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      • 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.
      • July 2019 (Revised November 2022)
      • Case

      Momofuku Ando and the Globalization of Noodles

      By: Geoffrey Jones and Megumi Takada
      This case examines the entrepreneurial career of Momofuku Ando, the Taiwanese-born Japanese entrepreneur who pioneered instant boodles with his Chicken Ramen (1958) and Cup Noodle (1971) products. It begins by reviewing his many previous unsuccessful ventures,... View Details
      Keywords: Entrepreneurship; Personal Development and Career; Failure; Success; Globalization; Corporate Social Responsibility and Impact; Food and Beverage Industry; Japan
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      Jones, Geoffrey, and Megumi Takada. "Momofuku Ando and the Globalization of Noodles." Harvard Business School Case 320-006, July 2019. (Revised November 2022.)
      • Summer 2019
      • Article

      The Price Effects of Cross-Market Mergers: Theory and Evidence from the Hospital Industry

      By: Leemore S. Dafny, Katherine Ho and Robin S. Lee
      We consider the effect of mergers between firms whose products are not viewed as direct substitutes for the same good or service but are bundled by a common intermediary. Focusing on hospital mergers across distinct geographic markets, we show that such combinations... View Details
      Keywords: Mergers and Acquisitions; Markets; Geographic Scope; Price; Outcome or Result; Insurance; Health Industry
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      Dafny, Leemore S., Katherine Ho, and Robin S. Lee. "The Price Effects of Cross-Market Mergers: Theory and Evidence from the Hospital Industry." RAND Journal of Economics 50, no. 2 (Summer 2019): 286–325.
      • 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).
      • 2022
      • Working Paper

      The Lifesaving Benefits of Convenient Infrastructure: Quantifying the Mortality Impact of Abandoning Shallow Tubewells Contaminated by Arsenic in Bangladesh

      By: Nina Buchmann, Erica Field, Rachel Glennerster and Reshmaan Hussam
      We document the consequences of a public health campaign which led to the sudden abandonment of local water infrastructure by one-fifth of Bangladesh’s population. Households who experienced quasi-randomly distributed arsenic contamination, and thus were likely to... View Details
      Keywords: Child Mortality; Arsenic; Unintended Consequences; Health Disorders; Safety; Outcome or Result; Bangladesh
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      Buchmann, Nina, Erica Field, Rachel Glennerster, and Reshmaan Hussam. "The Lifesaving Benefits of Convenient Infrastructure: Quantifying the Mortality Impact of Abandoning Shallow Tubewells Contaminated by Arsenic in Bangladesh." Working Paper, September 2022.
      • 2018
      • Working Paper

      Sustainability and Green Business in Latin America During Globalization Waves

      By: Geoffrey Jones
      This working paper examines the impact of modern business enterprise on the natural environment of Latin America during the globalization waves between the 19th century and the present day. It argues that although global capitalism created much wealth for the region,... View Details
      Keywords: Globalization; Natural Environment; Outcome or Result; Business History; Pollutants; Environmental Sustainability; Green Technology Industry; Beauty and Cosmetics Industry; Tourism Industry; Latin America
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      Jones, Geoffrey. "Sustainability and Green Business in Latin America During Globalization Waves." Harvard Business School Working Paper, No. 19-009, August 2018.
      • 2018
      • Chapter

      Work and Workplace

      By: Kai Ruggeri, Jana Berkessel, Jascha Achterberg, Gerhard M. Prinz, Alessandra Luna-Navarro, Jon M. Jachimowicz and A. V. Whillans
      Work is a major part of many lives. While individual experiences with work will differ—from how long we work to what jobs we have and to what extent we enjoy them—almost everyone is affected by employment, whether they have a job or not. Decades of research in the... View Details
      Keywords: Workplace; Behavioral Insights; Retirement Savings; Working Conditions; Employees; Performance; Happiness; Health; Job Search; Change
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      Ruggeri, Kai, Jana Berkessel, Jascha Achterberg, Gerhard M. Prinz, Alessandra Luna-Navarro, Jon M. Jachimowicz, and A. V. Whillans. "Work and Workplace." Chap. 9 in Behavioral Insights for Public Policy: Concepts and Cases, edited by Kai Ruggeri, 156–173. New York: Routledge, 2018.
      • 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
      Keywords: Spine Care; Outcomes Measurement; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Measurement and Metrics; Performance Improvement; Value
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      Kaplan, Robert S., and Derek Haas. "Defining, Measuring, and Improving Value in Spine Care." Seminars in Spine Surgery 30, no. 2 (June 2018): 80–83.
      • 2018
      • Working Paper

      Zig-Zagging Your Way to Transformative Impact

      By: V. Kasturi Rangan and Tricia Gregg
      Achieving transformative impact has been much discussed by social entrepreneurs, funders, and consultants. These discussions have focused on issues of increasing impact and scale, but often with no clear distinction between the two terms. In order to provide clarity,... View Details
      Keywords: Social Entrepreneurship; Performance Efficiency; Growth and Development; Outcome or Result; Strategy
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      Rangan, V. Kasturi, and Tricia Gregg. "Zig-Zagging Your Way to Transformative Impact." Harvard Business School Working Paper, No. 18-062, January 2018.
      • January 2018 (Revised June 2018)
      • Case

      Medtronic: Navigating a Shifting Healthcare Landscape

      By: Robert S. Kaplan, Michael E. Porter, Thomas W. Feeley and Alee Hernandez
      Medtronic is adapting its strategy to changes in healthcare competition and payments. It has decided to develop new relationships with payers, hospitals, and physicians to become more accountable for patient outcomes and total costs. The case describes new forms of... View Details
      Keywords: Value Based Health Care; Bundled Payments; Health Care and Treatment; Cost Management; Value Creation; Supply Chain Management; Customer Value and Value Chain; Health Industry; Health Industry; United States; Netherlands
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      Kaplan, Robert S., Michael E. Porter, Thomas W. Feeley, and Alee Hernandez. "Medtronic: Navigating a Shifting Healthcare Landscape." Harvard Business School Case 718-471, January 2018. (Revised June 2018.)
      • Article

      TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear

      By: Robert S. Kaplan, Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller and John I. Lowenstein
      Purpose  To perform a cost analysis comparison for managing common ocular disorders in an eye emergency department (ED) versus an urgent care setting using a time-driven activity-based cost model (TDABC) to assist physicians and staff in appropriate allocation of... View Details
      Keywords: Time-driven Activity-based Cost Model; Emergency Room; Urgent Care Clinic; Cost; Analysis; Activity Based Costing and Management; Health Care and Treatment
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      Kaplan, Robert S., Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller, and John I. Lowenstein. "TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear." Journal of Academic Ophthalmology 10 (2018).
      • January 2018
      • Article

      The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial

      By: Leslie K. John, Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein and Kevin Volpp
      Purpose: We tested the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally-available weight management program.
      Design: A randomized trial tested the impact of employer subsidy: 100%; 80% 50% and a hybrid 50% subsidy... View Details
      Keywords: Affordable Care Act (ACA); Subsidies; Weight Loss; Obesity; Incentives; Behavioral Economics; Motivation and Incentives; Behavior; Health Disorders; Health Care and Treatment; Compensation and Benefits; United States
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      John, Leslie K., Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein, and Kevin Volpp. "The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial." American Journal of Health Promotion 32, no. 1 (January 2018): 170–176.
      • 2017
      • Working Paper

      Creating the Market for Organic Wine: Sulfites, Certification, and Green Values

      By: Geoffrey Jones and Emily Grandjean
      This working paper examines the history of organic wine, which provides a case study of failed category creation. The modern organic wine industry emerged during the 1970s in the United States and Western Europe, but it struggled to gain traction compared to other... View Details
      Keywords: Product Launch; Failure; Problems and Challenges; Complexity; Governing Rules, Regulations, and Reforms; Agriculture and Agribusiness Industry; Food and Beverage Industry
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      Jones, Geoffrey, and Emily Grandjean. "Creating the Market for Organic Wine: Sulfites, Certification, and Green Values." Harvard Business School Working Paper, No. 18-048, December 2017.
      • Article

      The IT Transformation Health Care Needs

      By: Nikhil R. Sahni, Robert S. Huckman, Anuraag Chigurupati and David M. Cutler
      In recent years, health care organizations have made sizable investments in information technology. They’ve used their IT systems to replace paper records with electronic ones and to improve billing processes, thereby boosting revenue. But so far, IT has been of little... View Details
      Keywords: Health Care and Treatment; Information Technology; Performance Improvement; Business Model
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      Sahni, Nikhil R., Robert S. Huckman, Anuraag Chigurupati, and David M. Cutler. "The IT Transformation Health Care Needs." Harvard Business Review 95, no. 6 (November–December 2017): 128–136.
      • October 5, 2017
      • Article

      Making Patients and Doctors Happier—The Potential of Patient-Reported Outcomes

      By: Lisa Rotenstein, Robert S. Huckman and Neil Wagle
      Keywords: Health Care; Outcomes Measurement; Outcomes Reporting; Quality; Health Industry
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      Rotenstein, Lisa, Robert S. Huckman, and Neil Wagle. "Making Patients and Doctors Happier—The Potential of Patient-Reported Outcomes." New England Journal of Medicine 377, no. 14 (October 5, 2017): 1309–1312.
      • Article

      Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT

      By: Jonathan G. Rogg, Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang and Benjamin White
      Study objectives: Facing increased utilization and subsequent capacity and budget constraints, EDs must better understand bottlenecks and their effect on process flow to improve process efficiency. The primary objective of this study was to identify bottlenecks in... View Details
      Keywords: Health Care; Bottleneck; Health Care and Treatment; Operations; Health Industry; United States
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      Rogg, Jonathan G., Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang, and Benjamin White. "Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT." American Journal of Emergency Medicine 35, no. 10 (October 2017): 1510–1513.
      • 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; Health Industry; Utah; United States; North America
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      Hamermesh, Richard G., Kathy E. Giusti, Robert S. Huckman, and Julia Kelley. "Intermountain Healthcare: Pursuing Precision Medicine." Harvard Business School Case 818-018, September 2017. (Revised February 2023.)
      • September 2017
      • Article

      Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers

      By: Robert S. Kaplan, Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam and Christopher J. Hartnick
      Time-driven activity-based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic... View Details
      Keywords: Time-Driven Activity-Based Costing; Activity Based Costing and Management; Health Care and Treatment
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      Kaplan, Robert S., Jordan A. Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam, and Christopher J. Hartnick. "Time-Driven Activity-Based Costing to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers." The Laryngoscope 127, no. 9 (September 2017).
      • 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
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      Huckman, Robert S., and Brian W. Powers. "CareMore Health System." Harvard Business School Case 618-008, August 2017.
      • July 31, 2017
      • Article

      A Commitment Contract to Achieve Virologic Suppression in Poorly Adherent Patients with HIV/AIDS

      By: Marcella Alsan, John Beshears, Wendy S. Armstrong, James J. Choi, Brigitte C. Madrian, Minh Ly T. Nguyen, Carlos Del Rio, David Laibson and Vincent C. Marconi
      Objective: Assess whether a commitment contract informed by behavioral economics leads to persistent virologic suppression among HIV-positive patients with poor antiretroviral therapy (ART) adherence. Design: Single-center pilot randomized clinical trial and a... View Details
      Keywords: Adherence; Antiretroviral Therapy; Behavioral Economics; Commitment Contract; Financial Incentives; HIV-1 Virologic Suppression; Health Disorders; Motivation and Incentives
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      Alsan, Marcella, John Beshears, Wendy S. Armstrong, James J. Choi, Brigitte C. Madrian, Minh Ly T. Nguyen, Carlos Del Rio, David Laibson, and Vincent C. Marconi. "A Commitment Contract to Achieve Virologic Suppression in Poorly Adherent Patients with HIV/AIDS." AIDS 31, no. 12 (July 31, 2017): 1765–1769.
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