Publications
Publications
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- All HBS Web
(1,241)
- Faculty Publications (290)
- 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
- 2024
- Working Paper
Gastrointestinal Endoscopy--Without Cutting In: Case Histories of Transformational Advances
By: Amar Bhidé, Srikant M. Datar and Katherine Stebbins
This case history describes how endoscopy transformed the diagnosis of ulcers, cancerous polyps, and other alimentary canal diseases and enabled “minimally invasive” surgeries to treat such diseases. Specifically, we chronicle how: 1) flexible glass fiber endoscopes... View Details
- 2019
- Book
Patient Capital: The Challenges and Promises of Long-Term Investing
By: Victoria Ivashina and Josh Lerner
There has never been a greater need for long-term investments. And it is increasingly unlikely that the public sector will be willing or able to fill the gap. Those best positioned to address the long-run needs are likely to be the pools of capital in the hands of... 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
- 2019
- Chapter
Characterizing the Drug Development Pipeline for Precision Medicines
By: Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern
BOOK ABSTRACT: Personalized and precision medicine (PPM)—the targeting of therapies according to an individual’s genetic, environmental, or lifestyle characteristics—is becoming an increasingly important approach in health care treatment and prevention. The advancement... View Details
- 2019
- Working Paper
Biometric Monitoring, Service Delivery and Misreporting: Evidence from Healthcare in India
By: Thomas Bossuroy, Clara Delavallade and Vincent Pons
Developing countries increasingly use biometric identification technology in hopes of improving the reliability of administrative information and delivering social services more efficiently. This paper exploits the random placement of biometric tracking devices in... View Details
- Article
Extracorporeal Membrane Oxygenation Appropriateness: An Interdisciplinary Consensus-Based Approach
By: Robert S. Kaplan, Michael Nurok, Jonathan Warsh, Todd Griner, Mayumi Kharabi, Joseph Castongia, Cali Overbeck, Lisa Krueger, Bernice Coleman, Danny Ramzy, Joshua Chung, Alice Chan, Eric Ley, Sindhu Kubendran, Neil Parrish, Zhe Yu, Michael Landberg, Stuart Finder, Bradley T. Rosen, Harry Sax and Francisco Arabia
We describe a quality improvement initiative aimed at achieving interdisciplinary consensus about the appropriate delivery of extracorporeal membrane oxygenation (ECMO). Interdisciplinary rounds were implemented for all patients on ECMO and addressed whether care was... View Details
- 2019
- Chapter
Behavioral Economics and Health-Care Markets
By: Amitabh Chandra, Benjamin Handel and Joshua Schwartzstein
This chapter summarizes research in behavioral health economics, focusing on insurance markets and product markets in health care. We argue that the prevalence of choice difficulties and biases leading to mistakes in these markets establish a special place for them in... View Details
- January 2019
- Teaching Note
Pricing PatientPing
Teaching Note for HBS No. 818-017. PatientPing sells a software platform that allows health care providers to receive real-time notifications (“pings”) when one of their patients is admitted to or discharged from a health-care facility. The platform facilitates... View Details
- Article
Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated
By: Christopher Ody, Lucy Msall, Leemore S. Dafny, David Grabowski and David Cutler
Medicare’s Hospital Readmissions Reduction Program (HRRP) has been credited with lowering risk-adjusted readmission rates for targeted conditions at general acute care hospitals. However, these reductions appear to be illusory or overstated. This is because a... View Details
- 2018
- Chapter
The Orphan Drug Act at 35: Observations and an Outlook for the Twenty-First Century
By: Nicholas Bagley, Benjamin Berger, Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern
On the 35th anniversary of the adoption of the Orphan Drug Act (ODA), we describe the enormous changes in the markets for therapies for rare diseases that have emerged over recent decades. The most prominent example is the fact that the profit-maximizing price of new... View Details
- October 2018 (Revised August 2019)
- Case
Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?
By: Leemore Dafny
In July 2017, CEO Kevin Tabb of Boston's Beth Israel Deaconess Medical Center announced his plan to consolidate 11 Massachusetts hospitals under a common management structure. These hospitals collectively generated $5 billion in patient revenue and 25% of... 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
- Article
Financial Analysis of Pediatric Resident Physician Primary Care Longitudinal Outpatient Experience
By: Robert S. Kaplan, Carole H. Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Vivian S. Lee and Edward B. Clark
Objective
To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in an outpatient primary care practice with or... View Details
To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in an outpatient primary care practice with or... View Details
- July 2018
- Case
Ce Soir-Là, Ils n'Arrivent Plus Un par Un, Mais par Vagues: Coping with the Surge of Trauma Patients at L'Hôpital Universitaire La Pitié Salpêtrière—Friday, November 13, 2015
By: Herman B. "Dutch" Leonard, Emilie Billaud and Arnold M. Howitt
On November 13, 2015, Dr. Marie Borel, Dr. Emmanuelle Dolla, Dr. Frédéric Le Saché, and Professor Mathieu Raux were the doctors in charge of the trauma center at L’Hôpital de la Pitié Salpêtrière in Paris, where dozens of wounded and dying patients, most with severe... 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
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
- March 2018
- Teaching Note
Twine Health
By: Robert S. Huckman and Ariel D. Stern
In late 2014, Dr. John Moore (CEO), Frank Moss (chairman), and Scott Gilroy (CTO) of Twine Health (Twine) had to resolve several challenges that threatened to restrict the widespread dissemination of its sole product, Twine. Twine was a cloud-based platform that... View Details
- March 2018 (Revised January 2019)
- Case
Gilead Mexico
By: Michael Chu and V. Kasturi Rangan
With a breakthrough cure for Hepatitis C listing in the U.S. at $1,000/pill, Gilead must now solve the issue of making it available to patients across the world, much as it did for its blockbuster HIV/AIDS antiretrovirals. For Erik Musalem, the new general manager of... View Details