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      • November 2018
      • Case

      David Hysong and SHEPHERD Therapeutics

      By: Ananth Raman, John Masko and Aldo Sesia
      In 2016, David Hysong, at age 27, found out he had a rare, incurable cancer. Rather than wait around to die, Hysong, a recent graduate of Harvard Divinity School, decided to launch a biotechnology company called Shepherd Therapeutics to development treatments for his... View Details
      Keywords: Cancer; Therapeutics; Drugs; Health Care and Treatment; Business Startups; Product Development; Financing and Loans; Growth and Development Strategy; Problems and Challenges
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      Raman, Ananth, John Masko, and Aldo Sesia. "David Hysong and SHEPHERD Therapeutics." Harvard Business School Case 619-012, November 2018.
      • 2018
      • Chapter

      The Orphan Drug Act at 35: Observations and an Outlook for the Twenty-First Century

      By: Nicholas Bagley, Benjamin Berger, Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern
      On the 35th anniversary of the adoption of the Orphan Drug Act (ODA), we describe the enormous changes in the markets for therapies for rare diseases that have emerged over recent decades. The most prominent example is the fact that the profit-maximizing price of new... View Details
      Keywords: Health Care and Treatment; Laws and Statutes; Research and Development; Investment; Markets; Monopoly
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      Bagley, Nicholas, Benjamin Berger, Amitabh Chandra, Craig Garthwaite, and Ariel Dora Stern. "The Orphan Drug Act at 35: Observations and an Outlook for the Twenty-First Century." Chap. 4 in Innovation Policy and the Economy, Volume 19, edited by Josh Lerner and Scott Stern, 97–137. University of Chicago Press, 2018.
      • Article

      Lessons from Mayo Clinic's Redesign of Stroke Care

      By: Robert S. Kaplan, W. David Freeman, Kevin M. Barrett, Lisa Nordan, Aaron C. Spaulding and Meredith Karney
      Facing escalating costs of medications and technology, health care patients and providers in the United States continue to search for opportunities to reduce overall costs while maintaining and improving health care outcomes. The Mayo Clinic Comprehensive Stroke Center... View Details
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      Kaplan, Robert S., W. David Freeman, Kevin M. Barrett, Lisa Nordan, Aaron C. Spaulding, and Meredith Karney. "Lessons from Mayo Clinic's Redesign of Stroke Care." Special Issue on HBR Insight Center: The Future of Health Care. Harvard Business Review (website) (October 2018).
      • Article

      Financial Analysis of Pediatric Resident Physician Primary Care Longitudinal Outpatient Experience

      By: Robert S. Kaplan, Carole H. Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Vivian S. Lee and Edward B. Clark
      Objective
      To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in an outpatient primary care practice with or... View Details
      Keywords: Academic Medicine; Cost; Children; Graduate Medical Education
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      Kaplan, Robert S., Carole H. Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Vivian S. Lee, and Edward B. Clark. "Financial Analysis of Pediatric Resident Physician Primary Care Longitudinal Outpatient Experience." Academic Pediatrics 18, no. 7 (September–October 2018): 837–842.
      • June 2018
      • Supplement

      Amil and the Health Care System in Brazil (B)

      By: Regina Herzlinger, Ana Maria Malik, Ruth Costas and Priscilla Zogbi
      Brazilian Managed Care Organization Amil faces a series of challenges while trying to redefine the terms of its relationship with hospitals and clinics and to implement a new health care model based on primary care and family medicine. View Details
      Keywords: Health Care; Brazil; Managed Care; Innovation; Health Care Industry; Health Care and Treatment; Health; Cost Management; Innovation and Invention; Competitive Strategy; Health Industry; Insurance Industry; Brazil
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      Herzlinger, Regina, Ana Maria Malik, Ruth Costas, and Priscilla Zogbi. "Amil and the Health Care System in Brazil (B)." Harvard Business School Supplement 318-149, June 2018.
      • May 2018
      • Case

      Kaiser Permanente Colorado: Primary Care Plus

      By: Robert S. Kaplan and Mahek A. Shah
      A geriatrician in Kaiser Permanente’s Colorado region is concerned with the high and growing cost of treating the elderly population. She introduces a new care model, Primary Care Plus, using an interdisciplinary team of a primary care doctor, palliative care... View Details
      Keywords: Primary Health Care; Elderly Patients; Integrated Practice Unit; Interdisciplinary Care; Health Care and Treatment; Age; Cost Management; Performance Improvement; Health Industry; United States; Colorado
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      Kaplan, Robert S., and Mahek A. Shah. "Kaiser Permanente Colorado: Primary Care Plus." Harvard Business School Case 118-053, May 2018.
      • March 2018
      • Case

      University Hospitals Cleveland Medical Center: Managing Capacity in Neurology

      By: Joel Goh, Robert S. Huckman and Nikhil Sahni
      In December 2014, Dr. Anthony Furlan, chair of the Department of Neurology at University Hospitals Cleveland Medical Center (UH), faced a mandate from the hospital’s executive leadership team. Specifically, all UH departments were directed to take steps within six... View Details
      Keywords: Health Care; Hospitals; Capacity Planning; Scheduling; Health Care and Treatment; Service Operations; Performance Capacity; Health Industry; North America; United States; Ohio; Cleveland
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      Goh, Joel, Robert S. Huckman, and Nikhil Sahni. "University Hospitals Cleveland Medical Center: Managing Capacity in Neurology." Harvard Business School Case 618-062, March 2018.
      • March 2018
      • Teaching Note

      Twine Health

      By: Robert S. Huckman and Ariel D. Stern
      In late 2014, Dr. John Moore (CEO), Frank Moss (chairman), and Scott Gilroy (CTO) of Twine Health (Twine) had to resolve several challenges that threatened to restrict the widespread dissemination of its sole product, Twine. Twine was a cloud-based platform that... View Details
      Keywords: Health Care; Chronic Disease; Digital Health; Health Acceleration Challenge; Strategy; Disease Management; Health; Health Care and Treatment; Information Technology; Mobile and Wireless Technology; Technology Adoption; Health Industry; United States; Massachusetts
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      Huckman, Robert S., and Ariel D. Stern. "Twine Health." Harvard Business School Teaching Note 618-055, March 2018.
      • January 2018 (Revised May 2019)
      • Case

      Adeo Health Science: Turning a Product into a Brand

      By: Elizabeth A. Keenan and Jill Avery
      For decades, American parents were warned to avoid introducing potential allergens to their babies prior to their first birthday. But two influential clinical studies caused the medical establishment to radically reverse its position. Parents were now warned that... View Details
      Keywords: Startup; Health Care; Consumer; Consumer Products; Branding; Distribution; Retailing; Go To Market Strategy; Marketing; Marketing Channels; Marketing Communications; Brands and Branding; Marketing Strategy; Entrepreneurship; Health Care and Treatment; Consumer Products Industry; Health Industry; United States; North America
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      Keenan, Elizabeth A., and Jill Avery. "Adeo Health Science: Turning a Product into a Brand." Harvard Business School Case 518-065, January 2018. (Revised May 2019.)
      • January 2018
      • Article

      Innovation Incentives and Biomarkers

      By: Ariel Dora Stern, Brian M. Alexander and Amitabh Chandra
      Previously, we have discussed the importance of economic incentives in shaping markets for precision medicines. Here we consider incentives for biomarker development, including discovery and establishment. Biomarkers can reveal valuable information regarding diagnosis... View Details
      Keywords: Health Care and Treatment; Innovation and Invention; Research and Development; Markets
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      Stern, Ariel Dora, Brian M. Alexander, and Amitabh Chandra. "Innovation Incentives and Biomarkers." Clinical Pharmacology & Therapeutics 103, no. 1 (January 2018): 34–36.
      • 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).
      • 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.
      • 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
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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

      Infection Control at Massachusetts General Hospital (Abridged)

      By: Robert S. Huckman and Nikolaos Trichakis
      The case explores the challenges facing Massachusetts General Hospital concerning the adoption of a new infection control policy, which promises to improve operational performance, patient safety, and profitability. The new policy requires coordination between... View Details
      Keywords: Safety; Organizational Change and Adaptation; Integration; Health Care and Treatment; Policy; Health Industry; Boston
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      Huckman, Robert S., and Nikolaos Trichakis. "Infection Control at Massachusetts General Hospital (Abridged)." Harvard Business School Case 618-018, 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.
      • Article

      Time-Driven Activity-Based Costing for Surgical Episodes

      By: Peter Najjar, Matt Strickland and Robert S. Kaplan
      Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services... View Details
      Keywords: Surgery; Time-Driven Activity-Based Costing; Bundled Payments; Health Care and Treatment; Cost Management
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      Najjar, Peter, Matt Strickland, and Robert S. Kaplan. "Time-Driven Activity-Based Costing for Surgical Episodes." JAMA Surgery 152, no. 1 (January 2017): 96–97.
      • Article

      Adding Value by Talking More

      By: Robert S. Kaplan, Derek A. Haas and Jonathan Warsh
      The prevailing fee-for-service payment model has led health care administrators and physician practices to impose severe constraints on the time physicians spend talking, for which they are reimbursed poorly or not at all. New value-based reimbursement models, however,... View Details
      Keywords: Value Creation; Cost Management; Health Care and Treatment; Customer Focus and Relationships; Health Industry
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      Kaplan, Robert S., Derek A. Haas, and Jonathan Warsh. "Adding Value by Talking More." New England Journal of Medicine 375, no. 20 (November 17, 2016): 1918–1920.
      • 2017
      • Article

      The Impact of Training Informal Healthcare Providers in India: A Randomized Controlled Trial

      By: Jishnu Das, Abhijit Chowdhury, Reshmaan Hussam and Abhijit Banerjee
      Health care providers without formal medical qualifications provide more than 70% of all primary care in rural India. Training these informal providers may be one way to improve the quality of care where few alternatives exist. We report on a randomized controlled... View Details
      Keywords: Health Care; India; Business Training; RCT; Health Care and Treatment; Training; Performance Evaluation; Performance Improvement; India
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      Das, Jishnu, Abhijit Chowdhury, Reshmaan Hussam, and Abhijit Banerjee. "The Impact of Training Informal Healthcare Providers in India: A Randomized Controlled Trial." Science 354, no. 6308 (October 7, 2016): 80.
      • June 2016
      • Article

      Vaccination Rates Are Associated with Functional Proximity but Not Base Proximity of Vaccination Clinics

      By: John Beshears, James J. Choi, David Laibson, Brigitte C. Madrian and Gwendolyn I. Reynolds
      Background: Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of U.S. adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is... View Details
      Keywords: Geographic Location; Employees; Health Care and Treatment
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      Beshears, John, James J. Choi, David Laibson, Brigitte C. Madrian, and Gwendolyn I. Reynolds. "Vaccination Rates Are Associated with Functional Proximity but Not Base Proximity of Vaccination Clinics." Medical Care 54, no. 6 (June 2016): 578–583.
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