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August 2010 (Revised March 2012)
Case

The UCLA Medical Center: Kidney Transplantation

By: Michael E. Porter, Jennifer F Baron, Jacob Mathew Chacko and Robin Jian Tang

In 2010, organ transplantation remained among the few sets of medical conditions in the U.S. for which bundled payments were a dominant reimbursement model, and for which patient health outcomes were universally measured and reported. In 1986, UCLA Medical Center was... View Details

Keywords: Insurance; Health Care and Treatment; Health Disorders; Measurement and Metrics; Outcome or Result; Competitive Strategy; Integration; Health Industry; California

October 2015 (Revised July 2017)
Case

OMV Petrom: Investment as Partnership—When It Takes Three to Tango

By: Dante Roscini, Emer Maloney and Daniela Beyersdorfer

Petrom was privatized by the Romanian state in 2004 and acquired by Austrian oil company OMV, with the state retaining a 20.6% stake in the company. The situation was particularly challenging for the foreign investor since the sector in which the company operated was... View Details

Keywords: Partners and Partnerships; Privatization; Acquisition; Foreign Direct Investment; Cross-Cultural and Cross-Border Issues; Business and Government Relations; Energy Industry; Austria; Romania

November 10, 2020
Article

Value-Based Health Care in Four Different Health Care Systems

By: Mjåset Christer, Umar Ikram, Navraj S. Nagra and Thomas W. Feeley

Health care systems across the world have increasingly embraced a value-based health care (VBHC) agenda. They do so for different reasons, using different foundations, and variations on the tools and tactics to effect their strategic goals. The role of governments,... View Details

Keywords: Value-based Health Care; Comparative Analysis; Health Care and Treatment; Value; Global Range; Performance Improvement

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2022
Article

Rapid Growth of Remote Patient Monitoring Is Driven by a Small Number of Primary Care Providers

By: Mitchell Tang, Ateev Mehrotra and Ariel Dora Stern

Growing enthusiasm for remote patient monitoring has been motivated by the hope that it can improve care for patients with poorly controlled chronic illness. In a national commercially insured population in the U.S., we found that billing for remote patient monitoring... View Details

Keywords: Remote Monitoring; Medical Billing; Health Care Costs; Telehealth; Diabetes; Chronic Disease; Insurance Claims; Diseases; Primary Care Providers; COVID-19 Pandemic; Health Care and Treatment; Insurance; Cost; Health Industry; United States

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Other Article

Want to See the Future of Digital Health Tools? Look to Germany

By: Ariel Dora Stern, Henrik Matthies, Julia Hagen, Jan B. Brönneke and Jörg F. Debatin

A new law will make it easier to introduce and determine the benefits of new tools. Perhaps its most important provisions are its formalization of “prescribable applications,” which include standard software, SaaS, and mobile as well as browser-based apps, and the... View Details

Keywords: Health Care and Treatment; Transformation; Internet and the Web; Technological Innovation; Germany

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Article

Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

By: Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman

The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with... View Details

Keywords: Health Care and Treatment; Cost Management; Insurance; Problems and Challenges

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Working Paper

Rebates in the Pharmaceutical Industry: Evidence from Medicines Sold in Retail Pharmacies in the U.S.

By: Pragya Kakani, Michael Chernew and Amitabh Chandra

Rising list prices are often used to illustrate the burden of prescription drug spending, but payers routinely negotiate rebates from manufacturers that generate differences between list and net prices. List prices are easily available and affect patient cost-sharing,... View Details

Keywords: Pharmaceuticals; Rebates; Health Care and Treatment; Markets; Price; Analysis; Pharmaceutical Industry

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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

April 2008
Case

Ophthalmic Consultants of Boston and Dr. Bradford J. Shingleton (2004)

By: H. Kent Bowen and Marcelo Pancotto

Dr. Bradford Shingleton has developed some of the highest quality eye surgery techniques in the industry. He involves his nurses and technicians in creating a surgical service that is constantly improving. The case has many details about how Dr. Shingleton works with... View Details

Keywords: Health Care and Treatment; Independent Innovation and Invention; Service Operations; Performance Productivity; Practice; Problems and Challenges; Health Industry; Boston

Teaching Interest

Overview

By: Leemore S. Dafny

U.S. Healthcare Strategy

The U.S. healthcare sector accounts for 17 percent of GDP, and encompasses a diverse set of industries with public, nonprofit, and for-profit buyers and sellers. There are significant concerns about high and rising spending, and... View Details

Keywords: Healthcare; Health; Healthcare Reform; Life Sciences; Health Industry; United States

July 2024
Article

Mass General Brigham’s Patient-Reported Outcomes Measurement System: A Decade of Learnings

By: Jason B. Liu, Robert S. Kaplan, David W. Bates, Mario O. Edelen, Rachel C. Sisodia and Andrea L. Pusic

This article describes the strategies that leaders at the Mass General Brigham (MGB) health system have used in launching a standardized patient-reported outcome measure (PROM) collection program in 2012, a major step in the value-based transformation of health care.... View Details

Keywords: Patient-reported Outcomes; Value Based Health Care; Health Care and Treatment; Transformation; Outcome or Result; Organizational Change and Adaptation; Performance Improvement; Health Industry

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March 2015
Teaching Note

CVS Health: Promoting Drug Adherence

By: Leslie John, John Quelch and Robert Huckman

Email mking@hbs.edu for a courtesy copy.

This Teaching Note explains the theory of the case and teaching plan for the case: CVS Health: Promoting Drug Adherence (515010). The case finds Helena Foulkes, Executive... View Details

09 Aug 2016
First Look

August 9, 2016

when launching a new technology venture, the strategic complexities of multi-layer distribution channels, difficulties attaining reimbursement from third-party payers (particularly Medicare), and valuation issues when significant capital... View Details

Keywords: Sean Silverthorne

November 2023 (Revised April 2024)
Case

BiomX: Bringing Phage Back to the Stage

By: Paul A. Gompers, Elie Ofek, Orna Dan and Emilie Billaud

In the spring of 2023, and following the favorable results of a trial involving its phage cocktail for treating lung infections among cystic fibrosis (CF) patients, the leadership of BiomX had several critical issues to wrestle with. First, given its precarious... View Details

Keywords: Working Capital; Financing and Loans; Health Testing and Trials; Product Development; Research and Development; Science-Based Business; Commercialization; Biotechnology Industry; Pharmaceutical Industry

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

Article

Health App Policy: International Comparison of Nine Countries' Approaches

By: Anna Essén, Ariel Dora Stern, Christoffer Bjerre Haase, Josip Car, Felix Greaves, Dragana Paparova, Steven Vandeput, Rik Wehrens and David W. Bates

An abundant and growing supply of digital health applications (apps) exists in the commercial tech-sector, which can be bewildering for clinicians, patients, and payers. A growing challenge for the health care system is therefore to facilitate the identification of... View Details

Keywords: Digital Health; Apps; Health Care and Treatment; Internet and the Web; Policy; Global Range; Applications and Software

31 Mar 2023
Research & Ideas

Can a ‘Basic Bundle’ of Health Insurance Cure Coverage Gaps and Spur Innovation?

would make payments to health care providers on a risk-adjusted per-enrolled basis instead of a fee-for-service basis—as a tool to mitigate risks involved with centralized pricing and rate-setting. Evidence suggests that capitation can drive View Details

Keywords: by Kasandra Brabaw; Insurance; Health

22 Aug 2022
Research & Ideas

Can Amazon Remake Health Care?

First, the supply chain in health care is a mess. There are so many intermediaries selling to other people, and Amazon has done extremely well by streamlining the supply chain. So they must be thinking that the current insurers and other View Details

Keywords: by Christina Pazzanese, Harvard Gazette; Health

2024
Working Paper

Does Private Equity Have Any Business Being in the Health Care Business?

By: Nori Gerardo Lietz and Zirui Song

Private Equity (“PE”) has come under increased scrutiny by the press, academics, and policymakers, as well as the public, for its investments in health care delivery. This scrutiny has been exacerbated by recent high profile hospital bankruptcies following PE... View Details

Keywords: Private Equity; Government Administration; Acquisition; Health Industry

12 Jul 2004
Research & Ideas

Michael Porter’s Prescription For the High Cost of Health Care

becomes the engine of progress and reform. Improvement feeds on itself. For that process to begin, however, the locus of competition has to shift from "Who pays?" to "Who provides the best value?" Getting there will require changes in the strategies... View Details

Keywords: by Michael E. Porter; Health

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