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July 2019
Article

The Impact of Price Regulation on the Availability of New Drugs in Germany

By: Ariel Dora Stern, Felicitas Pietrulla, Annika Herr, Aaron S. Kesselheim and Ameet Sarpatwari

The 2011 German Pharmaceutical Market Restructuring Act (“AMNOG”) subjected branded, non-rare disease drugs to price regulation based on an assessment of their clinical benefit. Assessment outcomes range from “major added benefit” to “less benefit than the appropriate... View Details

Keywords: Regulation; Pharmaceuticals; Healthcare; Health Care and Treatment; Price; Governing Rules, Regulations, and Reforms; Pharmaceutical Industry; Germany

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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

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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01 Sep 2023
News

Elevator Pitch: Standard of Care

traditional operating room costs about $45 per minute,” Teodorescu says. “Our goal is to get the total cost for SurgiBox to just $90 by the end of 2023. If we can achieve that, it will establish a new... View Details

Keywords: entrepreneurship; healthcare; surgery; Ukraine; Ambulatory Health Care Services; Health, Social Assistance

Article

Value-based Healthcare: Implications for Thyroid Cancer

By: A.K. Ying, T.W. Feeley and M. E. Porter

Today's delivery of care to thyroid cancer patients is complex, and costly, with uneven outcomes that can be improved. The incidence of thyroid cancer is rising and requires coordinated, multidisciplinary care with high volume centers that is not always available in... View Details

Keywords: Bundled Reimbursement; Healthcare Reform; Integrated Practice Units; Outcomes; Patient-reported Outcomes; Thyroid Cancer; Health Care and Treatment; Cost; Information Technology; Value

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October 2022 (Revised September 2024)
Case

mPharma: Scaling Access to Affordable Primary Care in Africa

By: Regina E. Herzlinger and Ben Creo

mPharma hopes to scale up to create the largest pan-African healthcare company ever to provide much-needed primary care in retail pharmacies; a reliable, fairly priced supply of drugs; and micro-insurance for drugs. They must prioritize launching a telemedicine... View Details

01 Mar 2014
News

Clubs Hopping: A Healthy Dialogue

This past November, the HBS Healthcare Alumni Association held its 14th annual conference at the Charles Hotel in Boston, with more than 300 alumni coming to connect and hear from industry leaders. We asked HBSHAA president Tom Robinson... View Details

Keywords: Morrell, Daniel; healthcare; HBSAAA

November 8, 2018
Article

Transitioning Payment Models: Fee-for-Service to Value-Based Care

By: Thomas W. Feeley and Namita Seth Mohta

In a survey of the NEJM Catalyst Insights Council in July 2018, 42% of respondents say they think value-based reimbursement models will be the primary revenue model for U.S. health care. Indeed, this transition is already happening. Respondents report that a quarter of... View Details

Keywords: Payment Methods; Value-based Healthcare Reimbursements; Health Care and Treatment; Value; Transformation

September 2017 (Revised February 2023)
Case

Intermountain Healthcare: Pursuing Precision Medicine

By: Richard G. Hamermesh, Kathy E. Giusti, Robert S. Huckman and Julia Kelley

Headquartered in Salt Lake City, Intermountain Healthcare operates 23 hospitals and hundreds of clinics in Utah and Idaho and provides insurance to approximately 850,000 patients through its insurance arm, SelectHealth. In 2013, Intermountain, known for its commitment... View Details

Keywords: Precision Medicine; Healthcare; Innovation; Cancer; Cancer Research; Health Care; Technology; Health Care and Treatment; Innovation Leadership; Disruptive Innovation; Entrepreneurship; Decision Choices and Conditions; Health Industry; Insurance Industry; Utah; United States; North America

September 2018
Article

Discretionary Task Ordering: Queue Management in Radiological Services

By: Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats

Work-scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks... View Details

Keywords: Discretion; Scheduling; Queue; Healthcare; Learning; Experience; Decentralization; Operations; Service Operations; Service Delivery; Performance; Performance Effectiveness; Performance Efficiency; Performance Improvement; Performance Productivity; Decisions; Time Management; Cost vs Benefits; Health Industry

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November 2012 (Revised January 2013)
Case

Companion Diagnostics: Uncertainties for Approval and Reimbursement

By: Richard G. Hamermesh, Norman C. Selby and Phillip Andrews

The FDA approvals of novel therapeutics were seen as signs in the personalized medicine community of real progress in the growth of personalized medicine. The FDA's approval of such drugs, along with companion diagnostics, suggested a shift in thinking and regulatory... View Details

Keywords: Models Of Reimbursement; Personalized Medicine; Regulation; Healthcare Reform; Health Care and Treatment; Health Industry; United States

2017
Working Paper

Discretionary Task Ordering: Queue Management in Radiological Services

By: Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats

Work scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks... View Details

February 2016 (Revised March 2022)
Case

Express Scripts: Promoting Prescription Drug Home Delivery (B)

By: John Beshears, Patrick Rooney and Jenny Sanford

The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details

Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Health Care and Treatment; Service Delivery; Decision Choices and Conditions; Order Taking and Fulfillment; Compensation and Benefits

02 Mar 2007
What Do You Think?

What Is the Government’s Role in US Health Care?

Summing Up This month's exchange of ideas regarding U.S. healthcare reform ranged far and wide. Some of us were interested primarily in the issue of cost escalation and how to contain it. Others addressed... View Details

Keywords: by Jim Heskett; Health

March 2016 (Revised March 2022)
Teaching Note

Express Scripts: Promoting Prescription Drug Home Delivery (A) and (B)

By: John Beshears

The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. The case associated with this teaching note follows Bob Nease, chief scientist at Express Scripts, as he... View Details

Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Consumer Behavior; Distribution Channels; Health Care and Treatment; Service Industry; Pharmaceutical Industry

February 2016
Case

Express Scripts: Promoting Prescription Drug Home Delivery (A)

By: John Beshears, Patrick Rooney and Jenny Sanford

The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details

Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Health Care and Treatment; Order Taking and Fulfillment; Compensation and Benefits; Pharmaceutical Industry

22 Feb 2022
News

Elevator Pitch: Good Vibrations

fractures and subsequent complications kill 20 percent of their victims, and debilitating spine fractures represent a health care cost of $19 billion annually. “There are a number of medications to treat osteoporosis, but they’re... View Details

Keywords: medical device; healthcare; entrepreneurship; Alumni New Venture Competition

October 2016 (Revised March 2019)
Case

Carrum Health: Scaling Bundled Payments

By: Robert S. Huckman and Sarah Mehta

Founded in 2014, Carrum Health helped self-insured employers located in three markets (San Diego, California; Seattle, Washington; and San Francisco, California) save money on their employees’ planned surgeries. It did so by contracting directly with top-quality... View Details

Keywords: Health Financing; Health Insurance; Value-based Healthcare Reimbursements; Bundled Payments; Innovation; Scale; Health; Health Care and Treatment; Cost Management; Growth and Development Strategy; Decision Choices and Conditions; Health Industry; California; San Francisco; San Diego; Seattle

Forthcoming
Book

Innovating in Healthcare: Creating Breakthrough Tech, Services, Drugs, Products, and Business Models

By: Regina E. Herzlinger

Innovating in Healthcare offers effective approaches for designing, reworking, and implementing innovative healthcare services, products, and business models. It will help anyone working in healthcare service or product development, from hospitals to startups,... View Details

Keywords: Health Care and Treatment; Service Delivery; Product Development; Business Model; Innovation and Invention; Health Industry

April 2017
Supplement

Imprimis (B)

By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel

This case is a supplement to Imprimis (A). It describes the company’s decision to enter into the pharmaceutical compounding business in 2013–2014. Imprimis purchased a compounded ophthalmological medication called Dropless Therapy, which was injected into patients’... View Details

Keywords: Healthcare; Drug Compounding; Drug Development; Pharmaceuticals; Small Business; Decision-making, Business Model; Mark Baum; Imprimis; Decision Making; Strategy; Health Care and Treatment; Policy; Pharmaceutical Industry; United States

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