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Article

Time-Driven Activity-Based Costing for Surgical Episodes

By: Peter Najjar, Matt Strickland and Robert S. Kaplan

Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services... View Details

Keywords: Surgery; Time-Driven Activity-Based Costing; Bundled Payments; Health Care and Treatment; Cost Management

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December 2016
Article

Health Care Needs Real Competition

By: Leemore S. Dafny and Thomas H. Lee

The U.S. health care system is inefficient, unreliable, and crushingly expensive. There is no shortage of proposed solutions, but central to the best of them is the idea that health care needs more competition. In other sectors, competition improves quality and... View Details

Keywords: Competition; Health Care and Treatment; Health Industry; United States

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November 2016 (Revised February 2017)
Case

CVS Health: Redefining the Value Proposition

By: Michael E. Porter, Jorge Ramirez-Vallejo and Alexandra Houghtalin

This case explores how a company can use shared value as a lens to think about competition and strategy choices in a challenging and evolving industry. The case takes a historical look at the structure of the retail pharmacy industry and the changing nature of rivalry... View Details

Keywords: Shared Value; Pharmacy; Health Care; Strategy; Competitive Strategy; Retail Industry; Pharmaceutical Industry; United States

November 2016 (Revised October 2018)
Case

Augmedix

By: Frank V. Cespedes and Alexandra N. Rachlin

In April 2015, Ian Shakil and Pelu Tran, cofounders of Augmedix, are discussing how to grow their emerging health care startup. The company’s sole product, also called Augmedix, streams video of doctor-patient interactions to remote medical scribes, thus freeing... View Details

Keywords: Entrepreneurial Management; Sales Management; Scaling; Hiring; Pricing; Entrepreneurship; Marketing; Marketing Strategy; Product Marketing; Sales; Technology; Health Industry; United States

Article

Adding Value by Talking More

By: Robert S. Kaplan, Derek A. Haas and Jonathan Warsh

The prevailing fee-for-service payment model has led health care administrators and physician practices to impose severe constraints on the time physicians spend talking, for which they are reimbursed poorly or not at all. New value-based reimbursement models, however,... View Details

Keywords: Value Creation; Cost Management; Health Care and Treatment; Customer Focus and Relationships; Health Industry

October 2016 (Revised March 2019)
Case

Carrum Health: Scaling Bundled Payments

By: Robert S. Huckman and Sarah Mehta

Founded in 2014, Carrum Health helped self-insured employers located in three markets (San Diego, California; Seattle, Washington; and San Francisco, California) save money on their employees’ planned surgeries. It did so by contracting directly with top-quality... View Details

Keywords: Health Financing; Health Insurance; Value-based Healthcare Reimbursements; Bundled Payments; Innovation; Scale; Health; Health Care and Treatment; Cost Management; Growth and Development Strategy; Decision Choices and Conditions; Health Industry; California; San Francisco; San Diego; Seattle

September 2016 (Revised October 2018)
Case

Springfield Hospital

By: Susanna Gallani and Robert Kaplan

One of the key roles of costing systems is to support the evaluation of performance and facilitate appropriate resource allocations. Through participation in a comparative cost study, management at Springfield Hospital, known for its heavy focus on operational... View Details

Keywords: Time-Driven Activity-Based Costing; Variance Analysis; Activity Based Costing and Management; Health Care and Treatment; Health Industry

September 2016
Article

Communicating Value in Healthcare Using Radar Charts: A Case Study of Prostate Cancer

By: Nikhil G. Thaker, Tariq N. Ali, Michael E. Porter, Thomas W. Feeley, Robert S. Kaplan and Steven J. Frank

Question: Can we create a value-based tool to visualize the outcomes and cost of various treatments that could facilitate patient-centered decision making?

Summary Answer: We developed a standardized value framework by using radar charts to visualize and... View Details

Keywords: Decision Making; Health Care and Treatment; Health Industry

July–August 2016
Article

How to Pay for Health Care

By: Michael E. Porter and Robert S. Kaplan

The United States stands at a crossroads in how to pay for health care. Fee for service, the dominant model in the United States and many other countries, is now widely recognized as perhaps the biggest obstacle to improving health care delivery. A battle is currently... View Details

Keywords: Health Care and Treatment; Finance; Health Industry; United States

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Article

Time-Driven Activity-Based Costing in Emergency Medicine

By: Robert S. Kaplan, Brian J. Yun, Anand M. Prabhakar, Jonathan Warsh, John Brennan, Kyle E. Dempsey and Ali S. Raja

Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine... View Details

Keywords: Time-Driven Activity-Based Costing; Emergency Room; Health Care and Treatment; Value; Cost Management; Activity Based Costing and Management

Article

Understanding Psychological Safety in Healthcare and Education Organizations: A Comparative Perspective

By: Amy C. Edmondson, Monica Higgins, Sara J. Singer and Jennie Weiner

Psychological safety plays a vital role in helping people overcome barriers to learning and change in interpersonally challenging work environments. This article focuses on two such contexts—health care and education. The authors theorize differences in psychological... View Details

Keywords: Healthcare Organizations; Organizations; Health Care and Treatment; Health Industry

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June 2016
Article

Vaccination Rates Are Associated with Functional Proximity but Not Base Proximity of Vaccination Clinics

By: John Beshears, James J. Choi, David Laibson, Brigitte C. Madrian and Gwendolyn I. Reynolds

Background: Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of U.S. adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is... View Details

Keywords: Geographic Location; Employees; Health Care and Treatment

May 25, 2016
Comment

How Consumers and Businesses are Reshaping Public Health

By: John A. Quelch

Healthcare and education are two issues in which citizens around the world, rich and poor, are passionately interested. It has long been appreciated that the way that a society treats its youngest and oldest members says much about its moral maturity. Economic... View Details

18 Apr 2016 - 19 Apr 2016
Other Presentation

Creating Shared Value in Health Care

By: Michael E. Porter

The overall purpose of the conference was to inspire CEOs to become more aware of their public health footprint, how they can improve the sustainability of their products and health of their workforce and their untapped power to influence change and progress in the... View Details

Keywords: Society; Health Care; Community Impact; Shared Value; Value Creation; Organizations; Civil Society or Community; Health Care and Treatment; Business and Community Relations

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

Article

Value-based Healthcare: Implications for Thyroid Cancer

By: A.K. Ying, T.W. Feeley and M. E. Porter

Today's delivery of care to thyroid cancer patients is complex, and costly, with uneven outcomes that can be improved. The incidence of thyroid cancer is rising and requires coordinated, multidisciplinary care with high volume centers that is not always available in... View Details

Keywords: Bundled Reimbursement; Healthcare Reform; Integrated Practice Units; Outcomes; Patient-reported Outcomes; Thyroid Cancer; Health Care and Treatment; Cost; Information Technology; Value

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Article

Health Care Providers Need a Value Management Office

By: Robert S. Kaplan, Catherine H. MacLean, Alexander Dresner, Derek A. Haas and Thomas W. Feeley

Many health care organizations are striving to implement a value agenda that delivers better patient outcomes at lower cost, medical condition by medical condition. To accelerate the dissemination and adoption of the value agenda, across many more medical conditions,... View Details

Keywords: Service Delivery; Value; Health Care and Treatment; Health Industry

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November 2015
Article

Influence of Experience and the Surgical Learning Curve on Long-term Patient Outcomes in Cardiac Surgery

By: Bryan M. Burt, Andrew W. ElBardissi, Robert S. Huckman, Lawrence H. Cohn, Marisa W. Cevasco, James D. Rawn, Sary F. Aranki and John G. Byrne

OBJECTIVE: We hypothesized that increased post-graduate surgical experience correlates with improved operative efficiency and long-term survival in standard cardiac surgery procedures.

METHODS: Utilizing a prospectively collected retrospective database,... View Details

Keywords: Service Delivery; Value; Health Care and Treatment; Experience and Expertise; Health Industry

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October 26, 2015
Article

Measuring and Communicating Health Care Value with Charts

By: Robert S. Kaplan, Robin P. Blackstone, Derek A. Haas and Nikhil G. Thaker

The goal of a health care system should be to deliver the most value to patients: the outcomes achieved for treating a medical condition relative to the costs incurred over a complete care cycle. We have found that a radar (spider web) chart is an effective means to... View Details

Keywords: Service Delivery; Value; Health Care and Treatment; Health Industry

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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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