Publications
Publications
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- All HBS Web
(396)
- Faculty Publications (158)
- 2020
- Working Paper
Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities
By: David Cutler, Leemore S. Dafny, David Grabowski, Steven S. Lee and Christopher Ody
The landscape of the U.S. healthcare industry is changing dramatically as healthcare providers expand both within and across markets. While federal antitrust agencies have mounted several challenges to same-market combinations, they have not challenged any... View Details
- 2020
- Working Paper
Targeting for Long-Term Outcomes
By: Jeremy Yang, Dean Eckles, Paramveer Dhillon and Sinan Aral
Decision makers often want to target interventions so as to maximize an outcome that is observed only in the long term. This typically requires delaying decisions until the outcome is observed or relying on simple short-term proxies for the long-term outcome. Here we... View Details
- 2023
- Working Paper
When Should Public Programs Be Privately Administered? Theory and Evidence from the Paycheck Protection Program
By: Alexander Bartik, Zoë B. Cullen, Edward L. Glaeser, Michael Luca, Christopher Stanton and Adi Sunderam
What happens when public resources are allocated by private companies whose objectives may be
imperfectly aligned with policy goals? We study this question in the context of the Paycheck
Protection Program (PPP), which relied on private banks to disburse aid to small... View Details
- Article
The Importance of Being Causal
By: Iavor I Bojinov, Albert Chen and Min Liu
Causal inference is the study of how actions, interventions, or treatments affect outcomes of interest. The methods that have received the lion’s share of attention in the data science literature for establishing causation are variations of randomized experiments.... View Details
- 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
- June 2020
- Article
Overcoming Barriers to Early Disease Intervention
By: H. Hugo Caicedo, Daniel A. Hashimoto, Julio C. Caicedo, Alex Pentland and Gary P. Pisano
It is widely acknowledged that earlier intervention in many disease processes leads to better patient outcomes and lower treatment costs. To date, most efforts at early disease intervention have focused on "primary prevention" which focuses on preventing diseases in... View Details
- May 21, 2020
- Editorial
Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?
By: Leemore S. Dafny and J. Michael McWilliams
Primary care clinicians are the front line for patients with suspected infection. We rely on them to diagnose, triage, and manage patients with potential or confirmed COVID infections. They are also responsible for keeping non-COVID medical conditions under control... View Details
- May 2020
- Article
Negotiating a Better Future: How Interpersonal Skills Facilitate Inter-Generational Investment
By: Nava Ashraf, Natalie Bau, Corinne Low and Kathleen McGinn
Using a randomized control trial, we examine whether offering adolescent girls nonmaterial resources—specifically, negotiation skills—can improve educational outcomes in a low-income country. In so doing, we provide the first evidence on the effects of an intervention... View Details
- May–June 2020
- Article
The Agenda for the Next Generation of Health Care Information Technology
By: Thomas W. Feeley, Zachary Landman and Michael E. Porter
As the diffusion of value-based health care efforts accelerates globally, the need for interoperable information technology systems that support value-based care is essential. Such systems are needed to facilitate dramatic improvements in patient outcomes and... View Details
- 2020
- Chapter
Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better
By: Leemore S. Dafny
Love it or hate it, the Affordable Care Act (ACA) embraced and extended the role of private markets in financing and delivering health care in the United States. Ten years after the ACA’s passage, it is unclear whether health care markets are better (along a range of... View Details
- 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
- November 9, 2019
- Article
Effect of Revealing Authors' Conflicts of Interests in Peer Review: Randomized Controlled Trial
By: Leslie K. John, George Loewenstein, Andrew Marder and Michael Callaham
Objective: To assess the impact of disclosing authors’ conflict of interest declarations to peer reviewers at a medical journal.
Design: Randomised controlled trial.
Setting: The study was conducted within the manuscript review process at the... View Details
Design: Randomised controlled trial.
Setting: The study was conducted within the manuscript review process at the... View Details
- Article
Mandate Outcomes Reporting
By: Robert S. Kaplan and Michael E. Porter
Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to... View Details
- 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
- 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
- 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
- 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
- Article
Populism and the Return of the 'Paranoid Style': Some Evidence and a Simple Model of Demand for Incompetence as Insurance against Elite Betrayal
By: Rafael Di Tella and Julio J. Rotemberg
We present a simple model of populism as the rejection of “disloyal” leaders. We show that adding the assumption that people are worse off when they experience low income as a result of leader betrayal (than when it is the result of bad luck) to a simple voter choice... View Details
- Article
Defining, Measuring, and Improving Value in Spine Care
By: Robert S. Kaplan and Derek Haas
This chapter discusses how to measure and improve spine care outcomes and costs. Today’s commonly used outcome metrics, such as readmission and complication rates, are actually process and quality metrics. They are not the outcomes, such as improvement in pain and... View Details
- Article
Performance Effects of Setting a High Reference Point for Peer‐Performance Comparison
By: Henry Eyring and V.G. Narayanan
We conduct a field experiment, based on a registered report accepted by the Journal of Accounting Research, to test performance effects of setting a high reference point for peer‐performance comparison. Relative to providing the median as a reference point for... View Details