Publications
Publications
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- All HBS Web
(1,489)
- Faculty Publications (273)
- 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
- February 2018
- Case
Health Savings Accounts: Enabling Consumer Participation
By: Regina E. Herzlinger and James Wallace
Health savings accounts (HSAs), a creation of the 2003 Medicare Modernization Act, had become an integral part of the drive toward consumer-driven health care. Coupled with high-deductible health plans, HSAs allowed consumers to directly control a significant part of... View Details
- January 2018 (Revised June 2018)
- Case
Medtronic: Navigating a Shifting Healthcare Landscape
By: Robert S. Kaplan, Michael E. Porter, Thomas W. Feeley and Alee Hernandez
Medtronic is adapting its strategy to changes in healthcare competition and payments. It has decided to develop new relationships with payers, hospitals, and physicians to become more accountable for patient outcomes and total costs. The case describes new forms of... View Details
- January 2018
- Case
Partners In Health: Costing Primary Care in Haiti
By: Robert S. Kaplan and Mahek A. Shah
Partners in Health, a global NGO focused on delivering health care to residents of rural underserved communities, conducts a project on the cost of primary care at five sites in the Central Highlands of Haiti. It devises a simple approach for tracking the resources... View Details
- 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
- January 2018
- Article
The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial
By: Leslie K. John, Andrea Troxel, William Yancy, Joelle Y. Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott Halpern, George Loewenstein and Kevin Volpp
Purpose: We tested the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally-available weight management program.
Design: A randomized trial tested the impact of employer subsidy: 100%; 80% 50% and a hybrid 50% subsidy... View Details
Design: A randomized trial tested the impact of employer subsidy: 100%; 80% 50% and a hybrid 50% subsidy... View Details
- 2017
- Working Paper
Creating the Market for Organic Wine: Sulfites, Certification, and Green Values
By: Geoffrey Jones and Emily Grandjean
This working paper examines the history of organic wine, which provides a case study of failed category creation. The modern organic wine industry emerged during the 1970s in the United States and Western Europe, but it struggled to gain traction compared to other... View Details
- December 2017
- Article
Overall Cost Comparison of Gastrointestinal Endoscopic Procedures with Endoscopist- or Anesthesia-Supported Sedation by Activity-Based Costing Techniques
By: Richard A. Helmers, James A. Dilling, Christopher R. Chaffee, Mark V. Larson, Bradly J. Narr, Derek A. Haas and Robert S. Kaplan
Endoscopic/Colonoscopic procedures are done either with gastroenterologist-administered conscious sedation or with anesthesia-administered sedation with propofol. Anesthesia-administered sedation has medical and patient benefits but is more expensive to administer. We... View Details
- 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
- 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
- Article
Narrow Networks on the Health Insurance Marketplaces: Prevalence, Pricing, and the Cost of Network Breadth
By: Leemore S. Dafny, Igal Hendel, Victoria Marone and Christopher Ody
Anecdotal reports and systematic research highlight the prevalence of narrow-network plans on the Affordable Care Act’s health insurance Marketplaces. At the same time, Marketplace premiums in the period 2014–2016 were much lower than projected by the Congressional... View Details
- 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
- 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
- August 2017
- Article
Should Governments Invest More in Nudging?
By: Shlomo Benartzi, John Beshears, Katherine L. Milkman, Cass R. Sunstein, Richard H. Thaler, Maya Shankar, Will Tucker-Ray, William J. Congdon and Steven Galing
Governments are increasingly adopting behavioral science techniques for changing individual behavior in pursuit of policy objectives. The types of “nudge” interventions that governments are now adopting alter people’s decisions without coercion or significant changes... View Details
Keywords: Nudge; Nudge Unit; Choice Architecture; Behavioral Science; Behavioral Economics; Savings; Pension Plan; Education; College Enrollment; Energy; Electricity Usage; Preventive Health; Influenza Vaccination; Flu Shot; Open Materials; Behavior; Governance; Economics; Policy; Power and Influence
- June 2017 (Revised October 2017)
- Case
Becton Dickinson: Innovation and Growth (A)
By: Raffaella Sadun, Michael Beer and James Weber
In late 2015, CEO Vince Forlenza was reviewing Becton Dickinson’s transformation efforts designed to enable the company to innovate and grow in a changing environment. Becton Dickinson had been a successful medical device company for over 100 years. In recent years,... View Details
- 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
- April 2017
- Supplement
Imprimis (B)
By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel
This case is a supplement to Imprimis (A). It describes the company’s decision to enter into the pharmaceutical compounding business in 2013–2014. Imprimis purchased a compounded ophthalmological medication called Dropless Therapy, which was injected into patients’... View Details
- April 2017
- Supplement
Imprimis (C)
By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel
This case is a supplement to Imprimis (A & B). Set in 2015, it first describes Imprimis’s decision to introduce its own line of compounded eye drop medication called LessDrops. The case then examines the moral dilemma faced by CEO Mark Baum, who was struck by the... View Details
- 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
- Article
Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center
By: Robert S. Kaplan, Yoshimi Anzai, Marta E. Heilbrun, Derek Haas, Luca Boi, Kirk Moshre, Satoshi Minoshima and Vivian S. Lee
The lack of understanding the true costs (not charges) of delivering health care services poses tremendous challenges in the containment of health care costs. In this study, we applied an established cost accounting method, time-driven activity-based costing (TDABC),... View Details