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Show Results For
- All HBS Web
(167)
- News (46)
- Research (105)
- Multimedia (6)
- Faculty Publications (60)
- 25 Jul 2009
- News
Some Inconvenient Truths About Medicare and the New 'Public Plan'
- 02 Jan 2020
- News
Medicare for All or Public Option: Can Either Heal Health Care?
- Article
Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System
By: Regina E. Herzlinger and Bacchus Barua
An analysis of Canada’s single-payer healthcare system shows the dangers of the proposed Medicare for All model. In fact, the Canadian healthcare system is costly and drives poor outcomes when compared to objective performance measures. Alternatively, the Swiss and... View Details
Keywords: Healthcare Systems; Universal Health Coverage; Health Care and Treatment; Insurance; Canada; Switzerland; Netherlands
Herzlinger, Regina E., and Bacchus Barua. "Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System." Wall Street Journal (April 17, 2019).
- October 2012 (Revised October 2016)
- Case
Predilytics
By: Robert F. Higgins and Annelena Lobb
The management team at Predilytics, a healthcare analytics firm, must decide whether to accept a Series A venture capital financing deal. The company provided analytic services to healthcare plans, typically Medicare Advantage plans, in efforts to draw conclusions from... View Details
Keywords: Analytics; Healthcare; Medicare; Health Care and Treatment; Mathematical Methods; Health Industry; New England; United States
Higgins, Robert F., and Annelena Lobb. "Predilytics." Harvard Business School Case 813-023, October 2012. (Revised October 2016.)
- Article
Mandate Outcomes Reporting
By: Robert S. Kaplan and Michael E. Porter
Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to... View Details
Keywords: Outcomes Reporting; Outcomes Measurement; Medicare; Medicaid; Health Care and Treatment; Outcome or Result; Measurement and Metrics
Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
- November 2023
- Article
Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients with Hypertension
By: Mitchell Tang, Carter Nakamoto, Ariel Dora Stern, Jose Zubizarreta, Felippe Marcondes, Lori Uscher-Pines, Lee Schwamm and Ateev Mehrotra
Background: Remote patient monitoring (RPM) is a promising tool for improving chronic disease management. Use of RPM for hypertension monitoring is growing rapidly, raising concerns about increased spending. However, the effects of RPM are still... View Details
Tang, Mitchell, Carter Nakamoto, Ariel Dora Stern, Jose Zubizarreta, Felippe Marcondes, Lori Uscher-Pines, Lee Schwamm, and Ateev Mehrotra. "Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients with Hypertension." Annals of Internal Medicine 176, no. 11 (November 2023): 1465–1475.
- Fall 2008
- Article
Do Report Cards Tell Consumers Anything They Don’t Already Know? The Case of Medicare HMOs
By: Leemore S. Dafny and David Dranove
Dafny, Leemore S., and David Dranove. "Do Report Cards Tell Consumers Anything They Don’t Already Know? The Case of Medicare HMOs." RAND Journal of Economics 39, no. 3 (Fall 2008): 790–821.
- March 2019
- Article
Evidence of Upcoding in Pay-for-Performance Programs
By: Hamsa Bastani, Joel Goh and Mohsen Bayati
Recent Medicare legislation seeks to improve patient care quality by financially penalizing providers for hospital-acquired infections (HAIs). However, Medicare cannot directly monitor HAI rates and instead relies on providers accurately self-reporting HAIs in claims... View Details
Keywords: Medical Coding; Health Policy; Healthcare-acquired Conditions; Medicare; Health Care and Treatment; Policy; Performance Improvement; Quality; Measurement and Metrics; Government Legislation
Bastani, Hamsa, Joel Goh, and Mohsen Bayati. "Evidence of Upcoding in Pay-for-Performance Programs." Management Science 65, no. 3 (March 2019): 1042–1060. (2015 INFORMS Health Applications Society best student (H. Bastani) paper award.)
- 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
Keywords: Cost Sharing; Prescription Drugs; Drug Spending; Medicare; Dual Eligibility; Cost; Health Care and Treatment; Philanthropy and Charitable Giving; Pharmaceutical Industry
Dafny, Leemore, Christopher Ody, and Teresa Rokos. "Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities." Health Affairs 41, no. 9 (September 2022).
- 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
Huckman, Robert S., and Brian W. Powers. "CareMore Health System." Harvard Business School Case 618-008, August 2017.
- 01 Mar 2007
- News
Daniel Vasella
fundamental problem. The Medicare prescription drug program that went into effect last year bars the federal government from negotiating with drug companies over the prices seniors pay. The new Democratic majority in Congress has vowed to... View Details
- Article
Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated
By: Christopher Ody, Lucy Msall, Leemore S. Dafny, David Grabowski and David Cutler
Medicare’s Hospital Readmissions Reduction Program (HRRP) has been credited with lowering risk-adjusted readmission rates for targeted conditions at general acute care hospitals. However, these reductions appear to be illusory or overstated. This is because a... View Details
Keywords: Readmission Rates; Hospitals; Acute Care Hospitals; Medicare; Myocardial Infarction; Heart Failure; Health Care and Treatment
Ody, Christopher, Lucy Msall, Leemore S. Dafny, David Grabowski, and David Cutler. "Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated." Health Affairs 38, no. 1 (January 2019): 36–43.
- 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
Huckman, Robert S., and Brian W. Powers. "CareMore Health System (B)." Harvard Business School Supplement 618-009, August 2017.
- October 2013 (Revised October 2016)
- Case
Steward Health Care System
By: Robert F. Higgins and Noah Fisher
Steward Health has raised private equity and has converted from not-for-profit to for-profit. The case describes its Accountable Care Organization (ACO) and asks whether it should continue this experiment. View Details
Keywords: Accountable Care Organization; ACO; Medicare; Medicaid; Medical Services; Cerberus; Caritas; Health Care Policy; Health Care Industry; Provider Organizations; Health Care and Treatment; Health Industry; United States
Higgins, Robert F., and Noah Fisher. "Steward Health Care System." Harvard Business School Case 814-029, October 2013. (Revised October 2016.)
- 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
Hawkins, David F. "Caterpillar, Inc. (A)." Harvard Business School Case 111-031, January 2011. (Revised September 2011.)
- March 2021 (Revised July 2021)
- Case
Aledade
By: Regina E. Herzlinger, Samyukta Mullangi and Nicholas Samonas
To truly supercharge growth, should Aledade take a step back and focus on product development? View Details
- 08 Jun 2015
- Working Paper Summaries
Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending
- August 2022 (Revised January 2023)
- Case
Icario Health: AI to Drive Health Engagement
By: David C. Edelman
Icario Health has built a market-leading artificial intelligence (AI) engine to help health insurers drive better health behaviors for their members, enabling the insurers to improve their Medicare performance. View Details
Keywords: Marketing; Health Care and Treatment; AI and Machine Learning; Health Industry; United States
Edelman, David C. "Icario Health: AI to Drive Health Engagement." Harvard Business School Case 523-025, August 2022. (Revised January 2023.)
- 19 Feb 2013
- News
The Coming Failure of 'Accountable Care'
- April 2008 (Revised May 2008)
- Case
Commonwealth Care Alliance: Elderly and Disabled Care
By: Michael E. Porter and Jennifer F Baron
Individuals enrolled in both Medicare and Medicaid, known as dual eligibles, are among the highest-cost beneficiaries in the US. Commonwealth Care Alliance, a small nonprofit insurer and care delivery system in Massachusetts, operated under a public demonstration... View Details
Keywords: Programs; Public Sector; Alliances; Policy; Age; Service Delivery; Value; Health Care and Treatment; Welfare; Insurance Industry; Health Industry; Massachusetts
Porter, Michael E., and Jennifer F Baron. "Commonwealth Care Alliance: Elderly and Disabled Care." Harvard Business School Case 708-502, April 2008. (Revised May 2008.)