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    • Faculty Publications  (273)

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    • All HBS Web  (1,491)
      • Faculty Publications  (273)

      Health CostsRemove Health Costs →

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      • August, 2022
      • Article

      Billing and Insurance-Related Administrative Costs: A Cross-National Analysis

      By: Barak D. Richman, Robert S. Kaplan, Japees Kohli, Dennis Purcell, Mahek Shah, Igna Bonfrer, Brian Golden, Rosemary Hannam, Will Mitchell, Daniel Cehic, Garry Crispin and Kevin A. Schulman
      Billing and insurance-related costs are a significant source of wasteful health care spending in Organization for Economic Cooperation and Development nations, but these administrative burdens vary across national systems. We executed a microlevel accounting of these... View Details
      Keywords: Health Care Costs; Administrative Costs; Cost; Health Care and Treatment; Health Industry
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      Richman, Barak D., Robert S. Kaplan, Japees Kohli, Dennis Purcell, Mahek Shah, Igna Bonfrer, Brian Golden, Rosemary Hannam, Will Mitchell, Daniel Cehic, Garry Crispin, and Kevin A. Schulman. "Billing and Insurance-Related Administrative Costs: A Cross-National Analysis." Health Affairs 41, no. 8 (August, 2022): 1098–1106.
      • July 1, 2022
      • Editorial

      New Transparency Rule Helps Rein in Health Care Costs

      By: Regina E. Herzlinger and Cynthia A. Fisher
      Over the last year, consumer prices have grown 60% faster than wages. Employers can help their employees contend with this high inflation by addressing a long-running source: health care costs. View Details
      Keywords: Healthcare Costs; Consumer Prices; Inflation and Deflation; Wages; Health Industry
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      Herzlinger, Regina E., and Cynthia A. Fisher. "New Transparency Rule Helps Rein in Health Care Costs." Boston Herald (July 1, 2022).
      • Winter 2022
      • Article

      Determinants of Small Business Reopening Decisions After COVID Restrictions Were Lifted

      By: Dylan Balla-Elliott, Zoë B. Cullen, Edward L. Glaeser, Michael Luca and Christopher Stanton
      The COVID-19 pandemic led to dramatic economic disruptions, including government-imposed restrictions that temporarily shuttered millions of American businesses. We use a nation-wide survey of thousands of small business owners to establish three main facts about... View Details
      Keywords: COVID-19; Demand Forecasting; Reopening; Health Pandemics; Government Administration; Small Business
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      Balla-Elliott, Dylan, Zoë B. Cullen, Edward L. Glaeser, Michael Luca, and Christopher Stanton. "Determinants of Small Business Reopening Decisions After COVID Restrictions Were Lifted." Journal of Policy Analysis and Management 41, no. 1 (Winter 2022): 278–317.
      • July, 2022
      • Article

      Telehealth Visits After Shoulder Surgery: Higher Patient Satisfaction and Lower Costs

      By: Evan A. O'Donnell, Jillian E. Haberli, Andres Muniz Martinez, Daniel Yagoda, Robert S. Kaplan and Jon J.P. Warner
      Purpose and Methods: The study compared the cost of telemedicine visits with in-person clinic visits for routine follow-up after common shoulder surgeries. It also evaluated the safety and patient experience with telemedicine visits. Time-driven activity-based costing... View Details
      Keywords: Telehealth; Patient Satisfaction; Health Care and Treatment; Communication Technology; Health Industry
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      O'Donnell, Evan A., Jillian E. Haberli, Andres Muniz Martinez, Daniel Yagoda, Robert S. Kaplan, and Jon J.P. Warner. "Telehealth Visits After Shoulder Surgery: Higher Patient Satisfaction and Lower Costs." Journal of the American Academy of Orthopedic Surgeons Global Research and Reviews 6, no. 7 (July, 2022).
      • May 2022
      • Article

      Variance Analysis: New Insights from Health Care Applications

      By: Robert S. Kaplan and Susanna Gallani
      We use a health care application to illustrate how variance analysis can be used to benchmark costs across similar service delivery sites. Variances for personnel costs, typically the largest cost component in service organizations, are calculated for price, quantity,... View Details
      Keywords: Variance Analysis; Benchmarking; Time-Driven Activity-Based Costing; Health Care; Activity Based Costing and Management; Health Care and Treatment; Service Delivery; Service Industry
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      Kaplan, Robert S., and Susanna Gallani. "Variance Analysis: New Insights from Health Care Applications." Issues in Accounting Education 37, no. 2 (May 2022): 27–36.
      • 2022
      • Working Paper

      THEMIS: A Framework for Cost-Benefit Analysis of COVID-19 Non-Pharmaceutical Interventions

      By: Dimitris Bertsimas, Michael Lingzhi Li and Saksham Soni
      Since December 2019, the world has been ravaged by the COVID-19 pandemic, with over 150 million confirmed cases and 3 million confirmed deaths worldwide. To combat the spread of COVID-19, governments have issued unprecedented non-pharmaceutical interventions (NPIs),... View Details
      Keywords: COVID-19; Health Pandemics; Policy; Framework; Cost vs Benefits; Outcome or Result; United States; Germany; Brazil; Singapore; Spain
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      Bertsimas, Dimitris, Michael Lingzhi Li, and Saksham Soni. "THEMIS: A Framework for Cost-Benefit Analysis of COVID-19 Non-Pharmaceutical Interventions." Working Paper, April 2022.
      • February 8, 2022
      • Article

      Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions

      By: Alan Yang, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson and Robert S. Kaplan
      In 2017, patients made 145 million visits to emergency departments (EDs), generating $76.3 billion in charges. About a third of ED visits, however, were for conditions that were treatable in lower-resourced settings. We used time-driven activity-based costing (TDABC)... View Details
      Keywords: Time-Driven ABC; Health Care Costs; Activity Based Costing and Management; Health Care and Treatment
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      Yang, Alan, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson, and Robert S. Kaplan. "Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions." NEJM Catalyst (February 8, 2022).
      • Article

      Costs Without Value When Treating Pediatric Behavioral Patients in the ED

      By: Marcella Jewell, Syed S. Shehab, Robert S. Kaplan, Jack Fanton and Joeli Hettler
      Pediatric Emergency Department (ED) visits have greatly increased in recent years. An academic pediatric ED that annually treats about 1,000 behavioral health patients conducted a study to assess the true cost of caring for nonacute behavioral health patients. It... View Details
      Keywords: Costs; Value; Healthcare; Health Care and Treatment; Cost Management
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      Jewell, Marcella, Syed S. Shehab, Robert S. Kaplan, Jack Fanton, and Joeli Hettler. "Costs Without Value When Treating Pediatric Behavioral Patients in the ED." NEJM Catalyst Innovations in Care Delivery 3, no. 2 (February 2022).
      • 2022
      • Article

      Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing

      By: Nikhil G. Thaker, Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley and Steven J. Frank
      Integrated quality improvement (QI) and cost reduction strategies can help increase value in cancer care. We applied standard QI and TDABC methods to improve workflow efficiency and reduce costs for MRI-guided prostate brachytherapy. We constructed process maps,... View Details
      Keywords: Brachytherapy; Quality Improvement; Prostate; Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Performance Efficiency; Health Industry
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      Thaker, Nikhil G., Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley, and Steven J. Frank. "Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing." Brachytherapy 21, no. 1 (2022): 49–54.
      • January–February 2022
      • Article

      Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board

      By: Robert S. Kaplan, Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman and Michael-Anne Browne
      The U.S. Military Health System spends about $50 billion annually through its TRICARE health plans to provide care to 9.6 million active duty service members, retirees, and their families. TRICARE, historically, has used the predominant U.S. fee-for-service payment... View Details
      Keywords: Military Health System; Value-based Healthcare; Health Care and Treatment; United States
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      Kaplan, Robert S., Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman, and Michael-Anne Browne. "Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board." Military Medicine 187, nos. 1-2 (January–February 2022): 12–16.
      • Article

      Time-Driven Activity-Based Costing in Breast Cancer Care Delivery

      By: Navraj S. Nagra, Elena Tsangaris, Jessica Means, Michael J. Hassett, Laura S. Dominici, Jennifer R. Bellon, Justin Broyles, Robert S. Kaplan, Thomas W. Feeley and Andrea L. Pusic
      We used time-driven activity-based costing (TDABC) to calculate the complete cost of breast cancer care—initial treatment planning, chemotherapy, radiation therapy, surgical resection and reconstruction, and ancillary services (psychosocial oncology, physical therapy.... View Details
      Keywords: Healthcare; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost
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      Nagra, Navraj S., Elena Tsangaris, Jessica Means, Michael J. Hassett, Laura S. Dominici, Jennifer R. Bellon, Justin Broyles, Robert S. Kaplan, Thomas W. Feeley, and Andrea L. Pusic. "Time-Driven Activity-Based Costing in Breast Cancer Care Delivery." Annals of Surgical Oncology 29, no. 1 (January 2022): 510–521.
      • December 2021
      • Case

      Danish Crown: Feeding the Future

      By: David E. Bell, Damien P. McLoughlin, Daniela Beyersdorfer and Mette Fuglsang Hjortshoej
      Danish Crown, one of the world’s largest exporters of pork meat and one of Europe’s top five producers of beef, faced increasing headwinds in 2021, making CEO Jais Valeur feel like the core of the meat business was under attack. As a cooperative and prominent player in... View Details
      Keywords: Agribusiness; Animal-Based Agribusiness; Food; Environmental Management; Climate Change; Environmental Sustainability; Nutrition; Cooperative Ownership; Change Management; Transition; Leadership; Leading Change; Marketing; Product Marketing; Corporate Strategy; Agriculture and Agribusiness Industry; Food and Beverage Industry; Europe; Denmark
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      Bell, David E., Damien P. McLoughlin, Daniela Beyersdorfer, and Mette Fuglsang Hjortshoej. "Danish Crown: Feeding the Future." Harvard Business School Case 522-057, December 2021.
      • November–December 2021
      • Article

      Successfully Implementing TDABC in Health-Care Provider Organizations

      By: Susanna Gallani and Gregory Sabin
      This article describes some of the common obstacles that challenge the success of TDABC implementation in health-care provider organizations and suggests potential remedies and preventive measures. View Details
      Keywords: Time-Driven Activity-Based Costing; Implementation; Health Care and Treatment; Activity Based Costing and Management
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      Gallani, Susanna, and Gregory Sabin. "Successfully Implementing TDABC in Health-Care Provider Organizations." Cost Management 35, no. 6 (November–December 2021): 29–33. (Commissioned Article.)
      • November 2021
      • Article

      Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing

      By: Tyler R. McClintock, David F. Friedlander, Aiden Y. Feng, Mahek A. Shah, Daniel J. Pallin, Steven L. Chang, Angela M. Bader, Thomas W. Feeley, Robert S. Kaplan and George E. Haleblian
      Objective. To characterize full cycle of care costs for managing an acute ureteral stone using time-driven activity-based costing.
      Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
      Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Activity Based Costing and Management
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      McClintock, Tyler R., David F. Friedlander, Aiden Y. Feng, Mahek A. Shah, Daniel J. Pallin, Steven L. Chang, Angela M. Bader, Thomas W. Feeley, Robert S. Kaplan, and George E. Haleblian. "Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing." Urology 157 (November 2021): 107–113.
      • September 2021 (Revised October 2022)
      • Supplement

      Hester Pharmaceuticals (B): Securing Supply

      By: Dante Roscini and John Masko
      Supplements the (A) case. In late 2020, demand for Hester Pharmaceutical’s (Hester’s) breakthrough oncology drug Akrozumab was outstripping the company’s most optimistic projections. In order to increase manufacturing capacity and meet the demand, Hester was... View Details
      Keywords: COVID-19 Pandemic; Cost vs Benefits; Trade; Supply Chain; Global Strategy; Buildings and Facilities; Operations; Health Care and Treatment; Demand and Consumers; Global Range; Globalized Markets and Industries; Pharmaceutical Industry; Italy; China; United States; Germany
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      Roscini, Dante, and John Masko. "Hester Pharmaceuticals (B): Securing Supply." Harvard Business School Supplement 722-009, September 2021. (Revised October 2022.)
      • September 13, 2021
      • Article

      Managing Through Crunch Time—Without Burning Out Your Team

      By: Flavio Serapiao, Andrew Hill and Boris Groysberg
      Crunch times—the long, stressful hours of work that are often required in the final weeks before a new product launch—can have an inordinate impact on the success of businesses and they’re powerful shapers of organizational culture. Effective leaders understand that... View Details
      Keywords: Leadership; Situation or Environment; Management Skills
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      Serapiao, Flavio, Andrew Hill, and Boris Groysberg. "Managing Through Crunch Time—Without Burning Out Your Team." Harvard Business Review Digital Articles (September 13, 2021).
      • Article

      Supporting Value-Based Health Care—Aligning Financial and Legal Accountability

      By: Mark M. Zaki, Anupam B. Jena and Amitabh Chandra
      U.S. health care payment and delivery-system reforms have focused on improving care by making organizations accountable for outcomes, quality, and costs. Payers have supported the implementation of accountable care organizations (ACOs), bundled-payment models, and... View Details
      Keywords: Value-based Health Care; Accountability; Health Care and Treatment; United States
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      Zaki, Mark M., Anupam B. Jena, and Amitabh Chandra. "Supporting Value-Based Health Care—Aligning Financial and Legal Accountability." New England Journal of Medicine 385, no. 11 (September 9, 2021): 965–967.
      • Article

      A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal

      By: Jiayin Xue, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg and Kevin Schulman
      U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital... View Details
      Keywords: Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Health Industry; India; Nepal; United States
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      Xue, Jiayin, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg, and Kevin Schulman. "A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal." NEJM Catalyst Innovations in Care Delivery 2, no. 9 (September 2021).
      • Article

      Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected

      By: Maximilian J. Pany, Michael E. Chernew and Leemore S. Dafny
      Concern about high hospital prices for commercially insured patients has motivated several proposals to regulate these prices. Such proposals often limit regulations to highly concentrated hospital markets. Using a large sample of 2017 US commercial insurance claims,... View Details
      Keywords: Health Care Providers; Hospitals; Insurance Market Regulation; Price Regulation; Markets; Health Care and Treatment; Cost; Quality; Insurance; Price; Governing Rules, Regulations, and Reforms
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      Pany, Maximilian J., Michael E. Chernew, and Leemore S. Dafny. "Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected." Health Affairs 40, no. 9 (September 2021): 1386–1394.
      • July 2021 (Revised December 2021)
      • Case

      Pershing Square's Pandemic Trade (A)

      By: Emil N. Siriwardane, Luis M. Viceira, Dean Xu and Lucas Baker
      This case explores the decision that Bill Ackman, CEO and founder of the hedge fund Pershing Square Capital, was considering in late February 2020 about hedging the exposure of the fund’s portfolio from the potential financial fallout ensuing from an extreme event like... View Details
      Keywords: Health Pandemics; Financial Liquidity; Cost Management; Decision Choices and Conditions; Risk Management
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      Siriwardane, Emil N., Luis M. Viceira, Dean Xu, and Lucas Baker. "Pershing Square's Pandemic Trade (A)." Harvard Business School Case 222-007, July 2021. (Revised December 2021.)
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