Publications

February 2021 (Revised June 2021)
Case

Brainlab: Imaging a MedTech Future

By: Regina E. Herzlinger, Gregory P. Licholai and Federica Gabrieli

Can Brainlab, a privately held firm, compete with giants like Medtronic and Amazon in delivering the Digital Operating Room of the future? The CEO is pondering solutions for secure exchange of medical information, pricing a new robotic imaging device, and reorganizing... View Details

2021
Working Paper

Kidney Exchange: An Operations Perspective

By: Itai Ashlagi and Alvin E. Roth

Many patients in need of a kidney transplant have a willing but incompatible (or poorly matched) living donor. Kidney exchange programs arrange exchanges among such patient-donor pairs, in cycles and chains of exchange, so each patient receives a compatible kidney.... View Details

Keywords: Kidney Exchange Programs; Health Disorders; Health Care and Treatment; Programs; Design

2021
Working Paper

The Health Costs of Cost-Sharing

By: Amitabh Chandra, Evan Flack and Ziad Obermeyer

We use the design of Medicare’s prescription drug benefit program to demonstrate three facts about the health consequences of cost-sharing. First, we show that an as-if-random increase of 33.6% in out-of-pocket price (11.0 percentage points (p.p.) change in... View Details

Keywords: Cost-sharing; Impact; Health Care and Treatment; Insurance; Health; Consumer Behavior

January 2021
Case

Value-Based Insurance Design at Onex

By: Joshua Schwartzstein, Amitabh Chandra and Amram Migdal

The operating executives of Health and Benefits for Onex Partners, Megan Jackson Frye and Sam Camens, faced a challenge: Healthcare costs for employees of Onex’s portfolio companies were continuing to rise above the consumer price index, reflecting broader trends... View Details

December 9, 2020
Article

Give Employees Cash to Purchase Their Own Insurance

By: Regina E. Herzlinger and Barak D. Richman

Employers’ and employees’ health care costs continue to skyrocket. A solution is to allow employers to give employees pre-tax cash to purchase their own health insurance. This move, enabled by a newly enacted federal rule, would put competitive pressure on insurers,... View Details

Keywords: Health Insurance; Health Care and Treatment; Insurance; Employees; Government Legislation

November 2020
Teaching Note

DayTwo: Going to Market with Gut Microbiome

By: Ayelet Israeli

Teaching Note for HBS Case No. 519-010. DayTwo is a young Israeli startup that applies research on the gut microbiome and machine learning algorithms to deliver personalized nutritional recommendations to its users in order to minimize blood sugar spikes after meals.... View Details

November 2020 (Revised April 2021)
Case

Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care

By: Trevor Fetter and Kira Seiger

This case describes the increasing investment by private equity (PE) firms in patient care and other healthcare services. The case focuses on investments in physician staffing firms and roll-up strategy investments in physician practice management (PPM). Included in... View Details

October 2020
Article

The Elasticity of Science

By: Kyle Myers

This paper identifies the degree to which scientists are willing to change the direction of their work in exchange for resources. Data from the National Institutes of Health are used to estimate how scientists respond to targeted funding opportunities. Inducing a... View Details

Keywords: Scientists; Funding; Research; Change

September 2, 2020
Article

How to Pay for Public Option Without Tax Hike

By: Regina E. Herzlinger and Richard Boxer

A bipartisan combination of the two parties’ most popular initiatives can expand health care coverage, significantly reduce costs, and enable freedom of choice, without raising taxes. Along the way, we can revitalize competition between public and private plans. Our... View Details

Keywords: Health Insurance; Public Option; Health Care and Treatment; Insurance; Cost Management; United States

Article

Do We Spend Too Much on Health Care?

By: Katherine Baicker and Amitabh Chandra

Health system reforms—such as changes in insurance design, patient cost sharing, payment reform, or price regulation—should be judged by whether they move us toward higher-value use of resources, rather than by whether they reduce spending. View Details

Keywords: Health Care and Treatment; Cost; Governing Rules, Regulations, and Reforms; Value Creation

August 14, 2020
Comment

How Has COVID-19 Affected Health Insurance Offered by Small Businesses in the U.S.? Early Evidence from a Survey

By: Leemore S. Dafny, Yin Wei Soon, Zoë Cullen and Christopher T. Stanton

As the COVID-19 pandemic stretches toward its third quarter, loss of health insurance coverage has not figured prominently in the public debate. Data in this report demonstrate why that is, but also suggest that the apparent stability is fragile, with potentially... View Details

Keywords: Health Pandemics; Health Care and Treatment; Insurance; Small Business; Surveys; United States

June 30, 2020
Article

Bipartisan Tax-Free Solution to Health Care Financing: Coupling HRAs With a Public Option

By: Regina E. Herzlinger, Richard Boxer and James Wallace

A combination of health insurance initiatives by the presumptive 2020 Democratic and Republican presidential nominees could expand health care coverage and significantly reduce costs, without raising taxes. Along the way, the combination could revitalize private... View Details

Keywords: Health Care Financing; Public Option; Health Reimbursement Arrangement (HRA); Health Care and Treatment; Insurance; Cost Management

June 2020 (Revised October 2020)
Case

Muddy Waters vs. eHealth: The Debate of a 'Lifetime'

By: Jonas Heese and Cristo Liautaud

In May 2020, an analyst was assessing eHealth’s performance. eHealth was an online / tele-sales broker of health insurance products. The stock had recently hit all-time highs, closing at a peak of $146 on March 4, 2020. But now, May 4, 2020, eHealth traded at $103. The... View Details

Keywords: Revenue Recognition; Health; Insurance; Online Technology; Insurance Industry

Article

Treatment Of Opioid Use Disorder Among Commercially Insured U.S. Adults, 2008–17

By: Karen Shen, Eric Barrette and Leemore S. Dafny

There is abundant literature on efforts to reduce opioid prescriptions and misuse, but comparatively little on the treatment provided to people with opioid use disorder (OUD). Using claims data representing 12–15 million nonelderly adults covered through commercial... View Details

Keywords: Opioid Treatment; Medication-assisted Treatment; Substance Use Disorder; Private Insurance; Health Disorders; Health Care and Treatment; Insurance; United States

May 21, 2020
Editorial

Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?

By: Leemore S. Dafny and J. Michael McWilliams

Primary care clinicians are the front line for patients with suspected infection. We rely on them to diagnose, triage, and manage patients with potential or confirmed COVID infections. They are also responsible for keeping non-COVID medical conditions under control... View Details

Keywords: COVID-19; Primary Care; Health Pandemics; Health Care and Treatment; Financial Condition; Insurance

2020
Working Paper

Paying It Backward and Forward: Expanding Access to Convalescent Plasma Therapy Through Market Design

By: Scott Duke Kominers, Parag A. Pathak, Tayfun Sönmez and M. Utku Ünver

COVID-19 convalescent plasma (CCP) therapy is currently a leading treatment for COVID-19. At present, there is a shortage of CCP relative to demand. We develop and analyze a model of centralized CCP allocation that incorporates both donation and distribution. In order... View Details

Keywords: COVID-19; Convalescent Plasma; Vouchers; Health Pandemics; Health Care and Treatment; Resource Allocation; Market Design

February 2020 (Revised June 2020)
Case

From Cradle to Heaven: Taikang Insurance Group

By: William C. Kirby, Shu Lin, John P. McHugh and Yuanzhuo Wang

Taikang Insurance Group was a leading Chinese insurance and financial services institution. It operated in the insurance, asset management, and health and senior care industries. Due to China’s underdeveloped social welfare state, Taikang saw an opportunity for the... View Details

Keywords: Health; Insurance; Strategy; Insurance Industry; China

January 2, 2020
Article

Changes in Quality of Care After Hospital Mergers and Acquisitions

By: Nancy Dean Beaulieu, Leemore S. Dafny, B. E. Landon, Jesse Dalton, Ifedayo Kuye and J. Michael McWilliams

Background: The hospital industry has consolidated substantially during the past two decades and at an accelerated pace since 2010. Multiple studies have shown that hospital mergers have led to higher prices for commercially insured patients, but research about effects... View Details

Keywords: Hospitals; Mergers and Acquisitions; Health Care and Treatment; Quality

January 2, 2020
Article

Medicare for All or Public Option: Can Either Heal Health Care?

By: Regina E. Herzlinger and James Wallace

The United States has serious health care problems: More than 27 million uninsured people, costs that are growing faster than income, and a staggering $37 trillion of unfunded liabilities in the Medicare program. Perhaps most alarming: The US ranks lowest among... View Details

Keywords: Healthcare; Public Option; Medicare; Health Care and Treatment; Insurance; Cost Management; Problems and Challenges; United States