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- 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
Keywords: Time-Driven Activity-Based Costing; Activity Based Costing and Management; Health Care and Treatment
Kaplan, Robert S., 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 to Estimate Cost of Care at Multidisciplinary Aerodigestive Centers." The Laryngoscope 127, no. 9 (September 2017).
- September–October 2023
- Article
Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using Time-Driven Activity-Based Costing Method: A Single Center Study
By: Aamir Ali, Jordana Phillips, Damir Ljuboja, Syed S. Shehab, Etta D. Pisano, Robert S. Kaplan and Ammar Sarwar
We use time-driven activity-based costing (TDABC) to measure the cost of performing breast imaging using different modalities: full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), contrast-enhanced mammography (CEM), US and MRI exams, and... View Details
Keywords: Time-Driven Activity-Based Costing; Health Care; Breast Cancer; Health Care and Treatment; Cost; Cost Accounting; Health Industry
Ali, Aamir, Jordana Phillips, Damir Ljuboja, Syed S. Shehab, Etta D. Pisano, Robert S. Kaplan, and Ammar Sarwar. "Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using Time-Driven Activity-Based Costing Method: A Single Center Study." Journal of Breast Imaging 5, no. 5 (September–October 2023): 546–554.
- 20 Dec 2006
- Working Paper Summaries
The Demise of Cost and Profit Centers
Keywords: by Robert S. Kaplan
- 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
Keywords: Healthcare Costs; Medical Imaging; Computed Tomography; Activity-Based Costing; Cost Accounting; Activity Based Costing and Management; Health Care and Treatment; Performance Efficiency; Health Industry
Kaplan, Robert S., Yoshimi Anzai, Marta E. Heilbrun, Derek Haas, Luca Boi, Kirk Moshre, Satoshi Minoshima, and Vivian S. Lee. "Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center." Academic Radiology 24, no. 2 (February 2017): 200–208.
- December 1996 (Revised February 2000)
- Background Note
Assigning Support Department Expenses to Production Cost Centers (A)
By: Robert S. Kaplan
Describes the first stage of the two-stage cost assignment process from support/service departments to production cost centers. View Details
Keywords: Cost
Kaplan, Robert S. "Assigning Support Department Expenses to Production Cost Centers (A)." Harvard Business School Background Note 197-046, December 1996. (Revised February 2000.)
- 2006
- Working Paper
The Demise of Cost and Profit Centers
By: Robert S. Kaplan
Kaplan, Robert S. "The Demise of Cost and Profit Centers." Harvard Business School Working Paper, No. 07-030, December 2006.
- December 2013
- Article
Measuring the Value of Process Improvement Initiatives in a Preoperative Assessment Center using Time-driven Activity-based Costing
By: Katy E. French, Heidi W. Albright, John C. Frenzel, James R. Incalcaterra, Augustin C. Rubio, Jessica F. Jones and Thomas W. Feeley
Background: The value and impact of process improvement initiatives are difficult to quantify. We describe the use of time-driven activity-based costing(TDABC)in a clinical setting to quantify the value of process improvements in terms of cost, time and personnel... View Details
Keywords: Quality Improvement; Value Agenda; Time-Driven Activity-Based Costing; Accounting; Health; Measurement and Metrics; Value; Health Industry; North and Central America
French, Katy E., Heidi W. Albright, John C. Frenzel, James R. Incalcaterra, Augustin C. Rubio, Jessica F. Jones, and Thomas W. Feeley. "Measuring the Value of Process Improvement Initiatives in a Preoperative Assessment Center using Time-driven Activity-based Costing." Healthcare: The Journal of Delivery Science and Innovation 1, nos. 3-4 (December 2013): 136–142.
- August 2016
- Case
VMD Medical Imaging Center
By: Susanna Gallani and Eva Labro
VMD Medical Imaging Center, a local independent provider of medical imaging services, is facing some important challenges. Despite efficiency improvements and cost cutting initiatives carried out over the past few years, their profitability is shrinking; their prices... View Details
Keywords: Costing; Death Spiral; Transfer Pricing; Activity Based Costing and Management; Competitive Strategy; Medical Specialties; Health Industry
Gallani, Susanna, and Eva Labro. "VMD Medical Imaging Center." Harvard Business School Case 117-002, August 2016.
- November 2021
- Article
Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing
By: Tyler R. McClintock, David F. Friedlander, Aiden Y. Feng, Mahek A. Shah, Daniel J. Pallin, Steven L. Chang, Angela M. Bader, Thomas W. Feeley, Robert S. Kaplan and George E. Haleblian
Objective. To characterize full cycle of care costs for managing an acute ureteral stone using time-driven activity-based costing.
Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Activity Based Costing and Management
McClintock, Tyler R., David F. Friedlander, Aiden Y. Feng, Mahek A. Shah, Daniel J. Pallin, Steven L. Chang, Angela M. Bader, Thomas W. Feeley, Robert S. Kaplan, and George E. Haleblian. "Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing." Urology 157 (November 2021): 107–113.
- 2022
- Working Paper
Where the Cloud Rests: The Location Strategies of Data Centers
By: Shane Greenstein and Tommy Pan Fang
This study provides an analysis of the entry strategies of third-party data centers in the United States. We examine the market before the pandemic in 2018 and 2019, when supply and demand for data services were geographically stable. We compare with the entry... View Details
Greenstein, Shane, and Tommy Pan Fang. "Where the Cloud Rests: The Location Strategies of Data Centers." Harvard Business School Working Paper, No. 21-042, September 2020. (Revised June 2022.)
- January 1997
- Background Note
Assigning Support Department Expenses to Production Cost Centers (B): Flexible Budgets
By: Robert S. Kaplan
Describes the use of flexible budgets to assign support/service department costs to production cost centers. View Details
Kaplan, Robert S. "Assigning Support Department Expenses to Production Cost Centers (B): Flexible Budgets." Harvard Business School Background Note 197-048, January 1997.
- March 1978 (Revised October 1978)
- Case
Rosemont Hill Health Center
An administrator of a neighborhood health center is considering changing his cost accounting system from a single cost per visit to a cost per visit for each department in the center. Used to illustrate several issues related to cost accounting in health care:... View Details
Young, David W. "Rosemont Hill Health Center." Harvard Business School Case 178-189, March 1978. (Revised October 1978.)
- Article
A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal
By: Jiayin Xue, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg and Kevin Schulman
U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital... View Details
Keywords: Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Health Industry; India; Nepal; United States
Xue, Jiayin, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg, and Kevin Schulman. "A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal." NEJM Catalyst Innovations in Care Delivery 2, no. 9 (September 2021).
- November 1992 (Revised April 1993)
- Background Note
Accounting for Indirect Costs
By: William J. Bruns Jr.
An introduction to processes by which indirect costs are first assigned to cost centers and then assigned to products or services produced. A simple schematic illustrates how expenditures are assigned to service centers or production centers, service centers to... View Details
Bruns, William J., Jr. "Accounting for Indirect Costs." Harvard Business School Background Note 193-070, November 1992. (Revised April 1993.)
- November 1999 (Revised November 2000)
- Case
Cortlandt Town Center
By: William J. Poorvu and Arthur I Segel
CBL & Associates is trying to decide whether to go ahead with the development of a 790,000 square-foot power center with retailers such as Home Depot and Barnes & Noble. The costs are such that the developer needs to renegotiate its land acquisition price. Then the... View Details
Keywords: Buildings and Facilities; Decision Making; Entrepreneurship; Cost; Negotiation; Projects; Strategy; Construction Industry; Retail Industry
Poorvu, William J., and Arthur I Segel. "Cortlandt Town Center." Harvard Business School Case 800-232, November 1999. (Revised November 2000.)
- August 2016 (Revised June 2018)
- Teaching Note
VMD Medical Imaging Center
By: Susanna Gallani and Eva Labro
VMD Medical Imaging Center addresses a number of issues related to the role of costing systems in organizations and the challenges impacting their design and maintenance as the organization grows and develops over time. This teaching note begins by offering detailed... View Details
- September 2011
- Article
A Cancer Center Puts the New Approach to Work: Pilot
By: Heidi W. Albright and Thomas W. Feeley
The University of Texas MD Anderson Cancer Center is a National Cancer Institute–designated Comprehensive Cancer Center, located in Houston, Texas. Seeing more than 30,000 new patients every year, MD Anderson accounts for approximately 20% of
cancer care within the... View Details
Keywords: Health Care; Health Care Quality; Measurement; Costing; Accounting; Health; Quality; Health Industry; North and Central America
Albright, Heidi W., and Thomas W. Feeley. "A Cancer Center Puts the New Approach to Work: Pilot." R1109B. Harvard Business Review 89, no. 9 (September 2011): 15–16. (This article is a sidebar description of a pilot of time-driven activity-based costing in the HBR article "How to Solve the Cost Crisis in Health Care" by Robert S. Kaplan and Michael E. Porter.)
- March 2001 (Revised April 2001)
- Case
Montefiore Medical Center
By: Robert S. Kaplan and Syeda Noorein Inamdar
A large urban medical center implements the Balanced Scorecard management tool. Elaine Brennan, senior VP of operations, has reorganized a highly functional health care organization into decentralized patient care centers and support units. Having recently endured the... View Details
Keywords: Balanced Scorecard; Health Care and Treatment; Management Systems; Organizational Structure; Corporate Strategy; Leadership Development; Growth and Development Strategy; Financial Reporting; Budgets and Budgeting; Cost Accounting; Corporate Accountability; Communication; Health Industry
Kaplan, Robert S., and Syeda Noorein Inamdar. "Montefiore Medical Center." Harvard Business School Case 101-067, March 2001. (Revised April 2001.)
- Article
Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?
By: R. S. Kaplan, F. Erhun, V.G. Narayanan, B. Mistry and K. Brayton, et al
We use time-driven activity-based costing to estimate the cost of personnel and space for an elective coronary artery bypass graft (CABG) surgery at two U.S. hospitals, Intermountain and Baylor Heart, and Narayana Health (NH), in India. All three hospitals use modern... View Details
Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Organizational Structure; Performance Efficiency; India; United States
Kaplan, R. S., F. Erhun, V.G. Narayanan, B. Mistry, and K. Brayton, et al. "Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?" American Heart Journal 224 (June 2020): 148–155.
- February 2025
- Article
Innovations in Evaluating Ambulatory Costs of Cystic Fibrosis Care: A Comparative Study Across Multidisciplinary Care Centers in Ireland and the United States
By: Emma Brady, Ryan C. Perkins, Kate Cullen, Gregory S. Sawicki, Robert S. Kaplan and Gerardine Doyle
Lead clinicians at two large pediatric cystic fibrosis (CF) centers in the United States and Ireland measured and compared their ambulatory care costs. The clinicians selected three strata of patients (0–11 months, 1–5 years, and 6–17 years of age). Process maps were... View Details
Brady, Emma, Ryan C. Perkins, Kate Cullen, Gregory S. Sawicki, Robert S. Kaplan, and Gerardine Doyle. "Innovations in Evaluating Ambulatory Costs of Cystic Fibrosis Care: A Comparative Study Across Multidisciplinary Care Centers in Ireland and the United States." NEJM Catalyst Innovations in Care Delivery 6, no. 2 (February 2025).