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Publications

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    • All HBS Web  (1,809)
      • Faculty Publications  (291)

      Value Based Health CareRemove Value Based Health Care →

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      • 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.
      • 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.)
      • Article

      Surgeons and Administrators Co-Creating Value

      By: Michael Nurok, Thoralf Sundt, Robert S. Kaplan and Bruce Gewertz
      Most hospitals have arms-length relationships with physicians, viewing them as people they must ‘‘manage,’’ not as potentially valuable strategic partners. But surgeons make clinical decisions every day that have great influence on both patient outcomes and hospital... View Details
      Keywords: Value-based Health Care; Collaboration; Healthcare Administration; Health Care and Treatment; Management; Strategy; Value Creation
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      Nurok, Michael, Thoralf Sundt, Robert S. Kaplan, and Bruce Gewertz. "Surgeons and Administrators Co-Creating Value." Annals of Surgery 274, no. 6 (December 2021).
      • 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.
      • October 26, 2021
      • Article

      Value Chain Management to Implement Post-COVID-19 Health Care Strategy: The COVID-19 Crisis Has Created Areas of Innovation That Should Be Embraced by Health Care Leaders

      By: Michael E. Porter, Junaid Nabi and Thomas H. Lee
      Health care organizations must learn from what has worked during the COVID-19 crisis. Leaders have found that while they cannot do everything, they must define and manage the sequence of activities required to deliver high-value care. View Details
      Keywords: COVID-19 Pandemic; Value-based Health Care; Value Chain; Health Pandemics; Health Care and Treatment; Management; Strategy
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      Porter, Michael E., Junaid Nabi, and Thomas H. Lee. "Value Chain Management to Implement Post-COVID-19 Health Care Strategy: The COVID-19 Crisis Has Created Areas of Innovation That Should Be Embraced by Health Care Leaders." DOI: 10.1056/CAT.21.0302. NEJM Catalyst (October 26, 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

      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.
      • August 2021
      • Case

      Yummy: Delivering Value to Venezuela

      By: Ayelet Israeli, Jenyfeer Martinez Buitrago and Carla Larangeira
      By June 2021, Yummy had become Venezuela’s first and largest food delivery app and last-mile logistics company. In Caracas, the nation’s capital, Yummy held a 55% market share, while operations in other cities had already started to take place, including in three of... View Details
      Keywords: Internet and the Web; Health Pandemics; Business Startups; Growth and Development Strategy; Expansion
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      Israeli, Ayelet, Jenyfeer Martinez Buitrago, and Carla Larangeira. "Yummy: Delivering Value to Venezuela." Harvard Business School Case 522-034, August 2021.
      • July 2021 (Revised July 2022)
      • Case

      Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care

      By: Robert S. Kaplan, Navraj S. Nagra and Syed S. Shehab
      Dr. Andrea Pusic, breast cancer reconstruction surgeon, wants to extend outcomes measurement beyond traditional surgical metrics of infections, complications, and survival rates. The case describes her development of a new mobile phone app, which collects patients’... View Details
      Keywords: Health Care and Treatment; Outcome or Result; Cost Management; Activity Based Costing and Management; Mobile and Wireless Technology; Health Testing and Trials; Surveys; Health Industry; Boston
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      Kaplan, Robert S., Navraj S. Nagra, and Syed S. Shehab. "Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care." Harvard Business School Case 122-010, July 2021. (Revised July 2022.)
      • July 2021
      • Article

      Medical Debt in the U.S., 2009–2020

      By: Raymond Kluender, Neale Mahoney, Francis Wong and Wesley Yin
      Importance: Medical debt is an increasing concern in the US, yet there is limited understanding of the amount and distribution of medical debt, and its association with health care policies.

      Objective: To measure the amount of medical debt nationally and by... View Details
      Keywords: Debt; Borrowing and Debt; Health Care and Treatment; United States
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      Kluender, Raymond, Neale Mahoney, Francis Wong, and Wesley Yin. "Medical Debt in the U.S., 2009–2020." JAMA, the Journal of the American Medical Association 326, no. 3 (July 2021): 250–256.
      • June 2021
      • Article

      Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative

      By: Casey J. Allen, Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala and Matthew H.G. Katz
      We used national administrative data to assess multiple domains of value associated with enhanced recovery pathways for patients undergoing pancreatic surgery. Value metrics included in-hospital mortality, complication rates, length of stay (LOS), 30-day readmission... View Details
      Keywords: Value-based Health Care; Health Care and Treatment; Analytics and Data Science; Outcome or Result; Measurement and Metrics; Performance Improvement
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      Allen, Casey J., Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala, and Matthew H.G. Katz. "Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative." Journal of Surgical Research 262 (June 2021): 115–120.
      • May 2021
      • Article

      Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency

      By: J. Hart, K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels and S.D. Halpern
      Background: Clinicians’ use of choice architecture, or how they present options, systematically influences the choices made by patients and their surrogate decision makers. However, clinicians may incompletely understand this influence.... View Details
      Keywords: Choice Architecture; Health Care and Treatment; Interpersonal Communication; Decision Choices and Conditions; Competency and Skills
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      Hart, J., K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels, and S.D. Halpern. "Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency." BMJ Quality & Safety 30, no. 5 (May 2021).
      • May 2021
      • Article

      Value-Based Healthcare in Urology: A Collaborative Review

      By: Chanan Reitblat, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh and Boris Gershman
      Context:
      In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and... View Details
      Keywords: Value-based Healthcare; Integrated Practice Units; Outcome Measurement; Time-Driven Activity-Based Costing; Health Care and Treatment; Value; Cost Management; Strategy; Outcome or Result; Measurement and Metrics
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      Reitblat, Chanan, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh, and Boris Gershman. "Value-Based Healthcare in Urology: A Collaborative Review." European Urology 79, no. 5 (May 2021): 571–585.
      • April 17, 2021
      • Article

      Reimagining India's Health System: A Lancet Citizens' Commission

      By: Vikram Patel, Kiran Mazumdar-Shaw, Gagandeep Kang, Pamela Das and Tarun Khanna
      This commentary announces the launch of the Lancet Citizens’ Commission on Reimagining India’s Health System. The Commission is an ambitious, cross-sectoral effort to develop a citizens’ roadmap to achieving universal health coverage (UHC) in India in the next decade.... View Details
      Keywords: Universal Health Coverage; Health Care and Treatment; Reports; India
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      Patel, Vikram, Kiran Mazumdar-Shaw, Gagandeep Kang, Pamela Das, and Tarun Khanna. "Reimagining India's Health System: A Lancet Citizens' Commission." Lancet 397, no. 10283 (April 17, 2021). (Comment.)
      • April 2021
      • Case

      ClearChoice Dental Implant Centers

      By: Robert S. Kaplan, Ashiana Jivraj and Jane Barrow
      The case illustrates the application of value-based health care to dental medicine. ClearChoice Dental Implant Centers was a rapidly-growing network of dentist-owned independent implant clinics. The targeted market included 23 million people, 15% of the US adult... View Details
      Keywords: Value-based Health Care; Dental Medicine; Growth and Development Strategy; Expansion; Business Strategy; Customer Value and Value Chain; Customer Focus and Relationships; Health Industry; United States
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      Kaplan, Robert S., Ashiana Jivraj, and Jane Barrow. "ClearChoice Dental Implant Centers." Harvard Business School Case 121-082, April 2021.
      • April 2021
      • Article

      Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models

      By: Susanna Gallani, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar and Frank Opelka
      Modern medicine is undergoing a transformation that involves innovative surgical approaches, increased medical treatment options, clinical care pathways that require collaboration beyond hospital walls, and health data captured by electronic health records and other... View Details
      Keywords: Physician Compensation; Surgeons; Health Care and Treatment; Business Model; Compensation and Benefits
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      Gallani, Susanna, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar, and Frank Opelka. "Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models." Bulletin of the American College of Surgeons 106, no. 4 (April 2021): 33–39.
      • March 2021 (Revised January 2022)
      • Case

      Philips: Redefining Telehealth

      By: Regina E. Herzlinger, Alec Petersen, Natalie Kindred and Sara M. McKinley
      As one of the world’s largest healthcare companies, Philips sought to reach beyond the walls of the hospital and expand its hospital-to-home program to gain future competitive advantage through technology solutions combining predictive analytics with care delivery. By... View Details
      Keywords: Health Care; Philips; Visicu; Telemedicine; eICU; Accountable Care Organization; ACO; Bundled Payment; Hospital To Home; Patient Monitoring Devices; Home Health Care; Health Care and Treatment; Communication Technology; Quality; Safety; Performance Productivity; Performance Capacity; Performance Efficiency; Consumer Behavior; Emerging Markets; Health Industry; Health Industry; Netherlands
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      Herzlinger, Regina E., Alec Petersen, Natalie Kindred, and Sara M. McKinley. "Philips: Redefining Telehealth." Harvard Business School Case 321-135, March 2021. (Revised January 2022.) (As companion reading for this case, see: Regina E. Herzlinger and Charles Huang. "Note on Bundled Payment in Health Care," HBS Background Note 312-032.)
      • Article

      A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018

      By: J. Chirenda, B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison and R. S. Kaplan
      Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and... View Details
      Keywords: Time-Driven Activity-Based Costing; Provider Cost; Health Care and Treatment; Cost Management; Activity Based Costing and Management; Zimbabwe
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      Chirenda, J., B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison, and R. S. Kaplan. "A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018." BMC Health Services Research 21, no. 242 (2021).
      • March 2021
      • Article

      Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care

      By: Maximilian J. Pany, Lucy Chen, Bethany Sheridan and Robert S. Huckman
      Scope-of-practice regulations, including prescribing limits and supervision requirements, may influence the propensity of providers to form care teams. Therefore, policy makers need to understand the effect of both team-based care and provider type on clinical... View Details
      Keywords: Disease Management; Team-based Care; Health Care and Treatment; Groups and Teams; Performance
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      Pany, Maximilian J., Lucy Chen, Bethany Sheridan, and Robert S. Huckman. "Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care." Health Affairs 40, no. 3 (March 2021): 435–444.
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