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- February 2025
- Article
Variation in Batch Ordering of Imaging Tests in the Emergency Department and the Impact on Care Delivery
By: Jacob C. Jameson, Soroush Saghafian, Robert S. Huckman and Nicole Hodgson
Objectives: To examine heterogeneity in physician batch ordering practices and measure the impact of a physician's tendency to batch order imaging tests on patient outcomes and resource utilization.
Study Setting and Design: In this retrospective study, we used... View Details
Study Setting and Design: In this retrospective study, we used... View Details
- September 2024
- Case
The Health Equity Accelerator at Boston Medical Center
By: Susanna Gallani, Mary Witkowski and Katie Sonnefeldt
This case describes how Boston Medical Center, a hospital and safety net organization, changed its strategic approach to health equity after realizing that previous efforts were not sufficient to address the health disparities among their patients. In 2021, the Health... View Details
Keywords: Health Care and Treatment; Health Disorders; Innovation and Management; Innovation Leadership; Innovation Strategy; Adaptation; Business Strategy; Mission and Purpose; Decisions; Organizational Change and Adaptation; Organizational Structure; Diversity; Race; Ethnicity; Urban Scope; Local Range; Equality and Inequality; Health Industry; Boston
- May 2024 (Revised May 2024)
- 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
- March–April 2024
- Article
Retailers and Health Systems Can Improve Care Together
By: Robert S. Huckman, Vivian S. Lee and Bradley R Staats
Health systems are struggling to address the many shortcomings of health care delivery: rapidly growing costs, inconsistent quality, and inadequate and unequal access to primary and other types of care. However, if retailers and health systems were to form strong... View Details
- February 2024
- Case
Oak Street Health: From Start-up to Strategic Acquisition
By: Leemore S. Dafny and Thomas H. Lee
Oak Street Health opened its first primary care center for seniors in underserved communities in 2013. By 2022 the company had 169 centers and a market valuation exceeding $10 billion. Oak Street created value by accepting risk-adjusted, capitated payments for Medicare... 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
- January 2024
- Article
Cost of Exempting Sole Orphan Drugs from Medicare Negotiation
By: Matthew Vogel, Olivia Zhao, William B. Feldman, Amitabh Chandra, Aaron S. Kesselheim and Benjamin N. Rome
Importance: The Inflation Reduction Act (IRA) requires Medicare to negotiate prices for some high-spending drugs but exempts drugs approved solely for the treatment of a single rare disease.
Objective: To estimate Medicare spending and global... View Details
Objective: To estimate Medicare spending and global... View Details
- April 2023 (Revised January 2024)
- Background Note
Note on Healthcare in Ghana
By: Regina E. Herzlinger and Ben Creo
This note provides an overview of the healthcare system in Ghana. It discusses the public and private sector as well as traditional medical practice. It also discusses the country’s pharmaceutical industry. It is recommended as a companion to Professor Regina... View Details
Keywords: Africa; Pharmaceutical Companies; Pharmacy Benefit Manager; Health Care; Health Care Costs; Health Care Delivery; Health Care Entrepreneurship; Telehealth; Health Equity; Governing Rules, Regulations, and Reforms; Health Care and Treatment; Business and Government Relations; Health Industry; Pharmaceutical Industry; Ghana
- 2023
- Article
A Randomized Trial of Behavioral Nudges Delivered through Text Messages to Increase Influenza Vaccination among Patients with an Upcoming Primary Care Visit
By: Mitesh S. Patel, Katherine L. Milkman, Linnea Gandhi, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Seung Hyeong Lee, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
Purpose: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates.
Design: Randomized, controlled trial.
Setting: Two health systems in the Northeastern US between September 2020 and... View Details
Design: Randomized, controlled trial.
Setting: Two health systems in the Northeastern US between September 2020 and... View Details
- 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
- October 2022 (Revised September 2024)
- Case
mPharma: Scaling Access to Affordable Primary Care in Africa
By: Regina E. Herzlinger and Ben Creo
mPharma hopes to scale up to create the largest pan-African healthcare company ever to provide much-needed primary care in retail pharmacies; a reliable, fairly priced supply of drugs; and micro-insurance for drugs. They must prioritize launching a telemedicine... View Details
Keywords: Africa; Pharmaceutical Companies; Pharmacy Benefit Manager; Health Care; Health Care And Treatment; Health Care Costs; Health Care Delivery; Health Care Entrepreneurship; Telehealth; Health Equity; Corporate Strategy; Social Entrepreneurship; Equity; Growth and Development Strategy; Expansion; Product Launch; Customer Value and Value Chain; Social Enterprise; Multinational Firms and Management; Pharmaceutical Industry; Health Industry; Africa
- October 2022
- Article
It’s Not Just the Prices: Time-Driven Activity-Based Costing for Initiation of Veno-Venous Extracorporeal Membrane Oxygenation at Three International Sites—A Case Review
By: Michael Nurok, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes and Robert S. Kaplan
The United States spends more for intensive care units (ICUs) than do other high-income countries. We used time-driven activity-based costing (TDABC) to analyze ICU costs for initiation of extracorporeal membrane oxygenation (ECMO) for respiratory failure to estimate... View Details
- August 3, 2022
- Article
How Will Amazon Approach U.S. Primary Care?
By: Robert S. Huckman and Bradley Staats
Amazon has a playbook for reinventing businesses that it enters. It includes simplifying processes, experimenting to determine which new approaches work best, and continuously recombining its existing assets to come up with a better way to do things. It is likely to... View Details
- April 2022
- Teaching Note
CVS Health: Prescription for Transformation
By: Rosabeth Moss Kanter and Catarina Martinez
In 2021, new CEO Karen Lynch (named the most powerful woman in business) considered the next transformation phase for CVS Health (a Fortune 5 corporate giant). The 2018 acquisition of Aetna insurance brought her to the company as part of its long evolution from a... View Details
Keywords: Health; COVID-19 Pandemic; Primary Care; Leadership; Change Management; Women Executives; Retail; Pharmacy; Pharmacy Benefit Manager; Clinical Trials; Vaccination; Acquisition; Innovation and Invention; Transformation; Retail Industry; Pharmaceutical Industry; Health Industry; United States
- February 8, 2022
- Article
Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions
By: Alan Yang, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson and Robert S. Kaplan
In 2017, patients made 145 million visits to emergency departments (EDs), generating $76.3 billion in charges. About a third of ED visits, however, were for conditions that were treatable in lower-resourced settings. We used time-driven activity-based costing (TDABC)... 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
- Article
A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor's Appointment
By: Katherine L. Milkman, Mitesh S. Patel, Linnea Gandhi, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via... View Details
Keywords: Vaccination; COVID-19; Nudge; Influenza; Field Experiment; Health; Communication Strategy; Behavior
- May 2021
- Article
Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency
By: J. Hart, K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels and S.D. Halpern
Background: Clinicians’ use of choice architecture, or how they present options, systematically influences the choices made by patients and their surrogate decision makers. However, clinicians may incompletely understand this influence.... View Details
- March 2021
- Article
Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care
By: Maximilian J. Pany, Lucy Chen, Bethany Sheridan and Robert S. Huckman
Scope-of-practice regulations, including prescribing limits and supervision requirements, may influence the propensity of providers to form care teams. Therefore, policy makers need to understand the effect of both team-based care and provider type on clinical... View Details
- February 2021 (Revised March 2022)
- Case
Marvin: A Personalized Telehealth Approach to Mental Health
By: Regina E. Herzlinger, Eshani Sharma, Andrew Nguyen, Thomas Arsenault, Carin-Isabel Knoop and Julia Kelley
More than one third of Americans were said to suffer some type of behavioral health ailment at some point in their lifetime, with many people requiring chronic therapy or intervention. Despite significant clinical needs, access to reliable treatment has been difficult... View Details