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  • 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.)
  • 2023
  • Working Paper

Achieving Universal Health Insurance Coverage in the United States: Addressing Market Failures or Providing a Social Floor?

By: Katherine Baicker, Amitabh Chandra and Mark Shepard
The United States spends substantially more on health care than most developed countries, yet leaves a greater share of the population uninsured. We suggest that incremental insurance expansions focused on addressing market failures will propagate inefficiencies and... View Details
Keywords: Public Sector; Insurance; Health Care and Treatment; Policy; Innovation and Invention
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Baicker, Katherine, Amitabh Chandra, and Mark Shepard. "Achieving Universal Health Insurance Coverage in the United States: Addressing Market Failures or Providing a Social Floor?" NBER Working Paper Series, No. 30854, January 2023.
  • 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.
  • 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
  • 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.
  • 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.)
  • 2010
  • Chapter

Consumer-Driven Universal Health Care is the Best Solution

By: Regina E. Herzlinger
The best way to achieve universal health insurance coverage is to implement a consumer-controlled system rather than a government-controlled system. View Details
Keywords: Health Care and Treatment; Insurance; Customers; System
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Herzlinger, Regina E. "Consumer-Driven Universal Health Care is the Best Solution." In Current Controversies: Health Care, edited by Noel Merino. Farmington Hills, MI: Greenhaven Press, 2010.
  • December 1980 (Revised June 2006)
  • Case

University Health Services: Walk-In Clinic

The walk-in clinic for general outpatient care at a major university experiences complaints about excessive waiting times. The system is changed to provide for initial screening of arriving patients in order to route them to appropriate health care providers. The... View Details
Keywords: Organizational Change and Adaptation; Service Delivery; Health Care and Treatment; Performance Evaluation; Health Industry
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Maister, David H., Shauana Doyle, and Rocco Pigneri. "University Health Services: Walk-In Clinic." Harvard Business School Case 681-061, December 1980. (Revised June 2006.)
  • June 15, 2021
  • Article

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
President Joe Biden’s promise to give every American access to affordable health insurance is well-intentioned, but his plan’s policy elements—a public option, a permanent expanded tax credit—require congressional approval and would expend significant political and... View Details
Keywords: Health Insurance; Health Insurance Marketplaces; Health Care Delivery; Health Care Financing; Health Care Industry; Health Care and Treatment; Insurance; Service Delivery; Cost Management; Health Industry; United States
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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." Health Affairs Blog (June 15, 2021).
  • 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.)
  • November 2013 (Revised January 2015)
  • Case

Obamacare

By: Matthew Weinzierl and Katrina Flanagan
One vote in June, 2012, decided the fate of President Barack Obama's crowning first-term achievement: universal health insurance. Chief Justice John Roberts of the U.S. Supreme Court cast the deciding vote to uphold the keystone of the reform: the mandate to purchase... View Details
Keywords: Universal Health Insurance; Adverse Selection; Leviathan; Courts and Trials; Judgments; Insurance; Health Care and Treatment; Government and Politics; Insurance Industry; Insurance Industry; Insurance Industry; United States
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Weinzierl, Matthew, and Katrina Flanagan. "Obamacare." Harvard Business School Case 714-029, November 2013. (Revised January 2015.)
  • 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

A health insurance crisis may be looming for employees of small businesses, with many firms struggling to cover their share of these costs, new research from Harvard Business School finds. Nearly one-third... View Details
Keywords: by Rachel Layne; Health
  • 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).
  • 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.
  • 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.
  • 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
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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.)
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