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January 19, 2024
Article

Value-Based Health Care Can Transform the Treatment of Patients with Substance Use Disorder

By: Robert S. Kaplan and Sarah E. Wakeman

U.S. overdose deaths currently exceed 100,000 per year. New facilities, known as bridge clinics, are broadening access to high-quality care by offering outpatient substance use disorder (SUD) treatment with few access barriers. But many of the critical services offered... View Details

Keywords: Health Care and Treatment; Cost; Adoption

January 2024
Article

A Cost Model for a Low Threshold Clinic Treating Opioid Use Disorder

By: Sarah E. Wakeman, Elizabeth Powell, Syed Shehab, Grace Herman, Laura Kehoe and Robert S. Kaplan

The US fee-for-service payment system under-reimburses clinics offering access to comprehensive treatments for opioid use disorder (OUD). The funding shortfall limits a clinic’s ability to expand and improve access, especially for socially marginalized patients with... View Details

Keywords: Health Care and Treatment; Cost; Equality and Inequality; Health Industry

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January 2024
Article

Cost of Exempting Sole Orphan Drugs from Medicare Negotiation

By: Matthew Vogel, Olivia Zhao, William B. Feldman, Amitabh Chandra, Aaron S. Kesselheim and Benjamin N. Rome

Importance: The Inflation Reduction Act (IRA) requires Medicare to negotiate prices for some high-spending drugs but exempts drugs approved solely for the treatment of a single rare disease.
Objective: To estimate Medicare spending and global... View Details

Keywords: Health Care and Treatment; Insurance; Price; Health Industry

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January–February 2024
Article

Shared Service Delivery Can Increase Client Engagement: A Study of Shared Medical Appointments

By: Ryan W. Buell, Kamalini Ramdas, Nazlı Sönmez, Kavitha Srinivasan and Rengaraj Venkatesh

Problem Definition: Clients and service providers alike often consider one-on-one service delivery to be ideal, assuming – perhaps unquestioningly – that devoting individualized attention best improves client outcomes. In contrast, in shared service delivery, clients... View Details

Keywords: Health Care and Treatment; Customer Satisfaction; Outcome or Result; Performance Improvement

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December 2023
Article

Association of Hospital System Affiliation with COVID-19 Capacity Burden

By: Zachary Levin, Pinar Karaca-Mandic, Richard J. Boxer and Regina E. Herzlinger

What is the message? The COVID-19 pandemic exposed the highly variable and uncoordinated responses by hospitals. The authors found that while the non-top ten system affiliated hospitals had a larger COVID-19 share index relative to independent hospitals, top-ten system... View Details

Keywords: COVID-19 Pandemic; Resource Allocation; Health Pandemics; Demographics; Health Care and Treatment; Health Industry

2023
Working Paper

Healthcare Provider Bankruptcies

By: Samuel Antill, Jessica Bai, Ashvin Gandhi and Adrienne Sabety

Healthcare firms are increasingly filing for Chapter 11 bankruptcy. Using two strategies, we show causal evidence that bankruptcies harm patients through increased worker turnover. First, in an online experiment, experienced nurses assess hypothetical employers and... View Details

Keywords: Insolvency and Bankruptcy; Health Care and Treatment; Outcome or Result; Retention; Health Industry

October 2023
Case

Hey Jane: Delivering Abortion Pills to the Doorstep

By: Rembrand Koning, Geraldine Pena-Galea and Sarah Mehta

This case tells the story of Hey Jane, a telehealth clinic founded in 2020 that provides virtual medication abortion services to eligible patients in nine U.S. states. By January 2023, the company had served more than 20,000 patients and raised nearly $10 million in... View Details

Keywords: Operations; Business Startups; Health Care and Treatment; Growth and Development Strategy; Health Industry; Technology Industry; United States

2023
Working Paper

Are Hospital Quality Indicators Causal?

By: Amitabh Chandra, Maurice Dalton and Douglas O. Staiger

Hospitals play a key role in patient outcomes and spending, but efforts to improve their quality are hindered because we do not know whether hospital quality indicators are causal or biased. We evaluate the validity of commonly used quality indicators, such as... View Details

Keywords: Quality; Health Care and Treatment; Measurement and Metrics; Outcome or Result; Health Industry

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October 2023
Article

Health System Perspective on Cost for Delivering a Decision Aid for Prostate Cancer Using Time-Driven Activity-Based Costing

By: David R. Ho, Robert S. Kaplan, Jonathan Bergman, David F. Penson, Benjamin Waterman, Kristin C. Williams, Jefersson Villatoro, Lorna Kwan and Christopher S. Saigal

Previsit decision aids (DAs) have been shown to improve decisional quality. But the cost to deploy a DA has not been previously estimated. We interviewed or observed relevant personnel at three institutions that had implemented DA programs for men with prostate cancer.... View Details

Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost Accounting; Health Industry

September 2023
Teaching Note

Roche: ESG and Access to Healthcare

By: George Serafeim

Teaching Note for HBS Case No. 123-075. In May 2022, Roche Group, one of the largest healthcare companies in the world, hosted its first ESG investor event focused exclusively on its efforts to impact access to healthcare. While Roche had recently set an ambitious goal... View Details

Keywords: ESG; Access To Care; Healthcare; Healthcare Access; Innovation; Social Impact; Affordable; Health Care and Treatment; Innovation and Invention; Product Development; Resource Allocation; Corporate Social Responsibility and Impact; Health Industry

October 2023
Article

What Does the Inflation Reduction Act Mean for Patients and Physicians?

By: Amitabh Chandra and Benedic Ippolito

The debate around prescription drug measures in the recently passed U.S. Inflation Reduction Act (IRA), which limit some patients’ out-of-pocket costs, has not fully addressed their effect on physicians and patients via their effect on payers. Reducing patients’ costs... View Details

Keywords: Government Legislation; Price; Health Care and Treatment

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2023
Article

Evidence from the First Shared Medical Appointments (SMAs) Randomised Controlled Trial in India: SMAs Increase the Satisfaction, Knowledge, and Medication Compliance of Patients with Glaucoma

By: Nazlı Sönmez, Kavitha Srinivasan, Rengaraj Venkatesh, Ryan W. Buell and Kamalini Ramdas

In Shared Medical Appointments (SMAs), patients with similar conditions meet the physician together and each receives one-on-one attention. SMAs can improve outcomes and physician productivity. Yet privacy concerns have stymied adoption. In physician-deprived nations,... View Details

Keywords: Health Care and Treatment; Customer Satisfaction; Outcome or Result; India

June 2023
Supplement

Roche: ESG and Access to Healthcare

By: George Serafeim

In May 2022, Roche Group, one of the largest healthcare companies in the world, hosted its first ESG investor event focused exclusively on its efforts to impact access to healthcare. While Roche had recently set an ambitious goal to double the number of patients that... View Details

3 Jun 2023
Talk

Health Care Innovation Opportunities Created by COVID-19 and How to Make Them Happen

By: Regina E. Herzlinger

The crush of patients created by COVID enabled the creation of sites for care outside the traditional hospital, such as retail pharmacies, ambulatory surgery centers, urgent care centers, telemedicine, and wireless sensors. Public policy mirrored these changes by... View Details

Keywords: Policy; Health Pandemics; Health Care and Treatment; Innovation and Invention; Health Industry; Insurance Industry

March 2023
Case

Roche: ESG and Access to Healthcare

By: George Serafeim, Susanna Gallani and Benjamin Maletta

In May 2022, Roche Group, one of the largest healthcare companies in the world, hosted its first ESG investor event focused exclusively on its efforts to impact access to healthcare. While Roche had recently set an ambitious goal to double the number of patients that... View Details

2023
Article

Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital

By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk

The COVID-19 pandemic raised awareness of the need to better understand where and how patient-level costs are incurred in health care organizations. This study used time-driven activity-based costing to estimate COVID-19 patient-level hospital costs in a Brazilian... View Details

Keywords: Health Care and Treatment; Cost; Health Industry; Brazil

2023
Article

A Randomized Trial of Behavioral Nudges Delivered through Text Messages to Increase Influenza Vaccination among Patients with an Upcoming Primary Care Visit

By: Mitesh S. Patel, Katherine L. Milkman, Linnea Gandhi, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Seung Hyeong Lee, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth

Purpose: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates.
Design: Randomized, controlled trial.
Setting: Two health systems in the Northeastern US between September 2020 and... View Details

Keywords: Vaccination; Health Care and Treatment; Interpersonal Communication; Communication Technology; Behavior; Health Industry

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2023
Book

Workplace Conditions

By: Jill Maben, Jane Ball and Amy C. Edmondson

This Element reviews the evidence for three workplace conditions that matter for improving quality and safety in healthcare: staffing; psychological safety, teamwork, and speaking up; and staff health and well-being at work. The authors propose that these are... View Details

Keywords: Working Conditions; Outcome or Result; Safety; Well-being; Health Industry

January 2023
Case

Cleave Therapeutics: Taking a Risk on Oncology Drug Discovery

By: Regina Herzlinger and Brian Walker

What should a successful executive (HBS Baker Scholar) assess as her next move as the CEO of a firm with a promising and yet uncertain new drug? Amy Burroughs’ mandate to successfully commercialize Cleave Therapeutics’ drug for a cancer with no current successful... View Details

Keywords: Product Development; Leadership; Health Testing and Trials; Research and Development; Risk and Uncertainty; Financial Condition; Partners and Partnerships; Pharmaceutical Industry

January 2023
Teaching Note

Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care

By: Robert S. Kaplan

This Teaching Note was prepared to aid classroom instructors in the use of "Brigham and Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care," HBS Case No. 122-010. View Details

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