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- 2021
- Working Paper
Which Markets (Don't) Drive Pharmaceutical Innovation? Evidence From U.S. Medicaid Expansions
By: Craig Garthwaite, Rebecca Sachs and Ariel Dora Stern
Pharmaceutical innovation policy involves managing a tradeoff between high prices for new products in the short-term and stronger incentives to develop products for the future. Prior research has documented a causal relationship between market size and pharmaceutical... View Details
Keywords: Pharmaceuticals; Medicaid; Innovation and Invention; Policy; Markets; Research and Development; Pharmaceutical Industry
Garthwaite, Craig, Rebecca Sachs, and Ariel Dora Stern. "Which Markets (Don't) Drive Pharmaceutical Innovation? Evidence From U.S. Medicaid Expansions." NBER Working Paper Series, No. 28755, May 2021.
- September 2020
- Article
Medicaid Work Requirements in Arkansas: Two-Year Impacts on Coverage, Employment, and Affordability of Care
By: Benjamin D. Sommers, Lucy Chen, Robert J. Blendon, E. John Orav and Arnold M. Epstein
In June 2018 Arkansas became the first U.S. state to implement work requirements in Medicaid, requiring adults ages 30–49 to work twenty hours a week, participate in “community engagement” activities, or qualify for an exemption to maintain coverage. By April 2019,... View Details
Keywords: Medicaid; Health Care Policy; Health; Health Care and Treatment; Policy; Insurance; Health Industry; Arkansas
Sommers, Benjamin D., Lucy Chen, Robert J. Blendon, E. John Orav, and Arnold M. Epstein. "Medicaid Work Requirements in Arkansas: Two-Year Impacts on Coverage, Employment, and Affordability of Care." Health Affairs 39, no. 9 (September 2020).
- Article
Overturning the ACA's Medicaid Expansion Would Likely Decrease Low-Income, Reproductive-Age Women's Healthcare Spending and Utilization
By: Lucy Chen, Richard G. Frank and Haiden A. Huskamp
In late 2020, the Supreme Court began hearing a case challenging the Affordable Care Act (ACA), which led to coverage gains for many low-income, reproductive-age women. To explore potential implications of a full ACA repeal for this population, we examined gains... View Details
Keywords: Medicaid; Women's Health; Health Insurance; Health Care and Treatment; Gender; Insurance; Poverty; Health Industry; United States
Chen, Lucy, Richard G. Frank, and Haiden A. Huskamp. "Overturning the ACA's Medicaid Expansion Would Likely Decrease Low-Income, Reproductive-Age Women's Healthcare Spending and Utilization." Inquiry 57 (2020).
- 14 Jul 2006
- Op-Ed
The Case for Consumer-Driven Medicaid
The Medicaid program provides a much needed health insurance safety net for 52 million of our nation's poor and medically needy, but its price tag threatens the financial stability of the states, growing 9.5 percent in 2004 alone—far in... View Details
Keywords: by Regina E. Herzlinger
- 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
Keywords: Medicare; Medicaid; Bundled Payments; Health Care and Treatment; Cost Management; Performance Evaluation; Outcome or Result
Haas, Derek A., Xiaoran Zhang, Robert S. Kaplan, and Zirui Song. "Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements." JAMA Internal Medicine 179, no. 7 (July 2019): 924–931.
- August 2, 2005
- Article
Medicine for Medicaid
By: R. E. Herzlinger
Herzlinger, R. E. "Medicine for Medicaid." Wall Street Journal (August 2, 2005), A10.
- Article
Cross Country: They'd Sooner Fix Medicaid
By: Tom Coburn and Regina Herzlinger
Coburn, Tom, and Regina Herzlinger. "Cross Country: They'd Sooner Fix Medicaid." Wall Street Journal (May 18, 2006).
- Article
Mandate Outcomes Reporting
By: Robert S. Kaplan and Michael E. Porter
Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to... View Details
Keywords: Outcomes Reporting; Outcomes Measurement; Medicare; Medicaid; Health Care and Treatment; Outcome or Result; Measurement and Metrics
Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
- August 2017
- Supplement
CareMore Health System (B)
By: Robert S. Huckman and Brian W. Powers
This supplement to “CareMore Health System (A)” discusses the company's early experience introducing its managed Medicaid model in the Des Moines, Iowa, market. It also provides an update on the Memphis program discussed in the (A) case. View Details
Keywords: Health Care Delivery; Health Insurance; Medicare; Medicaid; Managed Care; Extensivist; Social Determinants Of Health; Health Care and Treatment; Insurance; Business Model; Growth and Development Strategy; Health Industry; United States
Huckman, Robert S., and Brian W. Powers. "CareMore Health System (B)." Harvard Business School Supplement 618-009, August 2017.
- August 2017
- Case
CareMore Health System
By: Robert S. Huckman and Brian W. Powers
CareMore Health System—a physician-founded care delivery system and health plan—had developed and refined an innovative care model for at-risk seniors enrolled in Medicare managed care (i.e., Medicare Advantage) plans. CareMore's President, Sachin Jain, and his... View Details
Keywords: Health Care Delivery; Health Insurance; Medicare; Medicaid; Managed Care; Extensivist; Social Determinants Of Health; Health Care and Treatment; Insurance; Business Model; Growth and Development Strategy; Decision Choices and Conditions; Health Industry; United States
Huckman, Robert S., and Brian W. Powers. "CareMore Health System." Harvard Business School Case 618-008, August 2017.
- October 2013 (Revised October 2016)
- Case
Steward Health Care System
By: Robert F. Higgins and Noah Fisher
Steward Health has raised private equity and has converted from not-for-profit to for-profit. The case describes its Accountable Care Organization (ACO) and asks whether it should continue this experiment. View Details
Keywords: Accountable Care Organization; ACO; Medicare; Medicaid; Medical Services; Cerberus; Caritas; Health Care Policy; Health Care Industry; Provider Organizations; Health Care and Treatment; Health Industry; United States
Higgins, Robert F., and Noah Fisher. "Steward Health Care System." Harvard Business School Case 814-029, October 2013. (Revised October 2016.)
- October 2024
- Article
Greater Covid-19 Vaccine Uptake among enrollees Offered Health and Social Needs Case Management: Results from a Randomized Trial
By: Margae Knox, Elizabeth A. Hernandez, Daniel M. Brown, Jennifer Ahern, Mark D. Fleming, Crystal Guo and Amanda L. Brewster
The CommunityConnect case management program for Medicaid beneficiaries is run by Contra Costa Health, a county safety net health system in California. Case management infrastructure modestly improved Covid-19 vaccine uptake in a population of Medicaid beneficiaries... View Details
Keywords: Health Care and Treatment; Health Pandemics; Medical Specialties; Programs; Human Needs; Welfare; Health Industry; California
Knox, Margae, Elizabeth A. Hernandez, Daniel M. Brown, Jennifer Ahern, Mark D. Fleming, Crystal Guo, and Amanda L. Brewster. "Greater Covid-19 Vaccine Uptake among enrollees Offered Health and Social Needs Case Management: Results from a Randomized Trial." Health Services Research 59, no. 5 (October 2024).
- Research Summary
Public Health Debate Over Smoking
In research relevant to the current public health debate about smoking, Professor King and co-authors examine the effect of the tobacco settlement on cigarette advertising in magazines, the advertising behavior of cigarette companies in recruiting underage teenagers... View Details
- July 2021
- Article
Medical Debt in the U.S., 2009–2020
By: Raymond Kluender, Neale Mahoney, Francis Wong and Wesley Yin
Importance: Medical debt is an increasing concern in the US, yet there is limited understanding of the amount and distribution of medical debt, and its association with health care policies.
Objective: To measure the amount of medical debt nationally and by... View Details
Objective: To measure the amount of medical debt nationally and by... View Details
Kluender, Raymond, Neale Mahoney, Francis Wong, and Wesley Yin. "Medical Debt in the U.S., 2009–2020." JAMA, the Journal of the American Medical Association 326, no. 3 (July 2021): 250–256.
- April 2008 (Revised May 2008)
- Case
Commonwealth Care Alliance: Elderly and Disabled Care
By: Michael E. Porter and Jennifer F Baron
Individuals enrolled in both Medicare and Medicaid, known as dual eligibles, are among the highest-cost beneficiaries in the US. Commonwealth Care Alliance, a small nonprofit insurer and care delivery system in Massachusetts, operated under a public demonstration... View Details
Keywords: Programs; Public Sector; Alliances; Policy; Age; Service Delivery; Value; Health Care and Treatment; Welfare; Insurance Industry; Health Industry; Massachusetts
Porter, Michael E., and Jennifer F Baron. "Commonwealth Care Alliance: Elderly and Disabled Care." Harvard Business School Case 708-502, April 2008. (Revised May 2008.)
- May 2016
- Article
How the Affordable Care Act Has Affected Cancer Care in the United States: Has Value for Cancer Patients Improved?
By: Stephen M. Schleicher, Nancy M. Wood, Seohyun Lee and Thomas W. Feeley
The Patient Protection and Affordable Care Act (ACA), passed in 2010, contained a number of provisions with potential to directly or indirectly affect cancer care. Value for patients was widely discussed throughout the bill, and the Centers for Medicare and Medicaid... View Details
Schleicher, Stephen M., Nancy M. Wood, Seohyun Lee, and Thomas W. Feeley. "How the Affordable Care Act Has Affected Cancer Care in the United States: Has Value for Cancer Patients Improved?" Oncology 30, no. 5 (May 2016): 468–474.
- February 2019
- Article
Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending
By: Leemore S. Dafny
There is limited empirical evidence about the impact of for-profit health insurers on various outcomes. I study the effects of conversions to for-profit status by Blue Cross Blue Shield (BCBS) affiliates in 11 states, spanning 28 geographic markets. I find both the... View Details
Keywords: Health Insurance; Medical Loss Ratio; Blue Cross; Corporate Governance; Health; Insurance; For-Profit Firms; Insurance Industry; United States
Dafny, Leemore S. "Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending." American Economic Journal: Economic Policy 11, no. 1 (February 2019): 222–265.
- February 2012 (Revised June 2013)
- Case
Moving to Universal Coverage: Health Care Reform in Massachusetts
By: Michael E. Porter and Jennifer F Baron
State health care reform in Massachusetts has involved a phased process, focusing first on coverage expansion and then turning to delivery system innovation and cost containment. In 2006, the state adopted an individual mandate to obtain health care coverage which,... View Details
Porter, Michael E., and Jennifer F Baron. "Moving to Universal Coverage: Health Care Reform in Massachusetts." Harvard Business School Case 712-466, February 2012. (Revised June 2013.)
- Article
The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit
By: Junaid Nabi and Robert S. Kaplan
The Centers of Medicare and Medicaid Services (CMS) recently announced that it will be removing more... View Details
Keywords: Ambulatory Care; Payment Policy; Health Care and Treatment; Governing Rules, Regulations, and Reforms
Nabi, Junaid, and Robert S. Kaplan. "The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit." Health Affairs Blog (June 2, 2021).