Publications
Publications
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(1,244)
- Faculty Publications (299)
- 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
- 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 (Revised January 2019)
- Case
ZappRx
By: Jeffrey J. Bussgang and Olivia Hull
In October 2015, ZappRx founder Zoe Barry is deciding between two business models for her health technology start-up. Her product, a software application that aims to expedite the prescription fulfillment process for patients with rare diseases, has attracted interest... 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
- 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
- 2017
- Working Paper
Identifying Sources of Inefficiency in Health Care
By: Amitabh Chandra and Douglas O. Staiger
In medicine, the reasons for variation in treatment rates across hospitals serving similar patients are not well understood. Some interpret this variation as unwarranted and push standardization of care as a way of reducing allocative inefficiency. However, an... 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
- October 5, 2017
- Article
Making Patients and Doctors Happier—The Potential of Patient-Reported Outcomes
By: Lisa Rotenstein, Robert S. Huckman and Neil Wagle
- Article
Describing Wait Time Bottlenecks for ED Patients Undergoing Head CT
By: Jonathan G. Rogg, Robert S. Huckman, Michael Lev, Ali Raja, Yuchiao Chang and Benjamin White
Study objectives: Facing increased utilization and subsequent capacity and budget constraints, EDs must better understand bottlenecks and their effect on process flow to improve process efficiency. The primary objective of this study was to identify bottlenecks in... 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