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  • January 2020
  • Article

Using Time-Driven Activity-Based Costing to Demonstrate Value in Perioperative Care: Recommendations and Review from the Society for Perioperative Assessment and Quality Improvement

By: O. Allin, R. D. Urman, A. F. Edwards, J. D. Blitz, K. J. Pfeifer, T. W. Feeley and A. M. Bader
A shift in health care payment models from volume toward value-based incentives will require deliberate input into systems development from both perioperative clinicians and administrators to ensure appropriate recognition of the value of all services... View Details
Keywords: Value-based Health Care; Outcomes; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost Management; Value; Activity Based Costing and Management
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Allin, O., R. D. Urman, A. F. Edwards, J. D. Blitz, K. J. Pfeifer, T. W. Feeley, and A. M. Bader. "Using Time-Driven Activity-Based Costing to Demonstrate Value in Perioperative Care: Recommendations and Review from the Society for Perioperative Assessment and Quality Improvement." Journal of Medical Systems 44, no. 1 (January 2020).
  • 12 Jul 2004
  • Research & Ideas

Michael Porter’s Prescription For the High Cost of Health Care

claims. This practice, known as "re-underwriting," negates the purpose of health insurance and must be eliminated. Fewer Lawsuits. Malpractice litigation and the associated defensive medical practices inflict huge View Details
Keywords: by Michael E. Porter; Health
  • 24 Jan 2014
  • Other Presentation

Value Based Health Care Delivery

By: Michael E. Porter
According to Harvard professor Michael Porter, health care reform is proving to be one of the defining issues of the 21st century, both in the United States and throughout the world. Costs are exploding even in single-payer systems driven by aging populations and... View Details
Keywords: Health Care; Service Delivery; Value; Health Care and Treatment; Health Industry
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Porter, Michael E. "Value Based Health Care Delivery." Harvard Kennedy School, Center for Public Leadership, Cambridge, MA, January 24, 2014.
  • April 2016 (Revised May 2016)
  • Case

Hôpital Universitaire de Mirebalais, Partners In Health in Haiti

By: Robert S. Kaplan, Bipin Mistry and Karla Bertrand
The case describes the application of Time-Driven Activity-Based Costing (TDABC) at a new tertiary hospital, operated by Partners in Health in Mirebelais, Haiti. A project team mapped the clinical processes for use in estimating the direct costs of personnel,... View Details
Keywords: Time-Driven Activity-Based Costing; Activity Based Costing and Management; Cost Accounting; Developing Countries and Economies; Health Care and Treatment; Health Industry; Haiti
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Kaplan, Robert S., Bipin Mistry, and Karla Bertrand. "Hôpital Universitaire de Mirebalais, Partners In Health in Haiti." Harvard Business School Case 116-041, April 2016. (Revised May 2016.)
  • Article

Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center

By: Robert S. Kaplan, Yoshimi Anzai, Marta E. Heilbrun, Derek Haas, Luca Boi, Kirk Moshre, Satoshi Minoshima and Vivian S. Lee
The lack of understanding the true costs (not charges) of delivering health care services poses tremendous challenges in the containment of health care costs. In this study, we applied an established cost accounting method, time-driven activity-based costing (TDABC),... View Details
Keywords: Healthcare Costs; Medical Imaging; Computed Tomography; Activity-Based Costing; Cost Accounting; Activity Based Costing and Management; Health Care and Treatment; Performance Efficiency; Health Industry
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Kaplan, Robert S., Yoshimi Anzai, Marta E. Heilbrun, Derek Haas, Luca Boi, Kirk Moshre, Satoshi Minoshima, and Vivian S. Lee. "Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center." Academic Radiology 24, no. 2 (February 2017): 200–208.
  • Article

Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?

By: R. S. Kaplan, F. Erhun, V.G. Narayanan, B. Mistry and K. Brayton, et al
We use time-driven activity-based costing to estimate the cost of personnel and space for an elective coronary artery bypass graft (CABG) surgery at two U.S. hospitals, Intermountain and Baylor Heart, and Narayana Health (NH), in India. All three hospitals use modern... View Details
Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Organizational Structure; Performance Efficiency; India; United States
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Kaplan, R. S., F. Erhun, V.G. Narayanan, B. Mistry, and K. Brayton, et al. "Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?" American Heart Journal 224 (June 2020): 148–155.
  • 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).
  • 05 May 2016
  • Cold Call Podcast

The Real Cost of Ignoring Mental Health in the Workplace

Keywords: Re: John A. Quelch
  • September 2014 (Revised March 2021)
  • Case

La Ribera Health Department (A)

By: Regina E. Herzlinger, Emer Moloney and Daniela Beyersdorfer
The La Ribera case studies depict an innovative low cost/high quality privately financed hospital model struggling to achieve alignment with the Six Factors. It is reimbursed by the public sector in a Spanish environment whose Consumers, Structure, and Public Policy... View Details
Keywords: Health Care; Health Care Financing; Health Care Industry; Health Care Operations; Health Care and Treatment; Operations; Business Model; Government and Politics; Programs; Innovation Strategy; Vertical Integration; Health Industry; Europe; Spain
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Herzlinger, Regina E., Emer Moloney, and Daniela Beyersdorfer. "La Ribera Health Department (A)." Harvard Business School Case 315-006, September 2014. (Revised March 2021.)
  • September 2014
  • Article

Defining the Value of Proton Therapy Using Time-Driven Activity-Based Costing

By: N.G. Thaker, A.B. Guzman, Thomas W. Feeley, T.M. Jones, J.R. Incalcaterra, C. Kolom, S.J. Frank, L.S. Tatum, Ronald S. Walters, Scott B. Cantor, D.I. Rosenthal, A.S. Garden, G.B. Gunn, C.D. Fuller and M.B. Palmer
Technological innovations in radiation therapy (RT) have rapidly improved the quality of care for patients with head and neck cancer. Intensity-modulated proton therapy (MPT) holds promise of further improving outcomes compared with the current photon-based technique... View Details
Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Technological Innovation; Activity Based Costing and Management
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Thaker, N.G., A.B. Guzman, Thomas W. Feeley, T.M. Jones, J.R. Incalcaterra, C. Kolom, S.J. Frank, L.S. Tatum, Ronald S. Walters, Scott B. Cantor, D.I. Rosenthal, A.S. Garden, G.B. Gunn, C.D. Fuller, and M.B. Palmer. "Defining the Value of Proton Therapy Using Time-Driven Activity-Based Costing." Oncology Payers, no. 1 (September 2014): 22–28.
  • Winter 2019
  • Article

Value-based Health Care: Lessons for the Anesthesiologist

By: J.A. Martin, B.L. Potter, T.F. Flanagan and T.W. Feeley
At one point or another in our life, we all become consumers of the health care industry. Indeed, health care affects everyone and encompasses a diverse set of services from childbirth, to illness prevention, to the management of chronic disease and end-of-life care.... View Details
Keywords: Value-based Health Care; Anesthesiologists; Health Care and Treatment; Value; Cost Management; Problems and Challenges; Health Industry; United States
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Martin, J.A., B.L. Potter, T.F. Flanagan, and T.W. Feeley. "Value-based Health Care: Lessons for the Anesthesiologist." International Anesthesiology Clinics 57, no. 1 (Winter 2019): 63–80.
  • Article

Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

By: Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman
The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with... View Details
Keywords: Health Care and Treatment; Cost Management; Insurance; Problems and Challenges
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Tseng, Phillip, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah, and Kevin A. Schulman. "Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System." JAMA, the Journal of the American Medical Association 319, no. 7 (February 20, 2018): 691–697.
  • 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.)
  • September 2011
  • Other Article

How to Solve the Cost Crisis in Health Care

By: Robert S. Kaplan and Michael E. Porter
Keywords: Health
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Kaplan, Robert S., and Michael E. Porter. "How to Solve the Cost Crisis in Health Care." Harvard Business Review 89, no. 9 (September 2011): 47–64.
  • September 2023
  • Article

The Health Costs of Dirty Energy: Evidence from the Capacity Market in Colombia

By: Achyuta Adhvaryu, Theresa Molina, Anant Nyshadham, Jorge Tamayo and Nicholas Torres
The health effects of “dirty” (fossil fuel driven) energy production are difficult to measure accurately due to the endogeneity of fuel choice. We exploit an electricity policy in Colombia that generates a price-based trigger for the use of thermal energy sources.... View Details
Keywords: Pollution; Health Disorders; Energy Industry; Colombia
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Adhvaryu, Achyuta, Theresa Molina, Anant Nyshadham, Jorge Tamayo, and Nicholas Torres. "The Health Costs of Dirty Energy: Evidence from the Capacity Market in Colombia." Art. 103116. Journal of Development Economics 164 (September 2023).
  • Article

Navy Medicine Introduces Value-Based Health Care

By: Alee Hernandez, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III and Michael E. Porter
In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could... View Details
Keywords: Military Health System; Health Care and Treatment; Cost Management; Projects
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Hernandez, Alee, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III, and Michael E. Porter. "Navy Medicine Introduces Value-Based Health Care." Health Affairs 38, no. 8 (August 2019): 1393–1400.
  • Research Summary

Cost Management Systems

By: Robert S. Kaplan
Robert S. Kaplan continues to explore the design and use of activity-based cost management systems for manufacturing and service companies. His most recent work, done collaboratively with Professor Michael E. Porter, applies time-driven activity-based costing (TDABC)... View Details
  • March 2016
  • Article

Using Quality Improvement Methods and Time-Driven Activity-Based Costing to Improve Value-Based Cancer Care Delivery at a Cancer Genetics Clinic

By: R.Y. Tan, M. Met-Domestici, K. Zhou, A.B. Guzman, S.T. Lim, K.C. Soo, T.W. Feeley and J. Ngeow
Purpose:
To meet increasing demand for cancer genetic testing and improve value-based cancer care delivery, National Cancer Centre Singapore restructured the Cancer Genetics Service in 2014. Care delivery processes were redesigned. We sought to improve access by... View Details
Keywords: Cancer Treatment; Value Based Health Care; Time-Driven Activity-Based Costing; Health Care and Treatment; Quality; Performance Improvement; Activity Based Costing and Management
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Tan, R.Y., M. Met-Domestici, K. Zhou, A.B. Guzman, S.T. Lim, K.C. Soo, T.W. Feeley, and J. Ngeow. "Using Quality Improvement Methods and Time-Driven Activity-Based Costing to Improve Value-Based Cancer Care Delivery at a Cancer Genetics Clinic." Journal of Oncology Practice 12, no. 3 (March 2016): 320–331. (e-Pub 1/2016. PMID: 26759493.)
  • 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

Managing Healthcare Costs and Value

By: Robert S. Kaplan, Michael E. Porter and Mark L. Frigo
Rising health care costs are a major global challenge. A number of factors contribute to this trend, including aging populations and medical technology. But an underlying and misunderstood source of health care’s escalating costs has been the inability of health care... View Details
Keywords: Health Care and Treatment; Cost; Cost Management; Cost Accounting; Health Industry
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Kaplan, Robert S., Michael E. Porter, and Mark L. Frigo. "Managing Healthcare Costs and Value." Strategic Finance 98, no. 7 (January 2017): 24–33.
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