Publications
Publications
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- All HBS Web
(1,489)
- Faculty Publications (273)
- 2019
- Working Paper
Thinking Outside the Box (12): The Benefits of Increased Transparency in Employer-Sponsored Health Insurance for the 180 Million Insured
By: Regina E. Herzlinger and Barak D. Richman
Economists have long noted that the tax exclusion of employer-sponsored insurance (ESI) caused workers to purchase health plans that differ in price and other characteristics from those they would otherwise choose for themselves. We explore the short-term and long-term... View Details
- October 10, 2019
- Article
The Case for the Public Option Over Medicare for All
By: Regina E. Herzlinger and Richard Boxer
How can the United States better control its health care costs and quality and still achieve universal coverage? The strongest choice is not Medicare for All, which would eliminate private insurance; it’s the public option, which would allow people to choose from... 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
- September 2019
- Technical Note
Care Economy in the U.S. (Primer)
By: Joseph B. Fuller, William R. Kerr, Manjari Raman and Carl Kreitzberg
This case describes how caregiving responsibilities influence American employees, firms, and the broader economy. It details how sociodemographic trends in the late 20th century transformed the way that Americans balance their personal and professional lives, analyzing... View Details
- September 2019
- Case
Bill & Melinda Gates Foundation: Shaping the Vaccine Manufacturing Ecosystem
By: Willy C. Shih
Vaccines for children has been a long-standing focus for the Bill & Melinda Gates Foundation, and its critical role in public health made its production an important economic and political issue. This case describes the Foundation's investment in a breakthrough vaccine... 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
- 2019
- Article
Time-Driven Activity-Based Cost Analysis for Outpatient Anticoagulation Therapy: Direct Costs in a Primary Care Setting with Optimal Performance
By: Robert S. Kaplan, Rohit A. Bobade, Richard A. Helmers, Thomas M. Jaeger, Laura J. Odell and Derek A. Haas
Objectives: To determine how overall cost of anticoagulation therapy for warfarin compares with that of Novel Oral Anticoagulants (NOACs). Also, to demonstrate a scientific, comprehensive, and an analytical approach to estimate direct costs involved in monitoring and... View Details
- March 2019
- Article
A Time-Driven Activity-Based Costing Analysis of Emergency Department Scribes
By: Robert S. Kaplan, Heather A. Heaton, David M. Nestler, William J. Barry, Richard A. Helmers, Mustafa Y. Sir, Deepi G. Goyal, Derek A. Haas and Annie T. Sadosty
Objectives: To apply time-driven activity-based costing (TDABC) methodology to determine emergency medicine physician documentation costs with and without scribes.
Methods: Two research assistants shadowed attending physicians for a total of 64 hours in the... View Details
Methods: Two research assistants shadowed attending physicians for a total of 64 hours in the... View Details
- Article
Health as a Way of Doing Business
By: Howard Koh, Sara J. Singer and Amy C. Edmondson
For too long, the worlds of business and health have been mired in a checkered, sometimes contentious, history. Millions of deaths worldwide can be attributed to risk factors including tobacco use, alcohol and drug misuse, and suboptimal dietary intake linked to... View Details
- December 2018
- Article
Improving Resilience Among Employees High in Depression, Anxiety, and Workplace Distress
By: Allison L. Williams, Acacia C. Parks, Grace Cormier, Julia Stafford and A.V. Whillans
Depression and anxiety are costly for both employees and employers, in terms of direct medical costs as well as costs stemming from lost productive time and missed days at work. Resilience training has been shown to improve workplace functioning for employees, which... View Details
- Article
Operational Efficiency and Effective Management in the Catheterization Laboratory
By: Grant W. Reed, Michael L. Tushman and Samir R. Kapadia
Operational efficiency is a core business principle in which organizations strive to deliver high-quality goods or services in a cost-effective manner. This concept has become increasingly relevant to cardiac catheterization laboratories, as insurers move away from... View Details
- 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
- September 2018
- Article
Discretionary Task Ordering: Queue Management in Radiological Services
By: Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats
Work-scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks... View Details
Keywords: Discretion; Scheduling; Queue; Healthcare; Learning; Experience; Decentralization; Operations; Service Operations; Service Delivery; Performance; Performance Effectiveness; Performance Efficiency; Performance Improvement; Performance Productivity; Decisions; Time Management; Cost vs Benefits; Health Industry
- 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
- 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
- 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
- May 2018
- Case
The Multiple Myeloma Research Foundation's Answer Fund
By: Richard G. Hamermesh and Matthew G. Preble
Keywords: Data Analytics; Customer Focus and Relationships; Customer Relationship Management; Cost vs Benefits; Investment Return; Health Care and Treatment; Innovation Leadership; Intellectual Property; Knowledge Sharing; Knowledge Dissemination; Leadership; Leading Change; Resource Allocation; Goals and Objectives; Marketing Communications; Performance; Programs; Projects; Business and Community Relations; Business and Stakeholder Relations; Networks; Partners and Partnerships; Research and Development; Genetics; Behavior; Motivation and Incentives; Social and Collaborative Networks; Nonprofit Organizations; Strategy; Health Industry; Health Industry; Health Industry; United States
- 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
- May 2018 (Revised October 2020)
- Supplement
La Ribera Health Department (B): Epilogue
By: Regina E. Herzlinger, Emer Moloney and Daniela Beyersdorfer
The La Ribera case studies depict an innovative low cost/high quality privately financed hospital model struggling to achieve alignment with the Six Factors. It is reimbursed by the public sector in a Spanish environment whose Consumers, Structure, and Public Policy... View Details