Publications

January 2024
Article

A Cost Model for a Low Threshold Clinic Treating Opioid Use Disorder

By: Sarah E. Wakeman, Elizabeth Powell, Syed Shehab, Grace Herman, Laura Kehoe and Robert S. Kaplan

The US fee-for-service payment system under-reimburses clinics offering access to comprehensive treatments for opioid use disorder (OUD). The funding shortfall limits a clinic’s ability to expand and improve access, especially for socially marginalized patients with... View Details

Keywords: Health Care and Treatment; Cost; Equality and Inequality; Health Industry

Article

Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

By: Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman

The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with... View Details

Keywords: Health Care and Treatment; Cost Management; Insurance; Problems and Challenges

24 Sep 2018
Research & Ideas

How Cost Accounting is Improving Healthcare in Rural Haiti

keep up with the demand to treat patients every day. And that’s why Partners in Health turned to the straightforward time-driven activity-based costing system to measure the... View Details

Keywords: by Carmen Nobel; Health

August 23, 2018
Article

Using a New EHR System to Increase Patient Engagement, Improve Efficiency, and Decrease Cost

By: Katy French, Barbra Bryce Speer, Alexis B. Guzman, Tayab Andrabi, Iris Recinos, Keith A. Shook, James R. Incalcaterra, John C. Frenzel and Thomas W. Feeley

Patients and providers are frustrated with seemingly endless data entry. We used our patients’ vested interest in their own health care by actively engaging them in the entry of their own medical information into the EHR. Prior to the implementation of the new EHR we... View Details

Keywords: Health Care and Treatment; Analytics and Data Science; Performance Efficiency; Cost Management

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May 2017
Supplement

Boston Children's Hospital Process Map Video

By: Robert S. Kaplan and Mary Witkowski

The 13 minute video simulates a discussion among orthopedic surgeons and cast room technicians about the processes and resources used when applying long leg casts for patients. The video should be used when teaching Boston Children’s Hospital (Abridged) case, #914-407,... View Details

Keywords: Activity Based Costing; Healthcare Costing; Process Maps; Activity Based Costing and Management; Health Care and Treatment

February 2025
Article

Innovations in Evaluating Ambulatory Costs of Cystic Fibrosis Care: A Comparative Study Across Multidisciplinary Care Centers in Ireland and the United States

By: Emma Brady, Ryan C. Perkins, Kate Cullen, Gregory S. Sawicki, Robert S. Kaplan and Gerardine Doyle

Lead clinicians at two large pediatric cystic fibrosis (CF) centers in the United States and Ireland measured and compared their ambulatory care costs. The clinicians selected three strata of patients (0–11 months, 1–5 years, and 6–17 years of age). Process maps were... View Details

Keywords: Health Care and Treatment; Cost; Service Delivery; Resource Allocation; Health Industry

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2021
Working Paper

How to Fix ESG Reporting

By: Robert S. Kaplan and Karthik Ramanna

Investors, advocacy groups, academics, and the 200 CEOs of the US Business Roundtable have asked corporations to take on an added purpose beyond a narrow pursuit of shareholder value. In response, many companies now issue ESG (Environmental, Societal, and Governance)... View Details

Keywords: ESG Reporting; Sustainability; Corporate Purpose; Greenhouse Gas; Activity-Based Costing; Environmental Sustainability; Environmental Management; Corporate Social Responsibility and Impact; Measurement and Metrics; Goals and Objectives; Agreements and Arrangements; Corporate Accountability

SSRN

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March 1, 2021
Article

Transitioning to Clean Energy Transportation Services: Life-cycle Cost Analysis for Vehicle Fleets

By: Stephen Comello, Gunther Glenk and Stefan Reichelstein

Comprehensive global decarbonization requires that transportation services cease to rely on fossil fuels for power generation. This paper develops a generic, time-driven life-cycle cost model for mobility services to address two closely related questions central to the... View Details

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Web

Measure Outcomes & Cost for Every Patient - Institute For Strategy And Competitiveness

introduced Time-Driven Activity-Based Costing (TDABC) to health care. In this unique approach, costing is approached from the bottom up looking... View Details

February 2006 (Revised September 2006)
Case

Sippican Corporation (A)

Presents a time-driven version of the Wilkerson Co. activity-based costing case (101092). Faced with declining profits, Sippican Corp. is struggling to understand why it is encountering severe price competition on one product line. The controller collects data that... View Details

Keywords: History; Business Model; Strategic Planning; Cost Accounting; Motivation and Incentives; Resource Allocation; Activity Based Costing and Management; Profit; Business Strategy; Budgets and Budgeting

October 22, 2015
Article

The Mayo Clinic Model for Running a Value-Improvement Program

By: Robert S. Kaplan, Derek A. Haas, Richard A. Helmers, March Rucci and Meredith Brady

Applying time-driven activity-based costing (TDABC) in health care cannot be delegated to the finance function. The most successful implementations have had strong executive support, exceptional clinical leaders, and dedicated, multi-disciplinary project teams. The... View Details

Keywords: Service Delivery; Activity Based Costing and Management; Health Care and Treatment; Health Industry

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March 2004 (Revised April 2005)
Case

Midwest Office Products

Presents an easy introduction to time-driven activity-based costing (ABC) that allows students to build a simple ABC model of order profitability. Midwest's time-driven ABC approach is based on two categories of parameter estimates. The first is the cost per hour of... View Details

Keywords: Cost; Price; Activity Based Costing and Management; Time Management; Financial Reporting; Profit; Performance Improvement; Order Taking and Fulfillment; Performance Evaluation

October 2016 (Revised December 2016)
Module Note

Strategy Execution Module 6: Evaluating Strategic Profit Performance

By: Robert Simons

This module reading demonstrates how to calculate and analyze the profit generated by different business strategies. Formulas and examples are provided to calculate profit generated by changes in market share, revenue growth, efficiency improvements, and support costs.... View Details

Keywords: Management Control Systems; Implementing Strategy; Execution; Evaluating Business Performance; Profitability Analysis; Variance Analysis; Measuring Effectiveness; Measuring Efficiency; Activity-Based Costing; Flexible Budget; Accounting; Strategy

11 Mar 2015
News

Paying more for comparable outcomes in prostate treatment

June 2014
Article

Improving Value with TDABC

The article discusses the benefits of time-driven activity-based costing (TDABC) combined with outcomes measurement for healthcare organizations. Topics covered include improving resource efficiency, optimizing care over the complete care cycle, and planning and... View Details

Keywords: Goals and Objectives; Activity Based Costing and Management; Health Care and Treatment; Health Industry

23 Oct 2015
News

The Mayo Clinic Model for Running a Value-Improvement Program

October 1990 (Revised April 1999)
Case

Hewlett-Packard: Queensferry Telecommunications Division

Queensferry Telecommunications Division has recently implemented an activity-based cost system. The case explores several issues. First, the role of variance analysis in an activity-based system. Second, the way to determine cost drive rates. Third, the evaluation of... View Details

Keywords: Activity Based Costing and Management; Telecommunications Industry

September 2009 (Revised October 2010)
Case

Elkay Plumbing Products Division

The vice president of sales learns that the most profitable 1% of the division's customers generate 100% of profits, and that two of the division's largest customers lose 50% of profits. The division has just finished a project to install a time-driven activity-based... View Details

Keywords: Activity Based Costing and Management; Profit; Management Systems; Consumer Products Industry; Industrial Products Industry

Article

Better Accounting Transforms Health Care Delivery

By: Robert S. Kaplan and Mary L. Witkowski

The paper describes the theory and preliminary results for an action research program that explores the implications from better measurements of health care outcomes and costs. After summarizing Porter's outcome taxonomy (Porter 2010), we illustrate how to use process... View Details

Keywords: Activity Based Costing and Management; Research; Health Care and Treatment; Health Industry