Publications

June 2021
Article

Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative

By: Casey J. Allen, Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala and Matthew H.G. Katz

We used national administrative data to assess multiple domains of value associated with enhanced recovery pathways for patients undergoing pancreatic surgery. Value metrics included in-hospital mortality, complication rates, length of stay (LOS), 30-day readmission... View Details

Keywords: Value-based Health Care; Health Care and Treatment; Analytics and Data Science; Outcome or Result; Measurement and Metrics; Performance Improvement

2021
Working Paper

Regulatory Approval and Expanded Market Size

By: Benjamin Berger, Amitabh Chandra and Craig Garthwaite

Regulatory review of new medicines is often viewed as a hindrance to innovation by increasing the hurdle to bring products to market. However, a more complete accounting of regulation must also account for its potential market expanding effects through quality... View Details

Keywords: New Medicines; Regulatory Approval; Health Care and Treatment; Research and Development; Governing Rules, Regulations, and Reforms; Markets; Expansion; Pharmaceutical Industry

May 2021
Case

Inclusive Innovation at Mass General Brigham

By: Katherine Baldiga Coffman and Olivia Hull

Massachusetts General Brigham (MGB) Chief Innovation Officer Christopher Coburn had overseen a period of exciting transformation and growth in healthcare innovation at MGB. In November 2019, the health system was the largest recipient of National Institutes of Health... View Details

Article

A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor's Appointment

By: Katherine L. Milkman, Mitesh S. Patel, Linnea Gandhi, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via... View Details

Keywords: Vaccination; COVID-19; Nudge; Influenza; Field Experiment; Health; Communication Strategy; Behavior

May 2021
Article

Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency

By: J. Hart, K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels and S.D. Halpern

Background: Clinicians’ use of choice architecture, or how they present options, systematically influences the choices made by patients and their surrogate decision makers. However, clinicians may incompletely understand this influence.... View Details

Keywords: Choice Architecture; Health Care and Treatment; Interpersonal Communication; Decision Choices and Conditions; Competency and Skills

May 2021
Article

Making Doctors Effective Managers and Leaders: A Matter of Health and Well-Being

By: Lisa Rotenstein, Robert S. Huckman and Christine K. Cassel

The COVID-19 crisis has forced physicians to make daily decisions that require knowledge and skills they did not acquire as part of their biomedical training. Physicians are being called upon to be both managers—able to set processes and structures—and leaders—capable... View Details

Keywords: Health Care and Treatment; Management; Leadership; Health Pandemics; Health Industry

Article

Missing the Near Miss: Recognizing Valuable Learning Opportunities in Radiation Oncology

By: Palak Kundu, Olivia Jung, Luca F. Valle, Amy C. Edmondson, Nzhde Agazaryan, John Hegde, Michael Steinberg and Ann Raldow

“Near miss” events are valuable low-cost learning opportunities in radiation oncology as they do not result in patient harm and are more pervasive than adverse events that do. Near misses vary depending on the presence of a latent error of behavior or process, and the... View Details

Keywords: Radiation Oncology; Cognitive Biases; Health Care and Treatment; Learning

May 2021
Article

Value-Based Healthcare in Urology: A Collaborative Review

By: Chanan Reitblat, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh and Boris Gershman

Context:
In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and... View Details

Keywords: Value-based Healthcare; Integrated Practice Units; Outcome Measurement; Time-Driven Activity-Based Costing; Health Care and Treatment; Value; Cost Management; Strategy; Outcome or Result; Measurement and Metrics

April 2021
Case

ClearChoice Dental Implant Centers

By: Robert S. Kaplan, Ashiana Jivraj and Jane Barrow

The case illustrates the application of value-based health care to dental medicine. ClearChoice Dental Implant Centers was a rapidly-growing network of dentist-owned independent implant clinics. The targeted market included 23 million people, 15% of the US adult... View Details

Keywords: Value-based Health Care; Dental Medicine; Growth and Development Strategy; Expansion; Business Strategy; Customer Value and Value Chain; Customer Focus and Relationships; Health Industry; United States

2021
Working Paper

Diagnosing Quality: Learning, Amenities, and the Demand for Health Care

By: Achyuta Adhvaryu, Emilio Gutierrez, Anant Nyshadham and Jorge Tamayo

We study the role of amenities in increasing demand for underutilized healthcare services. We evaluate the offer of a high-amenity diagnostic consultation for cataracts with a randomized price and find that a lower price for the high-amenity consultation increases... View Details

Keywords: Health Care Demand; Amenities; Health Care Quality; Cataracts; Surgery; Health Care and Treatment; Demand and Consumers; Quality; Learning; Mexico

April 2021
Article

Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models

By: Susanna Gallani, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar and Frank Opelka

Modern medicine is undergoing a transformation that involves innovative surgical approaches, increased medical treatment options, clinical care pathways that require collaboration beyond hospital walls, and health data captured by electronic health records and other... View Details

Keywords: Physician Compensation; Surgeons; Health Care and Treatment; Business Model; Compensation and Benefits

March 2021 (Revised January 2022)
Case

Philips: Redefining Telehealth

By: Regina E. Herzlinger, Alec Petersen, Natalie Kindred and Sara M. McKinley

As one of the world’s largest healthcare companies, Philips sought to reach beyond the walls of the hospital and expand its hospital-to-home program to gain future competitive advantage through technology solutions combining predictive analytics with care delivery. By... View Details

Article

A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018

By: J. Chirenda, B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison and R. S. Kaplan

Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and... View Details

Keywords: Time-Driven Activity-Based Costing; Provider Cost; Health Care and Treatment; Cost Management; Activity Based Costing and Management; Zimbabwe

February 2021
Case

New England Baptist Hospital: Getting Paid for Value

By: Robert S. Kaplan, Mary Witkowski, Toby E. Emanuel and Syed S. Shehab

New England Baptist Hospital (NEBH), a national leader in adult orthopedic care, has the lowest rate of complications and 30-day readmissions in New England, but gets paid 30% less for its surgeries than nearby institutions. NEBH introduces, with several large... View Details

Keywords: Healthcare; Healthcare Spending; Healthcare Innovation; Healthcare Industry; Health Care Outcomes; Health Care Delivery; Health Care Reform; Bundled Payments; Health Care and Treatment; Spending; Innovation and Invention; Value Creation; Strategy; Health Industry; North America

February 2021
Article

Assessment of Electronic Health Record Use Between U.S. and Non-U.S. Health Systems

By: A Jay Holmgren, Lance Downing, David W. Bates, Tait D. Shanafelt, Arnold Milstein, Christopher Sharp, David Cutler, Robert S. Huckman and Kevin A. Schulman

Importance: Understanding how the electronic health record (EHR) system changes clinician work, productivity, and well-being is critical. Little is known regarding global variation in patterns of use.
Objective: To provide insights into which EHR... View Details

Keywords: Electronic Health Records; Health Care and Treatment; Online Technology; Health Industry; Information Technology Industry

February 2021
Article

Health Care Measurements That Improve Patient Outcomes

By: Robert S. Kaplan, Lara Jehi, Clifford Y. Ko, Andrea Pusic and Mary Witkowski

This article describes the challenges and solutions in determining whether a patient’s treatment has been successful. Such an assessment depends on multiple factors, including the patient’s pretreatment status; the qualifications of personnel performing the treatment;... View Details

Keywords: Outcomes Measurement; Health Care and Treatment; Outcome or Result; Measurement and Metrics

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2021
Working Paper

Kidney Exchange: An Operations Perspective

By: Itai Ashlagi and Alvin E. Roth

Many patients in need of a kidney transplant have a willing but incompatible (or poorly matched) living donor. Kidney exchange programs arrange exchanges among such patient-donor pairs, in cycles and chains of exchange, so each patient receives a compatible kidney.... View Details

Keywords: Kidney Exchange Programs; Health Disorders; Health Care and Treatment; Programs; Design

2021
Working Paper

The Health Costs of Cost-Sharing

By: Amitabh Chandra, Evan Flack and Ziad Obermeyer

We use the design of Medicare’s prescription drug benefit program to demonstrate three facts about the health consequences of cost-sharing. First, we show that an as-if-random increase of 33.6% in out-of-pocket price (11.0 percentage points (p.p.) change in... View Details

Keywords: Cost-sharing; Impact; Health Care and Treatment; Insurance; Health; Consumer Behavior

January 28, 2021
Other Article

Lessons from the U.S.'s Rocky Vaccine Rollout

By: Robert S. Huckman and Bradley R. Staats

The rocky rollout of the COVID-19 vaccines is emblematic of many of the problems with the U.S. health care system. The United States is blessed with highly trained, excellent, and compassionate care providers and terrific research and development that has led to novel... View Details

Keywords: Health Care; COVID-19; Vaccines; Operations Improvement; Health Pandemics; Health Care and Treatment; Service Delivery; Operations; Performance Improvement; Health; Health Industry; United States