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- October 16, 2024
- Article
Physicians Can Help Cut Costs. They Just Need the Right Incentives.
By: Susanna Gallani and Derek A. Haas
Health care organizations have long tried to enlist physicians in their effort to control or reduce costs. One effective means for doing so is to create an incentive system that rewards physicians for their contributions. To design such a system, organizations should... View Details
- 2024
- Working Paper
Does Private Equity Have Any Business Being in the Health Care Business?
By: Nori Gerardo Lietz and Zirui Song
Private Equity (“PE”) has come under increased scrutiny by the press, academics, and policymakers, as well as the public, for its investments in health care delivery. This scrutiny has been exacerbated by recent high profile hospital bankruptcies following PE... View Details
- August 13, 2024
- Editorial
Can AI Save Physicians from Burnout?
By: Susanna Gallani, Lidia Moura and Katie Sonnefeldt
- July 2024
- Article
Mass General Brigham’s Patient-Reported Outcomes Measurement System: A Decade of Learnings
By: Jason B. Liu, Robert S. Kaplan, David W. Bates, Mario O. Edelen, Rachel C. Sisodia and Andrea L. Pusic
This article describes the strategies that leaders at the Mass General Brigham (MGB) health system have used in launching a standardized patient-reported outcome measure (PROM) collection program in 2012, a major step in the value-based transformation of health care.... View Details
- June 2024
- Article
Enhancing Value and Well-Being: The Basket of Motivators Framework for Aligning Neurology Clinical Practices with Performance Outcomes
By: Peter N. Hadar, Susanna Gallani and Lidia Moura
Physician burnout, which is prevalent in neurology, has accelerated in recent years. While multifactorial, a major contributing factor to burnout is a payment model that rewards volume over quality, leaving physicians overburdened and unfulfilled. The aim of this... View Details
- June 2024 (Revised August 2024)
- Case
Hospital for Special Surgery: Returning to a New Normal? (A)
By: Robert S. Huckman, Michael Lingzhi Li and Camille Gregory
Early on the morning of April 27, 2020, Justin Oppenheimer stood outside the entrance to the lobby of the Hospital for Special Surgery (HSS) Pavilion Building with mixed emotions. On one hand, Oppenheimer, HSS’ Enterprise Chief Operating Officer and Chief Strategy... View Details
- February 2024
- Article
Representation and Extrapolation: Evidence from Clinical Trials
By: Marcella Alsan, Maya Durvasula, Harsh Gupta, Joshua Schwartzstein and Heidi L. Williams
This article examines the consequences and causes of low enrollment of Black patients in clinical
trials. We develop a simple model of similarity-based extrapolation that predicts that evidence is
more relevant for decision-making by physicians and patients when it... View Details
- January 2024
- Background Note
Evaluating Innovations in the Organization of Primary Care: What Type of Innovation Is It and How Well Does It Align with the Six Factors?
By: Regina E. Herzlinger and James Wallace
How can we evaluate if innovative health care ventures can do good—benefit society—and do well—become financially viable? This question is the topic of the first module in the Innovating in Health Care course book.
This note and "Health Stop (A): What Type... View Details
This note and "Health Stop (A): What Type... View Details
- December 4, 2023
- Comment
The Great Resignation, Employment, and Wages in Health Care
By: Amitabh Chandra and Louis-Jonas Heizlsperger
Notwithstanding concerns about staffing levels and burnout in health care, federal wage and employment data does not support the suggestion that a COVID-19 pandemic-related spike in quitting has had an enduring impact for hospitals or physician offices. Employment in... View Details
- October 2023
- Article
What Does the Inflation Reduction Act Mean for Patients and Physicians?
By: Amitabh Chandra and Benedic Ippolito
The debate around prescription drug measures in the recently passed U.S. Inflation Reduction Act (IRA), which limit some patients’ out-of-pocket costs, has not fully addressed their effect on physicians and patients via their effect on payers. Reducing patients’ costs... View Details
- 2023
- Article
Evidence from the First Shared Medical Appointments (SMAs) Randomised Controlled Trial in India: SMAs Increase the Satisfaction, Knowledge, and Medication Compliance of Patients with Glaucoma
By: Nazlı Sönmez, Kavitha Srinivasan, Rengaraj Venkatesh, Ryan W. Buell and Kamalini Ramdas
In Shared Medical Appointments (SMAs), patients with similar conditions meet the physician together and each receives one-on-one attention. SMAs can improve outcomes and physician productivity. Yet privacy concerns have stymied adoption. In physician-deprived nations,... View Details
- Summer 2023
- Article
Do Policies to Increase Access to Treatment for Opioid Use Disorder Work?
By: Eric Barrette, Leemore S. Dafny and Karen Shen
Even among commercially insured individuals, opioid use disorder is undertreated in the United States: nearly half receive no treatment within six months of a new diagnosis. Using a difference-in-differences specification exploiting the extension of insurance parity... View Details
- 2023
- Article
Conduit Incentives: Eliciting Cooperation from Workers Outside of Managers' Control
By: Susanna Gallani
Can managers use monetary incentives to elicit cooperation from workers they cannot reward for their efforts? I study “conduit incentives,” an innovative incentive design, whereby managers influence bonus-ineligible workers’ effort by offering bonus-eligible employees... View Details
Keywords: Organizational Behavior Modification; Peer Monitoring; Persistence Of Performance Improvements; Crowding Out; Implicit Incentives; Compensation; Healthcare; Social Pressure; Image Motivation; Incentives; Motivation; Performance; Behavior; Motivation and Incentives; Compensation and Benefits; Governing Rules, Regulations, and Reforms; Organizational Culture; Health Industry; California
- December 2022
- Article
Collaborative Rooming: An Innovative Pilot Project to Overcome Primary Care Challenges
By: Gagandeep Singh, Jill G. Lenhart, Richard A. Helmers, Michele Renee Eberlee, Heather Costley, Joel B. Roberts and Robert S. Kaplan
Primary care physicians are overburdened with growing complexities and increasing expectations for primary care visits. To meet expectations, primary care physicians must multitask during visits and spend extra hours in the office for charting, billing, and... View Details
- Article
Surgeons and Administrators Co-Creating Value
By: Michael Nurok, Thoralf Sundt, Robert S. Kaplan and Bruce Gewertz
Most hospitals have arms-length relationships with physicians, viewing them as people they must ‘‘manage,’’ not as potentially valuable strategic partners. But surgeons make clinical decisions every day that have great influence on both patient outcomes and hospital... View Details
- 2021
- Working Paper
The Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes
By: Arlen Guarin, Christian Posso, Estefania Saravia and Jorge Tamayo
Identifying the effect of physicians’ skills on health outcomes is a challenging task due to the nonrandom sorting between physicians and hospitals. We overcome this challenge by exploiting a Colombian government program that randomly assigned 2,126 physicians to 618... View Details
- Article
Supporting Value-Based Health Care—Aligning Financial and Legal Accountability
By: Mark M. Zaki, Anupam B. Jena and Amitabh Chandra
U.S. health care payment and delivery-system reforms have focused on improving care by making organizations accountable for outcomes, quality, and costs. Payers have supported the implementation of accountable care organizations (ACOs), bundled-payment models, and... View Details
- 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
- June 10, 2021
- Article
Preparing Hospitals for the Next Pandemic
By: Regina E. Herzlinger and Barak D. Richman
The COVID-19 epidemic response has shown that the U.S. is blessed with heroic physicians and other health care providers, researchers, and facilities. But it has also revealed a health care system that was woefully unprepared for the surge of pandemic patients. In the... View Details
- June 2021
- Case
uBiome
By: Thomas R. Eisenmann and Olivia Graham
uBiome provided clinical tests that sequenced the DNA of human microbiome samples, providing data on health conditions directly to consumers or to prescribing physicians. Founded in 2012, the San Francisco-based startup raised $105 million from top-tier venture capital... View Details