Publications

March 2018 (Revised February 2020)
Teaching Note

Improving Access at VA

By: Ryan W. Buell and Robert S. Huckman

In 2015, the Department of Veterans Affairs (VA) ran the largest healthcare system in the United States, with over 1,700 sites of care that served nearly 9 million veterans. One year earlier, a scandal had erupted over a cover-up of the excessive wait times veterans... View Details

Keywords: Service Operations; Service Delivery; Social Issues; Health Care and Treatment; Government Administration; Performance Improvement; Public Administration Industry; Public Administration Industry; United States

June 2016
Article

When Doctors Go to Business School: Career Choices of Physician-MBAs

By: Damir Ljuboja, Brian W. Powers, Benjamin Robbins, Robert S. Huckman, Krishna Yeshwant and Sachin Jain

There has been substantial growth in the number of physicians pursuing Master of Business Administration (MBA) degrees over the past decade, but there is continuing debate over the utility of these programs and the career outcomes of their graduates. The authors... View Details

Keywords: Medical Education; MD; MBA; Physicians; Executive Education; Training; Personal Development and Career; Health Care and Treatment; Health Industry; United States

November–December 2014
Article

Using Time-Driven Activity-Based Costing to Identify Value-Improvement Opportunities in Healthcare

By: Robert S. Kaplan, Mary L. Witkowski, Megan Abbott, Alexis Guzman, Laurence Higgins, John Meara, Erin Padden, Apurva Shah, Peter Waters, Marco Weidemeier, Samuel Wertheimer and Thomas W. Feeley

As healthcare providers cope with pricing pressures and increased accountability for performance, they should be rededicating themselves to improving the value they deliver to their patients: better outcomes and lower costs. Time-driven activity-based costing offers... View Details

Keywords: Value Creation; Activity Based Costing and Management; Health Care and Treatment; Health Industry; United States; Europe

October 2013
Article

Barriers to Completion of Patient Reported Outcome Measures

By: Elizabeth H. Schamber, Steven K. Takemoto, Kate Eresian Chenek and Kevin J. Bozic

Patient Reported Outcomes Measures (PROMs) are commonly used in total joint arthroplasty (TJA) to assess surgical outcomes. However certain patient populations may be underrepresented due to lower survey completion rates. The purpose of this study is to evaluate... View Details

Keywords: Patient Reported Outcome Measures; PROM; Total Joint Arthroplasty; Hip; Knee; Electronic Survey; Equality and Inequality; Demographics; Surveys; Health Care and Treatment; Health Industry

2013
Working Paper

An Empirical Study of the Spillover Effects of Workload on Patient Length of Stay

By: Jillian Berry Jaeker and Anita Tucker

We use two years of inpatient data from 243 California hospitals to quantify the relationship between hospital-level workload and patient length of stay (LOS), and its "spillover" effects across patient types. Patients are categorized as medical or surgical, and the... View Details

Keywords: Workload; Processing Times; Healthcare; Working Conditions; Performance Productivity; Time Management; Health Care and Treatment; Health Industry; California

May 25, 2004
Article

Specialization and Its Discontents: The Pernicious Impact of Regulations Against Specialization and Physician Ownership on the U.S. Healthcare System

By: Regina E. Herzlinger

Keywords: Health Care and Treatment; Ownership; Governing Rules, Regulations, and Reforms; Health Industry; United States

Forthcoming
Article

Vertical Integration and Cream Skimming of Profitable Referrals: The Case of Hospital-Owned Skilled Nursing Facilities

By: David M. Cutler, Leemore Dafny, David C. Grabowski, Steven Lee and Christopher Ody

We examine whether vertical integration of hospitals and skilled nursing facilities (SNFs) could lessen competition by foreclosing rival SNFs’ access to lucrative referrals. We find that it could: among integrated providers, a one percent increase in SNF reimbursement... View Details

Keywords: Antitrust; Competition; Monopoly; Vertical Integration; Customer Value and Value Chain; Health Industry; United States

Register to Read

April 2012 (Revised February 2013)
Case

Learning About Reducing Hospital Mortality at Kaiser Permanente

By: Anita Tucker

In 2011, Kaiser Permanente Northern California (KPNC) region's efforts to reduce mortality in their 21 hospitals is showing promise. They developed and launched a region-wide initiative to improve the treatment of sepsis, a serious and often deadly medical condition.... View Details

Keywords: Change Management; Health Care and Treatment; Performance Improvement; Health Industry; California

Educators

May 2024 (Revised February 2025)
Case

Choosing the Course of Passion: Brooke Boyarsky Pratt at knownwell

By: Jon M. Jachimowicz and Alexis Lefort

Brooke Boyarsky Pratt (HBS ’13) enjoyed considerable success in her early career, quickly climbing the ranks to associate partner at McKinsey, and later becoming an executive vice president at Berkadia, a Berkshire Hathaway portfolio company. Throughout these years,... View Details

Keywords: Passion; Career; Career Planning; Purpose; Personal Development and Career; Mission and Purpose; Identity; Business Startups; Health Care and Treatment; Health Disorders; Growth and Development Strategy; Market Entry and Exit; Health Industry; United States

Educators

12 Jul 2021
News

Alumni Confront the COVID-19 Crisis

A longtime advocate of remote medicine, Mediva's work in this field has helped Japan's health care industry adapt to the impact that COVID-19 is having on in-person medical appointments. Oishi is a member of... View Details

November 2014
Teaching Note

Claritas Genomics

By: Robert F. Higgins and Matthew G. Preble

Dr. Patrice Milos is the first CEO of Claritas Genomics (Claritas) and she faces a number of challenges in scaling the young company. Claritas was formed around a lab spun out from Boston Children's Hospital (BCH) which had performed genomic tests for the hospital. Now... View Details

Keywords: Healthcare; Healthcare Startups; Genetic Testing; Genetics Diagnostics; Spinning Out Hospital Services; Spin-out; Health Care and Treatment; Genetics; Entrepreneurship; Biotechnology Industry; Biotechnology Industry; United States

June 1992
Teaching Note

Hospital Replacement Decision, Hospital Corp. of America: Financial Analysis, and Humana, Inc., Teaching Note

By: Regina E. Herzlinger

Keywords: Health Care and Treatment; Decision Making; Finance; Insurance Industry; Insurance Industry; United States

June 2014
Article

Improving Value with TDABC

By: Robert S. Kaplan

The article discusses the benefits of time-driven activity-based costing (TDABC) combined with outcomes measurement for healthcare organizations. Topics covered include improving resource efficiency, optimizing care over the complete care cycle, and planning and... View Details

Keywords: Goals and Objectives; Activity Based Costing and Management; Health Care and Treatment; Health Industry

Summer 2014
Article

Designed for Workarounds: A Qualitative Study of the Causes of Operational Failures in Hospitals

By: Anita L. Tucker, W. Scott Heisler and Laura D. Janisse

Frontline care providers in hospitals spend at least 10% of their time working around operational failures, which are situations where information, supplies, or equipment needed for patient care are insufficient. However, little is known about underlying causes of... View Details

Keywords: Supply Chain; Health Care and Treatment; Failure; Business Processes; Health Industry

January 2010
Teaching Note

State of Emergency at Mercy Hospital and The Jenner Situation (TN)

By: Richard G. Hamermesh

Teaching Note for [809070] and [409048]. View Details

Keywords: Health; Non-Governmental Organizations; Health Industry

October 2008
Case

Diagnostic Genomics

By: Regina E. Herzlinger and Mark P. Allyn

Should this gene detection firm enter the business of providing tests for the detection of genetic diseases? If so, how should it prioritize the tests it could develop? View Details

Keywords: Health Testing and Trials; Market Entry and Exit; Product Development; Genetics; Strategy; Health Industry; Health Industry

Educators

2024
Article

Psychological Safety as an Enduring Resource amid Constraints

By: Hassina Bahadurzada, Amy C. Edmondson and Michaela J. Kerrissey

While psychological safety is recognized as valuable in healthcare, its relationship to resource constraints is not well understood. We investigate whether psychological safety mitigates the negative impact of resource constraints on employees. Leveraging longitudinal... View Details

Keywords: Burnout; Psychological Safety; Healthcare Administration; Health Care and Treatment; Employees; Retention; Well-being; Health Industry

August 2010 (Revised May 2012)
Teaching Note

The UCLA Medical Center: Kidney Transplantation (TN)

By: Michael E. Porter and Jennifer F Baron

Teaching Note for 711410. View Details

Keywords: Health Care and Treatment; Service Delivery; Price; Programs; Measurement and Metrics; Health Industry