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      • January 2018
      • Case

      Partners In Health: Costing Primary Care in Haiti

      By: Robert S. Kaplan and Mahek A. Shah
      Partners in Health, a global NGO focused on delivering health care to residents of rural underserved communities, conducts a project on the cost of primary care at five sites in the Central Highlands of Haiti. It devises a simple approach for tracking the resources... View Details
      Keywords: Global Health; Public Health; Health Care and Treatment; Activity Based Costing and Management; Cost Accounting; Rural Scope; Health Industry; Haiti
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      Kaplan, Robert S., and Mahek A. Shah. "Partners In Health: Costing Primary Care in Haiti." Harvard Business School Case 118-051, January 2018.
      • January 2018
      • Article

      Innovation Incentives and Biomarkers

      By: Ariel Dora Stern, Brian M. Alexander and Amitabh Chandra
      Previously, we have discussed the importance of economic incentives in shaping markets for precision medicines. Here we consider incentives for biomarker development, including discovery and establishment. Biomarkers can reveal valuable information regarding diagnosis... View Details
      Keywords: Health Care and Treatment; Innovation and Invention; Research and Development; Markets
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      Stern, Ariel Dora, Brian M. Alexander, and Amitabh Chandra. "Innovation Incentives and Biomarkers." Clinical Pharmacology & Therapeutics 103, no. 1 (January 2018): 34–36.
      • Article

      TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear

      By: Robert S. Kaplan, Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller and John I. Lowenstein
      Purpose  To perform a cost analysis comparison for managing common ocular disorders in an eye emergency department (ED) versus an urgent care setting using a time-driven activity-based cost model (TDABC) to assist physicians and staff in appropriate allocation of... View Details
      Keywords: Time-driven Activity-based Cost Model; Emergency Room; Urgent Care Clinic; Cost; Analysis; Activity Based Costing and Management; Health Care and Treatment
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      Kaplan, Robert S., Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller, and John I. Lowenstein. "TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear." Journal of Academic Ophthalmology 10 (2018).
      • January 2018
      • Article

      The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial

      By: Leslie K. John, Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein and Kevin Volpp
      Purpose: We tested the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally-available weight management program.
      Design: A randomized trial tested the impact of employer subsidy: 100%; 80% 50% and a hybrid 50% subsidy... View Details
      Keywords: Affordable Care Act (ACA); Subsidies; Weight Loss; Obesity; Incentives; Behavioral Economics; Motivation and Incentives; Behavior; Health Disorders; Health Care and Treatment; Compensation and Benefits; United States
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      John, Leslie K., Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein, and Kevin Volpp. "The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial." American Journal of Health Promotion 32, no. 1 (January 2018): 170–176.
      • December 2017 (Revised April 2018)
      • Case

      The Children's Hospital of Philadelphia: Network Strategy 2016

      By: Michael E. Porter, Thomas W. Feeley and Toyin J. Okanlawon
      Children’s Hospital of Philadelphia (CHOP) began as a stand-alone hospital in the heart of downtown Philadelphia in 1855. By 2016 the CHOP Care Network stretched across Pennsylvania, New Jersey, and the New York metropolitan area, providing a wide range of services... View Details
      Keywords: Communication; Health Care and Treatment; Service Delivery; Organizational Structure; Networks; Integration; Strategy; Health Industry; Philadelphia
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      Porter, Michael E., Thomas W. Feeley, and Toyin J. Okanlawon. "The Children's Hospital of Philadelphia: Network Strategy 2016." Harvard Business School Case 718-420, December 2017. (Revised April 2018.)
      • Article

      (Mis)perceptions of Inequality

      By: Oliver P. Hauser and Michael I. Norton
      Inequality is arguably the defining societal issue of the 21st century. The debate over “who gets what’ underlies policy debates ranging from taxation to health care to wages and permeates society at all levels, attracting increasing interest from policymakers,... View Details
      Keywords: Equality and Inequality; Wealth and Poverty; Perception; Society; Policy
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      Hauser, Oliver P., and Michael I. Norton. "(Mis)perceptions of Inequality." Special Issue on Inequality and Social Class. Current Opinion in Psychology 18 (December 2017): 21–25.
      • December 2017
      • Article

      Overall Cost Comparison of Gastrointestinal Endoscopic Procedures with Endoscopist- or Anesthesia-Supported Sedation by Activity-Based Costing Techniques

      By: Richard A. Helmers, James A. Dilling, Christopher R. Chaffee, Mark V. Larson, Bradly J. Narr, Derek A. Haas and Robert S. Kaplan
      Endoscopic/Colonoscopic procedures are done either with gastroenterologist-administered conscious sedation or with anesthesia-administered sedation with propofol. Anesthesia-administered sedation has medical and patient benefits but is more expensive to administer. We... View Details
      Keywords: Health Care and Treatment; Cost; Activity Based Costing and Management
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      Helmers, Richard A., James A. Dilling, Christopher R. Chaffee, Mark V. Larson, Bradly J. Narr, Derek A. Haas, and Robert S. Kaplan. "Overall Cost Comparison of Gastrointestinal Endoscopic Procedures with Endoscopist- or Anesthesia-Supported Sedation by Activity-Based Costing Techniques." Mayo Clinic Proceedings: Innovations, Quality & Outcomes 1, no. 3 (December 2017): 234–241.
      • November 2017
      • Article

      A Retrospective Analysis of Hypertension Screening at a Mass Gathering in India: Implications for Non-communicable Disease Control Strategies

      By: S. Balsari, P. Vemulapalli, M. Gofine, K. Oswal, R. Merchant, S. Saunik, G. Greenough and T. Khanna
      Cardiovascular disease is the leading cause of mortality from noncommunicable diseases (NCD) in India. The government’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke seeks to increase capacity building, screening,... View Details
      Keywords: Health Disorders; Health Care and Treatment; Problems and Challenges; India
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      Balsari, S., P. Vemulapalli, M. Gofine, K. Oswal, R. Merchant, S. Saunik, G. Greenough, and T. Khanna. "A Retrospective Analysis of Hypertension Screening at a Mass Gathering in India: Implications for Non-communicable Disease Control Strategies." Journal of Human Hypertension 31, no. 11 (November 2017): 750–753.
      • 2017
      • Working Paper

      Identifying Sources of Inefficiency in Health Care

      By: Amitabh Chandra and Douglas O. Staiger
      In medicine, the reasons for variation in treatment rates across hospitals serving similar patients are not well understood. Some interpret this variation as unwarranted and push standardization of care as a way of reducing allocative inefficiency. However, an... View Details
      Keywords: Health Care and Treatment; Performance Efficiency; Performance Productivity; Mathematical Methods
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      Chandra, Amitabh, and Douglas O. Staiger. "Identifying Sources of Inefficiency in Health Care." NBER Working Paper Series, No. 24035, November 2017.
      • Article

      The IT Transformation Health Care Needs

      By: Nikhil R. Sahni, Robert S. Huckman, Anuraag Chigurupati and David M. Cutler
      In recent years, health care organizations have made sizable investments in information technology. They’ve used their IT systems to replace paper records with electronic ones and to improve billing processes, thereby boosting revenue. But so far, IT has been of little... View Details
      Keywords: Health Care and Treatment; Information Technology; Performance Improvement; Business Model
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      Sahni, Nikhil R., Robert S. Huckman, Anuraag Chigurupati, and David M. Cutler. "The IT Transformation Health Care Needs." Harvard Business Review 95, no. 6 (November–December 2017): 128–136.
      • October 5, 2017
      • Article

      Making Patients and Doctors Happier—The Potential of Patient-Reported Outcomes

      By: Lisa Rotenstein, Robert S. Huckman and Neil Wagle
      Keywords: Health Care; Outcomes Measurement; Outcomes Reporting; Quality; Health Industry
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      Rotenstein, Lisa, Robert S. Huckman, and Neil Wagle. "Making Patients and Doctors Happier—The Potential of Patient-Reported Outcomes." New England Journal of Medicine 377, no. 14 (October 5, 2017): 1309–1312.
      • Article

      Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT

      By: Jonathan G. Rogg, Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang and Benjamin White
      Study objectives: Facing increased utilization and subsequent capacity and budget constraints, EDs must better understand bottlenecks and their effect on process flow to improve process efficiency. The primary objective of this study was to identify bottlenecks in... View Details
      Keywords: Health Care; Bottleneck; Health Care and Treatment; Operations; Health Industry; United States
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      Rogg, Jonathan G., Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang, and Benjamin White. "Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT." American Journal of Emergency Medicine 35, no. 10 (October 2017): 1510–1513.
      • 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; Health Industry; Utah; United States; North America
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      Hamermesh, Richard G., Kathy E. Giusti, Robert S. Huckman, and Julia Kelley. "Intermountain Healthcare: Pursuing Precision Medicine." Harvard Business School Case 818-018, September 2017. (Revised February 2023.)
      • Article

      Narrow Networks on the Health Insurance Marketplaces: Prevalence, Pricing, and the Cost of Network Breadth

      By: Leemore S. Dafny, Igal Hendel, Victoria Marone and Christopher Ody
      Anecdotal reports and systematic research highlight the prevalence of narrow-network plans on the Affordable Care Act’s health insurance Marketplaces. At the same time, Marketplace premiums in the period 2014–2016 were much lower than projected by the Congressional... View Details
      Keywords: Health Care and Treatment; Insurance; Cost; United States
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      Dafny, Leemore S., Igal Hendel, Victoria Marone, and Christopher Ody. "Narrow Networks on the Health Insurance Marketplaces: Prevalence, Pricing, and the Cost of Network Breadth." Health Affairs 36, no. 9 (September 2017).
      • September 2017
      • Article

      Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers

      By: Robert S. Kaplan, Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam and Christopher J. Hartnick
      Time-driven activity-based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic... View Details
      Keywords: Time-Driven Activity-Based Costing; Activity Based Costing and Management; Health Care and Treatment
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      Kaplan, Robert S., Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam, and Christopher J. Hartnick. "Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers." The Laryngoscope 127, no. 9 (September 2017).
      • August 2017
      • Case

      Infection Control at Massachusetts General Hospital (Abridged)

      By: Robert S. Huckman and Nikolaos Trichakis
      The case explores the challenges facing Massachusetts General Hospital concerning the adoption of a new infection control policy, which promises to improve operational performance, patient safety, and profitability. The new policy requires coordination between... View Details
      Keywords: Safety; Organizational Change and Adaptation; Integration; Health Care and Treatment; Policy; Health Industry; Boston
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      Huckman, Robert S., and Nikolaos Trichakis. "Infection Control at Massachusetts General Hospital (Abridged)." Harvard Business School Case 618-018, August 2017.
      • August 2017
      • Teaching Note

      Health Stop (A) and (B)

      By: Regina Herzlinger
      Teaching Note for HBS Nos. 185-084 and 196-051. View Details
      Keywords: Health Care; Health; Health Industry
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      Herzlinger, Regina. "Health Stop (A) and (B)." Harvard Business School Teaching Note 318-047, August 2017.
      • August 2017 (Revised July 2018)
      • Case

      MannKind Corporation: Take a Deep Breath, This Time Afrezza Will Work

      By: Elie Ofek and Amanda Dai
      In June 2014, MannKind Corporation announced that after years of development and billions of dollars in expenses, the FDA had finally approved its drug, Afrezza. MannKind would thus be the only company with an inhalable insulin on the market. As an alternative to... View Details
      Keywords: Health Care and Treatment; Product Launch; Product Positioning; Marketing Strategy; Adoption; Pharmaceutical Industry
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      Ofek, Elie, and Amanda Dai. "MannKind Corporation: Take a Deep Breath, This Time Afrezza Will Work." Harvard Business School Case 518-031, August 2017. (Revised July 2018.)
      • 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.
      • 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.
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