View Details

Keywords: Physician Compensation; Surgeons; Health Care and Treatment; Business Model; Compensation and Benefits

2023
Article

Conduit Incentives: Eliciting Cooperation from Workers Outside of Managers' Control

By: Susanna Gallani

Can managers use monetary incentives to elicit cooperation from workers they cannot reward for their efforts? I study “conduit incentives,” an innovative incentive design, whereby managers influence bonus-ineligible workers’ effort by offering bonus-eligible employees... View Details

Keywords: Organizational Behavior Modification; Peer Monitoring; Persistence Of Performance Improvements; Crowding Out; Implicit Incentives; Compensation; Healthcare; Social Pressure; Image Motivation; Incentives; Motivation; Performance; Behavior; Motivation and Incentives; Compensation and Benefits; Governing Rules, Regulations, and Reforms; Organizational Culture; Health Industry; California

August 2023 (Revised October 2023)
Case

Beyond the Barricades: Chile 2023

By: Debora Spar, Willis Emmons, Leonard A. Schlesinger and Ruth Costas

Chile, often considered among Latin America's greatest economic success stories, suffered a shocking wave of protests in October 2019, as its citizens demanded reforms across healthcare and education systems, and protested inequality and rising costs of living. As... View Details

Keywords: Government Administration; Developing Countries and Economies; Economic Growth; Social Issues; Wealth and Poverty; Public Opinion; Equality and Inequality; Public Administration Industry; Chile; Latin America; South America

May 2009 (Revised October 2009)
Case

Newton-Wellesley Hospital

By: Richard M.J. Bohmer and Natalie Kindred

How will Newton-Wellesley Hospital (NWH) preserve its private practice tradition while remaining effective and competitive in a healthcare industry demanding increasing integration between physicians and hospitals? This is the decision facing Newton-Wellesley Hospital... View Details

Keywords: Business Model; Profit; Health Care and Treatment; Growth and Development Strategy; Organizational Change and Adaptation; Organizational Structure; Competitive Strategy; Integration; Health Industry; Massachusetts

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