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  • All HBS Web  (3,400)
    • People  (10)
    • News  (974)
    • Research  (1,698)
    • Events  (6)
    • Multimedia  (34)
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  • Article

Workplace Stressors & Health Outcomes: Health Policy for the Workplace

By: Joel Goh, Jeffrey Pfeffer and Stefanos A. Zenios
Extensive research focuses on the causes of workplace-induced stress. However, policy efforts to tackle the ever-increasing health costs and poor health outcomes in the United States have largely ignored the health effects of psychosocial workplace stressors such as... View Details
Keywords: Occupational Health; Mortality; Stress; Meta-analysis; Health
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Goh, Joel, Jeffrey Pfeffer, and Stefanos A. Zenios. "Workplace Stressors & Health Outcomes: Health Policy for the Workplace." Behavioral Science & Policy 1, no. 1 (Spring 2015): 43–52.
  • 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).
  • 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.
  • November 2004 (Revised September 2019)
  • Background Note

The U.S. Health Club Industry in 2004

By: John R. Wells, Gabriel Ellsworth and Benjamin Weinstock
In 2004, the $16.8 billion U.S. health club industry continued its strong record of growth. There were almost 27,000 health clubs in the United States, up from 6,700 two decades earlier, and these clubs claimed 41 million members, over 14% of the U.S. population.... View Details
Keywords: Health Clubs; Fitness; Gyms; Chain; Weight Loss; Obesity; Exercise; Personal Training; Bally Total Fitness; 24 Hour Fitness; YMCA; Gold's Gym; Curves; Franchise; Franchising; Subscription; Promotional Sales; Promotions; Fixed Costs; Body; Accrual Accounting; Revenue Recognition; Buildings and Facilities; Business Growth and Maturation; Business Model; For-Profit Firms; Trends; Customers; Demographics; Age; Income; Private Equity; Financing and Loans; Profit; Revenue; Geographic Scope; Multinational Firms and Management; Health; Nutrition; Business History; Employees; Retention; Human Capital; Working Conditions; Contracts; Business or Company Management; Goals and Objectives; Growth and Development Strategy; Markets; Demand and Consumers; Supply and Industry; Industry Growth; Industry Structures; Operations; Service Operations; Franchise Ownership; Private Ownership; Public Ownership; Problems and Challenges; Sales; Salesforce Management; Situation or Environment; Opportunities; Nonprofit Organizations; Welfare; Sports; Strategy; Business Strategy; Competition; Competitive Strategy; Consolidation; Corporate Strategy; Customization and Personalization; Expansion; Segmentation; Hardware; Health Industry; United States
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Wells, John R., Gabriel Ellsworth, and Benjamin Weinstock. "The U.S. Health Club Industry in 2004." Harvard Business School Background Note 705-445, November 2004. (Revised September 2019.)
  • 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
  • 05 May 2016
  • Cold Call Podcast

The Real Cost of Ignoring Mental Health in the Workplace

Keywords: Re: John A. Quelch
  • 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.
  • 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).
  • 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

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.
  • 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 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.
  • 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.
  • 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.
  • 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).
  • 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.)
  • 2019
  • Working Paper

Thinking Outside the Box (12): The Benefits of Increased Transparency in Employer-Sponsored Health Insurance for the 180 Million Insured

By: Regina E. Herzlinger and Barak D. Richman
Economists have long noted that the tax exclusion of employer-sponsored insurance (ESI) caused workers to purchase health plans that differ in price and other characteristics from those they would otherwise choose for themselves. We explore the short-term and long-term... 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; Income; Equality and Inequality; Taxation; Policy; United States
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Herzlinger, Regina E., and Barak D. Richman. "Thinking Outside the Box (12): The Benefits of Increased Transparency in Employer-Sponsored Health Insurance for the 180 Million Insured." Duke Law School Public Law & Legal Theory Series, No. 2020-4, December 2019.
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