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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.)
      • 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
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      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.
      • 2019
      • Chapter

      Teams and Team Effectiveness in Health Services Organizations

      By: Bruce J. Fried and Amy C. Edmondson
      Book Abstract: Completely updated to address the challenges faced by modern health care organizations, this edition of Shortell and Kaluzny's Health Care Management: Organization Design and Behavior offers a more global perspective on how the United States and... View Details
      Keywords: Groups and Teams; Performance Effectiveness; Health; Health Industry
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      Fried, Bruce J., and Amy C. Edmondson. "Teams and Team Effectiveness in Health Services Organizations." Chap. 5 in Shortell & Kaluzny's Health Care Management: Organization Design and Behavior. 7th ed., edited by Lawton Robert Burns, Elizabeth H. Bradley, and Bryan Jeffrey Weiner, 98–131. Boston, MA: Cengage Learning, 2019.
      • December 2018 (Revised July 2023)
      • Case

      Instituto Dara: Breaking the Cycle of Poverty and Illness at Scale

      By: Julie Battilana, Marissa Kimsey, Priscilla Zogbi and Johanna Mair
      Dr. Vera Cordeiro founded the NGO Instituto Dara in 1991 to help poor families break the cycle of poverty and illness in Brazil. She and her team of employees and volunteers developed a holistic methodology to address the multidimensional sources of poverty based on... View Details
      Keywords: Social Innovation; NGO; Scaling; Health; Social Enterprise; Social Entrepreneurship; Non-Governmental Organizations; Health Care and Treatment; Poverty; Health Industry; South America; Brazil
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      Battilana, Julie, Marissa Kimsey, Priscilla Zogbi, and Johanna Mair. "Instituto Dara: Breaking the Cycle of Poverty and Illness at Scale." Harvard Business School Case 419-048, December 2018. (Revised July 2023.)
      • November 2018
      • Case

      David Hysong and SHEPHERD Therapeutics

      By: Ananth Raman, John Masko and Aldo Sesia
      In 2016, David Hysong, at age 27, found out he had a rare, incurable cancer. Rather than wait around to die, Hysong, a recent graduate of Harvard Divinity School, decided to launch a biotechnology company called Shepherd Therapeutics to development treatments for his... View Details
      Keywords: Cancer; Therapeutics; Drugs; Health Care and Treatment; Business Startups; Product Development; Financing and Loans; Growth and Development Strategy; Problems and Challenges
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      Raman, Ananth, John Masko, and Aldo Sesia. "David Hysong and SHEPHERD Therapeutics." Harvard Business School Case 619-012, November 2018.
      • Article

      Operational Efficiency and Effective Management in the Catheterization Laboratory

      By: Grant W. Reed, Michael L. Tushman and Samir R. Kapadia
      Operational efficiency is a core business principle in which organizations strive to deliver high-quality goods or services in a cost-effective manner. This concept has become increasingly relevant to cardiac catheterization laboratories, as insurers move away from... View Details
      Keywords: Cath Lab; Catheterization Laboratory; Health Care and Treatment; Performance Efficiency; Management; Performance Productivity; Cost Management; Health Industry
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      Reed, Grant W., Michael L. Tushman, and Samir R. Kapadia. "Operational Efficiency and Effective Management in the Catheterization Laboratory." Journal of the American College of Cardiology 72, no. 20 (November 20, 2018): 2507–2517.
      • 2018
      • Chapter

      The Orphan Drug Act at 35: Observations and an Outlook for the Twenty-First Century

      By: Nicholas Bagley, Benjamin Berger, Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern
      On the 35th anniversary of the adoption of the Orphan Drug Act (ODA), we describe the enormous changes in the markets for therapies for rare diseases that have emerged over recent decades. The most prominent example is the fact that the profit-maximizing price of new... View Details
      Keywords: Health Care and Treatment; Laws and Statutes; Research and Development; Investment; Markets; Monopoly
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      Bagley, Nicholas, Benjamin Berger, Amitabh Chandra, Craig Garthwaite, and Ariel Dora Stern. "The Orphan Drug Act at 35: Observations and an Outlook for the Twenty-First Century." Chap. 4 in Innovation Policy and the Economy, Volume 19, edited by Josh Lerner and Scott Stern, 97–137. University of Chicago Press, 2018.
      • October 2018 (Revised April 2019)
      • Teaching Note

      Kids & Company: Entering the U.S.

      By: Boris Groysberg and Matthew G. Preble
      Teaching Note for HBS No. 418-011. View Details
      Keywords: Child Care; Childcare; Day Care; Daycare; Strategy; Growth Management; Business Strategy; Competitive Advantage; Expansion; Leadership; Product Marketing; Brands and Branding; Service Delivery; Service Operations; Product Design; Product Development; Selection and Staffing; Customer Focus and Relationships; United States; Canada
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      Groysberg, Boris, and Matthew G. Preble. "Kids & Company: Entering the U.S." Harvard Business School Teaching Note 419-002, October 2018. (Revised April 2019.)
      • October 2018 (Revised August 2019)
      • Case

      Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?

      By: Leemore Dafny
      In July 2017, CEO Kevin Tabb of Boston's Beth Israel Deaconess Medical Center announced his plan to consolidate 11 Massachusetts hospitals under a common management structure. These hospitals collectively generated $5 billion in patient revenue and 25% of... View Details
      Keywords: Beth Israel Deaconess; Lahey; Partners; Health Care; Hospitals; Payers; Providers; Anti-trust; Health Care Regulation; Mergers and Acquisitions; Health Care and Treatment; Market Design; Duopoly and Oligopoly; Negotiation; Consolidation; Competition; Health Industry; Massachusetts; Boston
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      Dafny, Leemore. "Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?" Harvard Business School Case 319-026, October 2018. (Revised August 2019.)
      • October 2018
      • Case

      Fundraising at St. Camillus Hospital

      By: Srikant M. Datar and Caitlin N. Bowler
      St. Camillus is a fictional non-profit hospital in rural Maine facing a serious budget deficit. As Director of Marketing, Victoria Stern is building a team to modernize the hospital fundraising efforts. An interview with a promising candidate, who is also a digital... View Details
      Keywords: Data Analysis; Data Privacy; Data Governance; Non-profit; Health Care; Fundraising; Data Security; Analytics and Data Science; Safety; Governance; Ethics; Health Care and Treatment; Cybersecurity
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      Datar, Srikant M., and Caitlin N. Bowler. "Fundraising at St. Camillus Hospital." Harvard Business School Case 119-027, October 2018.
      • Article

      Lessons from Mayo Clinic's Redesign of Stroke Care

      By: Robert S. Kaplan, W. David Freeman, Kevin M. Barrett, Lisa Nordan, Aaron C. Spaulding and Meredith Karney
      Facing escalating costs of medications and technology, health care patients and providers in the United States continue to search for opportunities to reduce overall costs while maintaining and improving health care outcomes. The Mayo Clinic Comprehensive Stroke Center... View Details
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      Kaplan, Robert S., W. David Freeman, Kevin M. Barrett, Lisa Nordan, Aaron C. Spaulding, and Meredith Karney. "Lessons from Mayo Clinic's Redesign of Stroke Care." Special Issue on HBR Insight Center: The Future of Health Care. Harvard Business Review (website) (October 2018).
      • October 2018 (Revised April 2019)
      • Case

      The Brigham and Women's Hospital Innovation Hub: Driving Internal Innovation

      By: Ariel D. Stern and Robert S. Huckman
      Keywords: Healthcare; Innovation; Hospital; Health; Health Care
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      Stern, Ariel D., and Robert S. Huckman. "The Brigham and Women's Hospital Innovation Hub: Driving Internal Innovation." Harvard Business School Case 619-026, October 2018. (Revised April 2019.)
      • September 2018 (Revised December 2019)
      • Case

      Zebra Medical Vision

      By: Shane Greenstein and Sarah Gulick
      An Israeli startup founded in 2014, Zebra Medical Vision developed algorithms that produced diagnoses from X-rays, mammograms, and CT-scans. The algorithms used deep learning and digitized radiology scans to create software that could assist doctors in making... View Details
      Keywords: Radiology; Machine Learning; X-ray; CT Scan; Medical Technology; Probability; FDA 510(k); Diagnosis; Business Startups; Health Care and Treatment; Information Technology; Applications and Software; Competitive Strategy; Product Development; Commercialization; Decision Choices and Conditions; Health Industry; Health Industry; Health Industry; Israel
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      Greenstein, Shane, and Sarah Gulick. "Zebra Medical Vision." Harvard Business School Case 619-014, September 2018. (Revised December 2019.)
      • September 2018
      • Article

      Discretionary Task Ordering: Queue Management in Radiological Services

      By: Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats
      Work-scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks... View Details
      Keywords: Discretion; Scheduling; Queue; Healthcare; Learning; Experience; Decentralization; Operations; Service Operations; Service Delivery; Performance; Performance Effectiveness; Performance Efficiency; Performance Improvement; Performance Productivity; Decisions; Time Management; Cost vs Benefits; Health Industry
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      Ibanez, Maria, Jonathan R. Clark, Robert S. Huckman, and Bradley R. Staats. "Discretionary Task Ordering: Queue Management in Radiological Services." Management Science 64, no. 9 (September 2018): 4389–4407. (Working paper available here. Winner of the 2017 Best Paper Competition of the POMS College of Healthcare Operations Management. Featured in Forbes, Quartz, and Inc.)
      • August 2018 (Revised August 2019)
      • Case

      Oscar Health Insurance: What Lies Ahead for a Unicorn Insurance Entrant?

      By: Leemore Dafny and Victoria Marone
      Keywords: Oscar Insurance; Fintech; US Health Care; Affordable Care Act (ACA); Health Insurance Marketplaces; Insurer Competition; Provider Consolidation; Market Entry; Health Care and Treatment; Entrepreneurship; Market Entry and Exit; Negotiation; Growth Management; Health Industry; Health Industry; New York (state, US); New Jersey
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      Dafny, Leemore, and Victoria Marone. "Oscar Health Insurance: What Lies Ahead for a Unicorn Insurance Entrant?" Harvard Business School Case 319-025, August 2018. (Revised August 2019.)
      • August 2018 (Revised February 2023)
      • Case

      Hubble Contact Lenses: Data Driven Direct-to-Consumer Marketing

      By: Jill Avery and Ayelet Israeli
      As its Series A extension round approaches, the founders of Hubble, a subscription-based, social-media fueled, direct-to-consumer (DTC) brand of contact lenses, are reflecting on the marketing strategies that have taken them to a valuation of $200 million and debating... View Details
      Keywords: DTC; Direct To Consumer Marketing; Health Care; Mobile; Attribution; Experimentation; Experiments; Churn/retention; Customer Lifetime Value; Internet Marketing; Big Data; Analytics; A/B Testing; CRM; Advertising; Marketing; Marketing Channels; Marketing Strategy; Media; Brands and Branding; Marketing Communications; Digital Marketing; Consumer Behavior; Acquisition; Growth and Development Strategy; Customer Focus and Relationships; Social Media; E-commerce; Analytics and Data Science; Health Industry; Health Industry; United States; North America; Europe
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      Avery, Jill, and Ayelet Israeli. "Hubble Contact Lenses: Data Driven Direct-to-Consumer Marketing." Harvard Business School Case 519-011, August 2018. (Revised February 2023.)
      • July 2018
      • Case

      Ce Soir-Là, Ils n'Arrivent Plus Un par Un, Mais par Vagues: Coping with the Surge of Trauma Patients at L'Hôpital Universitaire La Pitié Salpêtrière—Friday, November 13, 2015

      By: Herman B. "Dutch" Leonard, Emilie Billaud and Arnold M. Howitt
      On November 13, 2015, Dr. Marie Borel, Dr. Emmanuelle Dolla, Dr. Frédéric Le Saché, and Professor Mathieu Raux were the doctors in charge of the trauma center at L’Hôpital de la Pitié Salpêtrière in Paris, where dozens of wounded and dying patients, most with severe... View Details
      Keywords: Health Care and Treatment; Crisis Management; Performance Capacity; Decision Making; Leadership; Health Industry; Europe; France; Paris
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      Leonard, Herman B. "Dutch", Emilie Billaud, and Arnold M. Howitt. "Ce Soir-Là, Ils n'Arrivent Plus Un par Un, Mais par Vagues: Coping with the Surge of Trauma Patients at L'Hôpital Universitaire La Pitié Salpêtrière—Friday, November 13, 2015." Harvard Business School Case 319-032, July 2018.
      • July 2018
      • Article

      Reimagining Health Data Exchange: An Application Programming Interface-Enabled Roadmap for India

      By: Satchit Balsari, Alexander Fortenko MD, MPH, Joaquin A. Blaya PhD, Adrian Gropper MD, Malavika Jayaram LLM, Rahul Matthan LLM, Ram Sahasranam, Mark Shankar MD, Suptendra N. Sarbadhikari PhD, Barbara Bierer, Kenneth D. Mandl MD, Sanjay Mehendale MD, MPH and Tarun Khanna
      In February 2018, the Government of India announced a massive public health insurance scheme extending coverage to 500 million citizens, in effect making it the world’s largest insurance program. To meet this target, the government will rely on technology to... View Details
      Keywords: Health Information Exchange; India; Health APIs; Health Care and Treatment; Information; Analytics and Data Science; Information Technology; Health Industry; India
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      Balsari, Satchit, Alexander Fortenko MD, MPH, Joaquin A. Blaya PhD, Adrian Gropper MD, Malavika Jayaram LLM, Rahul Matthan LLM, Ram Sahasranam, Mark Shankar MD, Suptendra N. Sarbadhikari PhD, Barbara Bierer, Kenneth D. Mandl MD, Sanjay Mehendale MD, MPH, and Tarun Khanna. "Reimagining Health Data Exchange: An Application Programming Interface-Enabled Roadmap for India." Journal of Medical Internet Research 20, no. 7 (July 2018).
      • July–August 2018
      • Article

      When Technology Gets Ahead of Society

      By: Tarun Khanna
      New technologies can be unsettling for industry incumbents, regulators, and consumers, because norms and institutions for dealing with them don’t yet exist. Interestingly, businesspeople in emerging economies face similar challenges: The rules are unclear and... View Details
      Keywords: Technological Innovation; Society; Situation or Environment; Infrastructure; Entrepreneurship; Performance Effectiveness; Cooperation
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      Khanna, Tarun. "When Technology Gets Ahead of Society." Harvard Business Review 96, no. 4 (July–August 2018): 86–95.
      • June 2018
      • Supplement

      Amil and the Health Care System in Brazil (B)

      By: Regina Herzlinger, Ana Maria Malik, Ruth Costas and Priscilla Zogbi
      Brazilian Managed Care Organization Amil faces a series of challenges while trying to redefine the terms of its relationship with hospitals and clinics and to implement a new health care model based on primary care and family medicine. View Details
      Keywords: Health Care; Brazil; Managed Care; Innovation; Health Care Industry; Health Care and Treatment; Health; Cost Management; Innovation and Invention; Competitive Strategy; Health Industry; Health Industry; Brazil
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      Herzlinger, Regina, Ana Maria Malik, Ruth Costas, and Priscilla Zogbi. "Amil and the Health Care System in Brazil (B)." Harvard Business School Supplement 318-149, June 2018.
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