Publications

March 2012 (Revised January 2013)
Case

Boston Children's Hospital: Measuring Patient Costs

By: Robert S. Kaplan, Mary L. Witkowski and Jessica A. Hohman

The case describes two pilot projects on applying activity-based costing to measuring the cost of treating patients. It presents process maps and financial data relating to the processes used during (1) an office visit to a plastic surgeon for three different diagnoses... View Details

Keywords: Health Care; Time-Driven Activity-Based Costing; Costing; Hospitals; Activity Based Costing and Management; Mathematical Methods; Health Industry

27 Nov 2023
News

The Key Hurdle: Paying For Value-Based Care

2023
Article

Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital

By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk

The COVID-19 pandemic raised awareness of the need to better understand where and how patient-level costs are incurred in health care organizations. This study used time-driven activity-based costing to estimate COVID-19 patient-level hospital costs in a Brazilian... View Details

Keywords: Health Care and Treatment; Cost; Health Industry; Brazil

April 2016 (Revised May 2016)
Case

Hôpital Universitaire de Mirebalais, Partners In Health in Haiti

By: Robert S. Kaplan, Bipin Mistry and Karla Bertrand

The case describes the application of Time-Driven Activity-Based Costing (TDABC) at a new tertiary hospital, operated by Partners in Health in Mirebelais, Haiti. A project team mapped the clinical processes for use in estimating the direct costs of personnel,... View Details

Keywords: Time-Driven Activity-Based Costing; Activity Based Costing and Management; Cost Accounting; Developing Countries and Economies; Health Care and Treatment; Health Industry; Haiti

01 Mar 2012
News

How to Close the Health Gap

higher rates in poor countries. You’ve heard of the wealth gap. Welcome to the health gap. The people who need the medicines most in the world are the least likely to receive them. “Now that we have such extraordinary capabilities, what... View Details

Keywords: Sean Silverthorne; Ambulatory Health Care Services; Ambulatory Health Care Services; Ambulatory Health Care Services; Ambulatory Health Care Services

17 Sep 2020
Research & Ideas

Many Small-Business Employees May Be Close to Losing Health Insurance

overwhelmingly reported they would pay wages first, but health care premiums were the second-most critical bill overall, and clearly ahead of rent,” the researchers write. “As one respondent put it,... View Details

Keywords: by Rachel Layne; Health

2023
Article

Dynamic HTA for Digital Health Solutions: Opportunities and Challenges for Patient-Centered Evaluation

By: Jan B. Brönneke, Annika Herr, Simon Reif and Ariel D. Stern

Germany’s 2019 Digital Healthcare Act (Digitale-Versorgung-Gesetz, or DVG) created a number of opportunities for the digital transformation of the health care delivery system. Key among these was the creation of a reimbursement pathway for patient-centered digital... View Details

Keywords: Digital Transformation; Applications and Software; Product Development; Insurance; Policy; Health Industry; Germany

January 2016
Article

Incorporating Longitudinal Pediatric Patient-centered Outcome Measurement into the Clinical Workflow Using a Commercial Electronic Health Record: A Step Toward Increasing Value for the Patient

By: Kathleen Carberry, Zachary Landman, Michelle Xie, Thomas W. Feeley, John Henderson and Charles Fraser Jr.

Patient-centered outcomes measurement provides healthcare organizations with crucial information for increasing value for patients; however, organizations have struggled to obtain outcomes data from electronic health record (EHR) systems. This study describes how Texas... View Details

Keywords: Epic; Electronic Health Records; Outcomes; Value; Patient-Centered Outcomes Measurement; Value Creation; Information Technology; Health Care and Treatment; Customer Focus and Relationships; Health Industry; Texas

Find at Harvard

04 May 2016
News

Every Company Is a Health Company

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

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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21 Oct 2009
News

Redefining Health Care: Elizabeth Teisberg Interviewed

November 2015 (Revised October 2016)
Case

athenahealth's More Disruption Please Program

By: Robert F. Higgins and Erin Trimble

Keywords: Health Care Entrepreneurship; Health Care; Healthcare; Healthcare Industry; Healthcare Innovation; Healthcare IT; Disruptive Innovation; Disruptive Change; Health Industry; Boston

23 Nov 2016
News

Opposition builds in Mountain States, Wellmont Health hospital merger

March 2017
Article

Variation in the Cost of Care for Primary Total Knee Arthroplasties

By: Derek A. Haas and Robert S. Kaplan

The study examined the cost variation across 29 high-volume U.S. hospitals for delivering a primary total knee arthroplasty without major complicating conditions. Hospital and physician personnel costs were calculated using time-driven activity-based costing.... View Details

Keywords: Cost Management; Performance Productivity; Health Care and Treatment; Health Industry

August 2023
Article

Impact of Social Needs Case Management on Use of Medical and Behavioral Health Services: Secondary Analysis of a Randomized Controlled Trial

By: Mark D. Fleming, Crystal Guo, Margae Knox, Daniel M. Brown, Elizabeth A. Hernandez and Amanda L. Brewster

Social needs case management is an increasingly common strategy used by health care organizations to address integrated health and social needs. These programs connect patients to resources such as food assistance, housing, transportation, or income benefits, in... View Details

Keywords: Health Care and Treatment; Medical Specialties; Programs; Human Needs; Welfare; Health Industry; California

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2012
Report

Better Outcomes, Lower Costs: A Conversation with Dr. Atul Gawande

By: Mark R. Kramer

In the face of increasing health care costs and uncertainty about health care quality in the United States, community-based collective impact initiatives driven by regional funders offers a new way to improve patient outcomes at the local level. Collectively,... View Details

Keywords: Community Foundations; Health Outcomes; Health Care and Treatment; Quality; Cost Management; United States