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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

May 11, 2017
Article

Good Riddance to Big Insurance Mergers

By: Leemore S. Dafny

Federal judges issued preliminary injunctions halting mergers of four of the five largest U.S. health insurers. These decisions provide more precedent to support challenges of mergers between competitors in health care markets—whether payers or providers. View Details

Keywords: Mergers and Acquisitions; Insurance; Health Care and Treatment; Health Industry; Health Industry

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January 2017 (Revised October 2023)
Case

Classtivity: Payal's Pirouette

By: Jeffrey J. Bussgang and Olivia Hull

A few months after launching a new fitness technology product, the small staff of New York startup Classtivity gathers on a Saturday in April 2013 to take stock. With one successful pivot under its belt, Classtivity is finally generating revenue and enthusiasm among... View Details

December 2016
Article

Health Care Needs Real Competition

By: Leemore S. Dafny and Thomas H. Lee

The U.S. health care system is inefficient, unreliable, and crushingly expensive. There is no shortage of proposed solutions, but central to the best of them is the idea that health care needs more competition. In other sectors, competition improves quality and... View Details

Keywords: Competition; Health Care and Treatment; Health Industry; United States

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December 2016
Article

Selective Regulator Decoupling and Organizations' Strategic Responses

By: Jonas Heese, Ranjani Krishnan and Frank Moers

Organizations often respond to institutional pressures by symbolically adopting policies and procedures but decoupling them from actual practice. Literature has examined why organizations decouple from regulatory pressures. In this study, we argue that decoupling... View Details

Keywords: Regulator Leniency; Beneficence; Mispricing; Upcoding; Nonprofit Organizations; Health Care and Treatment; Revenue; Health Industry

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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

Article

Undermining Value-Based Purchasing — Lessons from the Pharmaceutical Industry

By: Leemore S. Dafny, Christopher Ody and Matt Schmitt

The analogy between value-based purchasing in pharmaceuticals and the new frontier of alternative payment models for health care providers is relatively straightforward. Insurers are increasingly demanding steep discounts from providers in exchange for inclusion in... View Details

Keywords: Drug Copayment Coupons; Prescription Drug Policy; Health Care and Treatment; Insurance; Cost; Policy; Pharmaceutical Industry

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June 24, 2016
Article

Health Insurance Mergers Put Consumers Last

By: John A. Quelch

2016
Book

Innovation Policy and the Economy, Volume 17

By: Shane Greenstein, Josh Lerner and Scott Stern

The seventeenth volume of the National Bureau of Economic Research’s Innovation Policy and the Economy provides an accessible forum for bringing the work of leading academic researchers to an audience of policymakers and those interested in the interaction... View Details

Keywords: Innovation and Invention; Technological Innovation; Governance; Policy; Economy

2016
Blog

Building A Culture of Health - John A. Quelch: Creating A Culture of Health

By: John A. Quelch

All American companies are in the health business whether they like it or not. The private sector directly pays for one-fifth of the whopping 17.5% of GDP spent on healthcare in the United States. Rather than viewing health merely as an insurance expense to be... View Details

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

May 16, 2016
Article

Food Safety Economics: The Cost of a Sick Customer

By: Dina Gerdeman and John A. Quelch

Chipotle Mexican Grill’s ongoing struggle to win customers back months after a contaminated food crisis highlights the challenges companies face with keeping food safe.

Chipotle has seen its shares tumble and recently reported its first-ever quarterly loss... View Details

2016
Blog

Building A Culture of Health - John A. Quelch: The Marketing of Prevention

By: John A. Quelch

The US will devote 17.5% of GDP to health care this year, around $3 trillion. Yet only 3 percent of that will be spent on prevention, including both primary prevention (preventing illness in the first place) and secondary prevention (preventing sick people getting... View Details

Keywords: Healthcare; Healthcare Marketing; Prevention; Wellbeing; Health; Marketing; Health Industry; Health Industry; Health Industry; Europe; North and Central America

Article

Beyond Statistics: The Economic Content of Risk Scores

By: Liran Einav, Amy Finkelstein, Raymond Kluender and Paul Schrimpf

"Big data" and statistical techniques to score potential transactions have transformed insurance and credit markets. In this paper, we observe that these widely-used statistical scores summarize a much richer heterogeneity, and may be endogenous to the context in which... View Details

Keywords: Analytics and Data Science; Risk and Uncertainty; Insurance Industry

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March 2016 (Revised March 2022)
Teaching Note

Evive Health and Workplace Influenza Vaccinations

By: John Beshears

Evive Health is a company that manages communication campaigns on behalf of health insurance plans and large employers. Using big data techniques and insights from behavioral economics, Evive deploys targeted and effective messages that improve individuals' health... View Details

March 2016
Case

Evive Health and Workplace Influenza Vaccinations

By: John Beshears

Evive Health is a company that manages communication campaigns on behalf of health insurance plans and large employers. Using big data techniques and insights from behavioral economics, Evive deploys targeted and effective messages that improve individuals' health... View Details

Keywords: Vaccination; Influenza; Flu Shot; Preventive Care; Health Care; Behavioral Economics; Choice Architecture; Nudge; Experimental Design; Randomized Controlled Trial; RCT; Causal Inference; Consumer Behavior; Health Care and Treatment; Health Testing and Trials; Communication Strategy; Health Industry

March 2016
Case

Residency Select or J3Personica?

By: William Kerr and Kathryn S. Roloff

Residency Select, LLC provides psychometric assessments for matching medical students to residency programs. After a series of successful pilots, founder Alan Friedman is considering whether to continue developing his offerings in this area, or whether to expand into... View Details

Keywords: Marketplace Matching; Expansion; Higher Education; Entrepreneurship; Health Care and Treatment; Growth and Development Strategy; Service Industry

February 2016 (Revised May 2016)
Case

Employee Health

By: John A. Quelch and Emily C. Boudreau

Keywords: Health Care; Empoylee Wellness Programs; Health Insurance; Mental Health; Corporate Culture; Employee Compensation; Health; Corporate Strategy; Europe; Asia; North America

2016
Teaching Note

Advanced Leadership Pathways: General Gale Pollock and Services for the Vision Impaired

By: Rosabeth M. Kanter, Tessa Natanay Hamilton and Ai-Ling Jamila Malone

Teaching note for case 314029. Following a successful military career as an Army Nurse, achieving rank as Major General, becoming the first female Acting Surgeon General of the Army, and the 22nd Chief of the Army Nurse Corps, Pollock developed a vested interest in... View Details

Keywords: Health Care; Health Care Education; Insurance Companies; Military; Leadership Skills; Health Care and Treatment; Education; Insurance; Business Startups; Information Technology; Applications and Software; Change Management; Health Industry; Health Industry

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