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2019
Chapter

Characterizing the Drug Development Pipeline for Precision Medicines

By: Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern

BOOK ABSTRACT: Personalized and precision medicine (PPM)—the targeting of therapies according to an individual’s genetic, environmental, or lifestyle characteristics—is becoming an increasingly important approach in health care treatment and prevention. The advancement... View Details

Keywords: Healthcare; Precision Medicine

Article

Four Things No One Will Tell You About ESG Data

By: Sakis Kotsantonis and George Serafeim

As the ESG finance field and the use of ESG data in investment decision-making continue to grow, the authors seek to shed light on several important aspects of ESG measurement and data. This article is intended to provide a useful guide for the rapidly rising number of... View Details

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March 2019
Article

A Time-Driven Activity-Based Costing Analysis of Emergency Department Scribes

By: Robert S. Kaplan, Heather A. Heaton, David M. Nestler, William J. Barry, Richard A. Helmers, Mustafa Y. Sir, Deepi G. Goyal, Derek A. Haas and Annie T. Sadosty

Objectives: To apply time-driven activity-based costing (TDABC) methodology to determine emergency medicine physician documentation costs with and without scribes.

Methods: Two research assistants shadowed attending physicians for a total of 64 hours in the... View Details

Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Analysis

Article

Operational Efficiency and Effective Management in the Catheterization Laboratory

By: Grant W. Reed, Michael L. Tushman and Samir R. Kapadia

Operational efficiency is a core business principle in which organizations strive to deliver high-quality goods or services in a cost-effective manner. This concept has become increasingly relevant to cardiac catheterization laboratories, as insurers move away from... View Details

Keywords: Cath Lab; Catheterization Laboratory; Health Care and Treatment; Performance Efficiency; Management; Performance Productivity; Cost Management; Health Industry

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July 2018 (Revised January 2021)
Case

RunKeeper

By: Shikhar Ghosh and Shweta Bagai

The case examines the focus of an early stage company and how venture capital can distort a founder’s view. It encompasses issues such as financing, understanding the founders’ definition of success/failure, defining and pivoting a business model, and determining the... View Details

Keywords: Early Stage Funding; Pivot; Entrepreneurship; Venture Capital; Business Model; Health Industry

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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January 2018 (Revised July 2019)
Case

Big Apple Circus: Time to Fold the Tent?

By: David G. Fubini and Matthew Wiger

By 2016, the Big Apple Circus has weathered many storms in its 38 seasons as one of the most well-known New York City nonprofits. Will Weiss, the executive director, has witnessed his share of chaos during four years at Big Apple. After a slight resurgence following... View Details

Keywords: Turnarounds; Bankruptcy; ＂Live Entertainment; Art; Crisis Management; Financial Crisis; Organizational Culture; Entertainment; Insolvency and Bankruptcy; Decision Choices and Conditions; Entertainment and Recreation Industry

January 2018 (Revised April 2021)
Case

Capital Allocation at HCA

By: W. Carl Kester and Emily R. McComb

In early 2017, HCA Holdings, an investor-owned hospital management company, faced a strategically important capital allocation decision. After the exit of its private equity sponsors in 2016, HCA had to determine how best to allocate its substantial annual free cash... View Details

Keywords: Capital Allocation; Cash Distribution Policy; Dividends; Share Repurchases; Growth Strategy And Execution; Growth Investing; Capital Expenditures; Debt Management; Debt Reduction; Debt Policy; Hospital Management; Investor-owned Hospital Chains; Capital Budgeting; Capital Structure; Cash Flow; Corporate Finance; Decision Choices and Conditions; Health Industry; United States

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

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

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

August 2017
Article

Should Governments Invest More in Nudging?

By: Shlomo Benartzi, John Beshears, Katherine L. Milkman, Cass R. Sunstein, Richard H. Thaler, Maya Shankar, Will Tucker-Ray, William J. Congdon and Steven Galing

Governments are increasingly adopting behavioral science techniques for changing individual behavior in pursuit of policy objectives. The types of “nudge” interventions that governments are now adopting alter people’s decisions without coercion or significant changes... View Details

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June 2017 (Revised October 2017)
Case

Becton Dickinson: Innovation and Growth (A)

By: Raffaella Sadun, Michael Beer and James Weber

In late 2015, CEO Vince Forlenza was reviewing Becton Dickinson’s transformation efforts designed to enable the company to innovate and grow in a changing environment. Becton Dickinson had been a successful medical device company for over 100 years. In recent years,... View Details

Keywords: Transformation; Change Management; Innovation Leadership; Mergers and Acquisitions; Organizational Change and Adaptation; Organizational Culture; Organizational Design; Strategy; Growth and Development Strategy; Health Industry; Health Industry; Health Industry; United States

Article

Drivers of the Variation in Prosthetic Implant Purchase Prices for Total Knee and Total Hip Arthroplasties

By: Derek A. Haas, Kevin J Bozic, Anthony M. DiGioia, Zirui Song and Robert S. Kaplan

Previous studies have documented wide variation in health-care spending and prices; however, the causes for the variation in supply purchase prices across providers are not well understood. The purpose of this study was to determine the drivers of variation in... View Details

Keywords: Costing; Cost Variation; Total Knee Arthroplasty; Total Hip Arthroplasty; Prosthetic Implant Cost; Health Care and Treatment; Cost Management; Health Industry; Health Industry

Article

Time-Driven Activity-Based Costing in Emergency Medicine

By: Robert S. Kaplan, Brian J. Yun, Anand M. Prabhakar, Jonathan Warsh, John Brennan, Kyle E. Dempsey and Ali S. Raja

Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine... View Details

Keywords: Time-Driven Activity-Based Costing; Emergency Room; Health Care and Treatment; Value; Cost Management; Activity Based Costing and Management

June 2016
Article

Vaccination Rates Are Associated with Functional Proximity but Not Base Proximity of Vaccination Clinics

By: John Beshears, James J. Choi, David Laibson, Brigitte C. Madrian and Gwendolyn I. Reynolds

Background: Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of U.S. adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is... View Details

Keywords: Geographic Location; Employees; Health Care and Treatment

May 25, 2016
Comment

How Consumers and Businesses are Reshaping Public Health

By: John A. Quelch

Healthcare and education are two issues in which citizens around the world, rich and poor, are passionately interested. It has long been appreciated that the way that a society treats its youngest and oldest members says much about its moral maturity. Economic... View Details

November 2015
Article

Influence of Experience and the Surgical Learning Curve on Long-term Patient Outcomes in Cardiac Surgery

By: Bryan M. Burt, Andrew W. ElBardissi, Robert S. Huckman, Lawrence H. Cohn, Marisa W. Cevasco, James D. Rawn, Sary F. Aranki and John G. Byrne

OBJECTIVE: We hypothesized that increased post-graduate surgical experience correlates with improved operative efficiency and long-term survival in standard cardiac surgery procedures.

METHODS: Utilizing a prospectively collected retrospective database,... View Details

Keywords: Service Delivery; Value; Health Care and Treatment; Experience and Expertise; Health Industry

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July 2015
Background Note

The State of U.S. Public Health: Challenges and Trends

By: Rosabeth M. Kanter, Howard Koh and Pamela Yatsko

The World Health Organization defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity." For many Americans, the World Health Organization's definition of true health seems unattainable, given... View Details

Keywords: Public Health; Public Sector; Health Care and Treatment; Health Industry; United States

March 2015
Case

The I-PASS Patient Handoff Program

By: Robert S. Huckman and Michael Norris

In 2015, the I-PASS Patient Handoff Program Team, led by six pediatricians around the U.S., had to determine the best way to disseminate their program that had been proven to reduce communication errors in patient handoffs in hospital settings. Should they turn it into... View Details

Keywords: Health Care; Hospitals; Operations Improvement; Entrepreneurship; Health Care and Treatment; Health Industry; United States

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