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Publications

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    • All HBS Web  (1,007)
      • Faculty Publications  (230)

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      • September–October 2020
      • Article

      The Past, Present, and (Near) Future of Gene Therapy and Gene Editing

      By: Julia Pian, Amitabh Chandra and Ariel Dora Stern
      Emerging gene therapy and gene-editing technologies will have a growing impact on patient lives and health-care delivery. We analyzed a decade of data on clinical trials and venture capital investments to understand the likely trajectory of genetically focused... View Details
      Keywords: Gene Therapy; Gene Editing; Impact; Health Care and Treatment; Technological Innovation; Health Testing and Trials; Venture Capital; Change
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      Pian, Julia, Amitabh Chandra, and Ariel Dora Stern. "The Past, Present, and (Near) Future of Gene Therapy and Gene Editing." NEJM Catalyst Innovations in Care Delivery 1, no. 5 (September–October 2020).
      • July 28, 2020
      • Article

      Economic Vulnerability of Households with Essential Workers

      By: Grace McCormack, Christopher Avery, Ariella Kahn-Lang Spitzer and Amitabh Chandra
      The label of “essential worker” reflects society’s needs but does not mean that society has compensated those workers for additional risks incurred on the job during the current pandemic. When an essential worker contracts severe acute respiratory syndrome coronavirus... View Details
      Keywords: Essential Workers; Health Pandemics; Household; Financial Condition; United States
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      McCormack, Grace, Christopher Avery, Ariella Kahn-Lang Spitzer, and Amitabh Chandra. "Economic Vulnerability of Households with Essential Workers." JAMA, the Journal of the American Medical Association 324, no. 4 (July 28, 2020): 388–390.
      • Article

      Assessing the Value of Pediatric Aerodigestive Care

      By: Robert S. Kaplan, Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher and Evan Propst
      Leaders at six hospitals conducted a research study to assess and compare the health outcomes and costs of pediatric aerodigestive care. Four of the hospitals delivered care with an integrated practice unit (IPU) while two delivered care traditionally, with isolated... View Details
      Keywords: Time-Driven Activity-Based Costing; Value-based Health Care; Integrated Practice Unit; Health Care and Treatment; Cost Management; Performance Improvement
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      Kaplan, Robert S., Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher, and Evan Propst. "Assessing the Value of Pediatric Aerodigestive Care." NEJM Catalyst Innovations in Care Delivery 1, no. 4 (July–August 2020).
      • July 2020
      • Article

      Healthy Business? Managerial Education and Management in Healthcare

      By: Nicholas Bloom, Renata Lemos, Raffaella Sadun and John Van Reenen
      We investigate the link between hospital performance and managerial education by collecting a large database of management practices and skills in hospitals across nine countries. We find that hospitals that are closer to universities offering both medical education... View Details
      Keywords: Management; Hospitals; Mortality; Education; Health Care and Treatment; Performance Improvement; Business Education; Management Practices and Processes
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      Bloom, Nicholas, Renata Lemos, Raffaella Sadun, and John Van Reenen. "Healthy Business? Managerial Education and Management in Healthcare." Review of Economics and Statistics 102, no. 3 (July 2020): 506–517.
      • July–September 2020
      • Article

      Innovation Contest: Effect of Perceived Support for Learning on Participation

      By: Olivia Jung, Andrea Blasco and Karim R. Lakhani
      Background: Frontline staff are well positioned to conceive improvement opportunities based on first-hand knowledge of what works and does not work. The innovation contest may be a relevant and useful vehicle to elicit staff ideas. However, the success of the... View Details
      Keywords: Contest; Innovation; Employee Engagement; Organizational Learning; Health Care; Health Care Delivery; Innovation and Invention; Organizations; Learning; Employees; Perception; Health Care and Treatment
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      Jung, Olivia, Andrea Blasco, and Karim R. Lakhani. "Innovation Contest: Effect of Perceived Support for Learning on Participation." Health Care Management Review 45, no. 3 (July–September 2020): 255–266.
      • 2024
      • Working Paper

      Cephalosporins—Fighting Hospital Infections: Case Histories of Transformational Advances

      By: Amar Bhidé, Srikant Datar and Katherine Stebbins
      This case history describes the development of three generations of cephalosporins – antibiotics that have significantly reduced hospital infections. Specifically, we chronicle how: 1) Early (pre-cephalosporin) antibiotics were developed in the first half of the 20th... View Details
      Keywords: Health Care and Treatment; Technological Innovation; Innovation Strategy; Technology Adoption; Collaborative Innovation and Invention; Innovation and Invention; Governing Rules, Regulations, and Reforms
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      Bhidé, Amar, Srikant Datar, and Katherine Stebbins. "Cephalosporins—Fighting Hospital Infections: Case Histories of Transformational Advances." Harvard Business School Working Paper, No. 20-133, July 2020. (Revised May 2024.)
      • 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

      The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding

      By: Brian Franklin, Sharif Vakili, Robert S. Huckman, Sarah Hosein, Nicholas Falk, Katherine Cheng, Maria Murray, Sheila Harris, Charles A. Morris and Eric Goralnick
      Delayed access to inpatient beds for admitted patients contributes significantly to emergency department (ED) boarding and crowding, which have been associated with deleterious patient safety effects. To expedite inpatient bed availability, some hospitals have... View Details
      Keywords: Health Care Delivery; Emergency Room; Operations Improvement; Operations Management; Health Care and Treatment; Service Delivery; Operations; Management; Performance Improvement; Service Operations
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      Franklin, Brian, Sharif Vakili, Robert S. Huckman, Sarah Hosein, Nicholas Falk, Katherine Cheng, Maria Murray, Sheila Harris, Charles A. Morris, and Eric Goralnick. "The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding." Annals of Emergency Medicine 75, no. 6 (June 2020): 704–714.
      • Article

      The Business of Medicine in the Era of COVID-19

      By: David M. Cutler, Sayeh Nikpay and Robert S. Huckman
      This Viewpoint discusses the shifting landscape of health care financing, regulation, and delivery as a result of the coronavirus pandemic, and discusses regulatory and other changes that need to be in place if telehealth and physician practice and hospital mergers... View Details
      Keywords: Health Care; COVID-19; Telemedicine; Business; Health Pandemics; Health Care and Treatment; Change; Competition
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      Cutler, David M., Sayeh Nikpay, and Robert S. Huckman. "The Business of Medicine in the Era of COVID-19." JAMA, the Journal of the American Medical Association 323, no. 20 (May 26, 2020): 2003–2004.
      • May 2020
      • Article

      Identifying Sources of Inefficiency in Health Care

      By: Amitabh Chandra and Douglas O. Staiger
      In medicine, the reasons for variation in treatment rates across hospitals serving similar patients are not well understood. Some interpret this variation as unwarranted and push standardization of care as a way of reducing allocative inefficiency. However, an... View Details
      Keywords: Health Care and Treatment; Performance Efficiency; Performance Productivity; Mathematical Methods
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      Chandra, Amitabh, and Douglas O. Staiger. "Identifying Sources of Inefficiency in Health Care." Quarterly Journal of Economics 135, no. 2 (May 2020): 785–843.
      • April 15, 2020
      • Other Article

      Designating Certain Post-Acute Care Facilities As COVID-19 Skilled Care Centers Can Increase Hospital Capacity And Keep Nursing Home Patients Safer

      By: Leemore S. Dafny and Steven S. Lee
      As the number of COVID-19 cases nationwide continues to grow, many hospitals will need to convert acute care beds into intensive care beds and discharge stable patients to post-acute care settings such as nursing homes. In addition, nursing homes unable to care for... View Details
      Keywords: COVID-19; Nursing Homes; Health Pandemics; Health Care and Treatment; Safety; Quality
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      Dafny, Leemore S., and Steven S. Lee. "Designating Certain Post-Acute Care Facilities As COVID-19 Skilled Care Centers Can Increase Hospital Capacity And Keep Nursing Home Patients Safer." Health Affairs Blog (April 15, 2020).
      • April 3, 2020
      • Article

      How Hospitals Can Manage Supply Chain Shortages as Demand Surges

      By: Richard M.J. Bohmer, Gary P. Pisano, Raffaella Sadun and Thomas C. Tsai
      The best practices in supply chain and operations management can help health care providers cope with the surge in patients and the supply shortages. They will help them create a comprehensive strategy aimed at both the demand- and supply-side roots of the problem. The... View Details
      Keywords: Hospitals; Health Pandemics; Health Care and Treatment; Supply Chain Management; Operations; Management; Strategy
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      Bohmer, Richard M.J., Gary P. Pisano, Raffaella Sadun, and Thomas C. Tsai. "How Hospitals Can Manage Supply Chain Shortages as Demand Surges." Harvard Business Review (website) (April 3, 2020).
      • 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
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      Beaulieu, Nancy Dean, Leemore S. Dafny, B. E. Landon, Jesse Dalton, Ifedayo Kuye, and J. Michael McWilliams. "Changes in Quality of Care After Hospital Mergers and Acquisitions." New England Journal of Medicine 382, no. 1 (January 2, 2020): 51–59.
      • November 2019 (Revised December 2019)
      • Case

      Martini Klinik: Prostate Cancer Care 2019

      By: Michael E. Porter, Jens Deerberg-Wittram and Thomas W. Feeley
      Since its establishment in 2005, Hamburg’s Martini Klinik had single mindedly focused on prostate cancer care with a commitment to measure long-term health outcomes for every patient. A wholly owned subsidiary of the University Hospital Hamburg, Martini Klinik was a... View Details
      Keywords: Health Care; Michael Porter; Jens Deerberg-Wittram; Clifford Marks; Prostate Cancer; Health Care Policy; Value Agenda; Integrated Practice Units; Outcomes Measurement; Health Care and Treatment; Value; Health Disorders; Insurance; Medical Specialties; Outcome or Result; Measurement and Metrics; Business Processes; Insurance Industry; Health Industry; Germany
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      Porter, Michael E., Jens Deerberg-Wittram, and Thomas W. Feeley. "Martini Klinik: Prostate Cancer Care 2019." Harvard Business School Case 720-359, November 2019. (Revised December 2019.)
      • Article

      Achieving Value in Highly Complex Acute Care: Lessons from the Delivery of Extra Corporeal Life Support

      By: Michael Nurok, Jonathan Warsh, Erik Dong, Jeffrey Lopez, Mayumi Kharabi and Robert S. Kaplan
      We applied a value (outcomes and cost) analysis to extracorporeal life support (ECLS), a relatively rare but very expensive ICU therapy with highly variable outcomes. To address the outcome component of the value approach, we created guidelines for ECLS delivery; to... View Details
      Keywords: Health Care and Treatment; Cost Management; Value; Analysis
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      Nurok, Michael, Jonathan Warsh, Erik Dong, Jeffrey Lopez, Mayumi Kharabi, and Robert S. Kaplan. "Achieving Value in Highly Complex Acute Care: Lessons from the Delivery of Extra Corporeal Life Support." NEJM Catalyst (October 31, 2019).
      • 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.
      • July 2019
      • Article

      Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements

      By: Derek A. Haas, Xiaoran Zhang, Robert S. Kaplan and Zirui Song
      In 2016, the Centers for Medicare & Medicaid Services (CMS) launched its first mandatory bundled payment program, the Comprehensive Care for Joint Replacement (CJR) model, by randomizing metropolitan statistical areas (MSAs) into the payment model. The paper analyzed... View Details
      Keywords: Medicare; Medicaid; Bundled Payments; Health Care and Treatment; Cost Management; Performance Evaluation; Outcome or Result
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      Haas, Derek A., Xiaoran Zhang, Robert S. Kaplan, and Zirui Song. "Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements." JAMA Internal Medicine 179, no. 7 (July 2019): 924–931.
      • Article

      Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System

      By: Regina E. Herzlinger and Bacchus Barua
      An analysis of Canada’s single-payer healthcare system shows the dangers of the proposed Medicare for All model. In fact, the Canadian healthcare system is costly and drives poor outcomes when compared to objective performance measures. Alternatively, the Swiss and... View Details
      Keywords: Healthcare Systems; Universal Health Coverage; Health Care and Treatment; Insurance; Canada; Switzerland; Netherlands
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      Herzlinger, Regina E., and Bacchus Barua. "Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System." Wall Street Journal (April 17, 2019).
      • 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
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      Chandra, Amitabh, Craig Garthwaite, and Ariel Dora Stern. "Characterizing the Drug Development Pipeline for Precision Medicines." Chap. 5 in Economic Dimensions of Personalized and Precision Medicine, edited by Ernest R. Berndt, Dana P. Goldman, and John W. Rowe, 115–158. University of Chicago Press, 2019.
      • Article

      Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated

      By: Christopher Ody, Lucy Msall, Leemore S. Dafny, David Grabowski and David Cutler
      Medicare’s Hospital Readmissions Reduction Program (HRRP) has been credited with lowering risk-adjusted readmission rates for targeted conditions at general acute care hospitals. However, these reductions appear to be illusory or overstated. This is because a... View Details
      Keywords: Readmission Rates; Hospitals; Acute Care Hospitals; Medicare; Myocardial Infarction; Heart Failure; Health Care and Treatment
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      Ody, Christopher, Lucy Msall, Leemore S. Dafny, David Grabowski, and David Cutler. "Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated." Health Affairs 38, no. 1 (January 2019): 36–43.
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