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- All HBS Web
(1,556)
- News (254)
- Research (1,126)
- Events (2)
- Multimedia (1)
- Faculty Publications (362)
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- May 2017
- Supplement
Boston Children's Hospital Process Map Video
By: Robert S. Kaplan and Mary Witkowski
The 13 minute video simulates a discussion among orthopedic surgeons and cast room technicians about the processes and resources used when applying long leg casts for patients. The video should be used when teaching Boston Children’s Hospital (Abridged) case, #914-407,... View Details
Keywords: Activity Based Costing; Healthcare Costing; Process Maps; Activity Based Costing and Management; Health Care and Treatment
Kaplan, Robert S., and Mary Witkowski. "Boston Children's Hospital Process Map Video." Harvard Business School Multimedia/Video Supplement 117-703, May 2017.
- March 2012 (Revised January 2013)
- Case
Boston Children's Hospital: Measuring Patient Costs
By: Robert S. Kaplan, Mary L. Witkowski and Jessica A. Hohman
The case describes two pilot projects on applying activity-based costing to measuring the cost of treating patients. It presents process maps and financial data relating to the processes used during (1) an office visit to a plastic surgeon for three different diagnoses... View Details
Keywords: Health Care; Time-Driven Activity-Based Costing; Costing; Hospitals; Activity Based Costing and Management; Mathematical Methods; Health Industry
Kaplan, Robert S., Mary L. Witkowski, and Jessica A. Hohman. "Boston Children's Hospital: Measuring Patient Costs." Harvard Business School Case 112-086, March 2012. (Revised January 2013.)
- 1990
- Chapter
Cost of Product and Process Complexity
By: S. Datar, R. Banker, S. Kekre and T. Mukhopadhyay
Datar, S., R. Banker, S. Kekre, and T. Mukhopadhyay. "Cost of Product and Process Complexity." Chap. 9 in Measures for Manufacturing Excellence, edited by Robert S. Kaplan, 269–290. Boston: Harvard Business School Press, 1990.
- 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.
- 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.
- September 2013
- Case
Boston Children's Hospital: Measuring Patient Costs (Abridged)
By: Robert S. Kaplan
The case describes a pilot project on applying activity-based costing to measure the cost of treating patients. After an overview of Boston Children's Hospital and its local health care market environment, the case presents process maps and financial data relating to... View Details
Keywords: Health Care; Time-Driven Activity-Based Costing; Costing; Hospitals; Activity Based Costing and Management
Kaplan, Robert S. "Boston Children's Hospital: Measuring Patient Costs (Abridged)." Harvard Business School Case 914-407, September 2013.
- July–August 2018
- Article
Using Time-Driven Activity-Based Costing to Model the Costs of Various Process-Improvement Strategies in Acute Pain Management
By: Keyuri Popat, Kelly Ann Gracia, Alexis B. Guzman and Thomas W. Feeley
Pain control for patients undergoing thoracic surgery is essential for their comfort and for improving their ability to function after surgery, but it can significantly increase costs. Here, we demonstrate how time-driven activity-based costing (TDABC) can be used to... View Details
Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost Management; Performance Improvement
Popat, Keyuri, Kelly Ann Gracia, Alexis B. Guzman, and Thomas W. Feeley. "Using Time-Driven Activity-Based Costing to Model the Costs of Various Process-Improvement Strategies in Acute Pain Management." Journal of Healthcare Management 63, no. 4 (July–August 2018): e76–e85.
- Article
A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018
By: J. Chirenda, B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison and R. S. Kaplan
Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and... View Details
Keywords: Time-Driven Activity-Based Costing; Provider Cost; Health Care and Treatment; Cost Management; Activity Based Costing and Management; Zimbabwe
Chirenda, J., B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison, and R. S. Kaplan. "A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018." BMC Health Services Research 21, no. 242 (2021).
- 2022
- Article
Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing
By: Nikhil G. Thaker, Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley and Steven J. Frank
Integrated quality improvement (QI) and cost reduction strategies can help increase value in cancer care. We applied standard QI and TDABC methods to improve workflow efficiency and reduce costs for MRI-guided prostate brachytherapy. We constructed process maps,... View Details
Keywords: Brachytherapy; Quality Improvement; Prostate; Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Performance Efficiency; Health Industry
Thaker, Nikhil G., Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley, and Steven J. Frank. "Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing." Brachytherapy 21, no. 1 (2022): 49–54.
- Article
Time-Driven Activity-Based Costing in Emergency Medicine
By: Robert S. Kaplan, Brian J. Yun, Anand M. Prabhakar, Jonathan Warsh, John Brennan, Kyle E. Dempsey and Ali S. Raja
Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine... View Details
Keywords: Time-Driven Activity-Based Costing; Emergency Room; Health Care and Treatment; Value; Cost Management; Activity Based Costing and Management
Kaplan, Robert S., Brian J. Yun, Anand M. Prabhakar, Jonathan Warsh, John Brennan, Kyle E. Dempsey, and Ali S. Raja. "Time-Driven Activity-Based Costing in Emergency Medicine." Annals of Emergency Medicine 67, no. 6 (June 2016): 765–772.
- 2016
- Working Paper
Paying (for) Attention: The Impact of Information Processing Costs on Bayesian Inference
By: Scott Duke Kominers, Xiaosheng Mu and Alexander Peysakhovich
Human information processing is often modeled as costless Bayesian inference.
However, research in psychology shows that attention is a computationally costly and potentially limited resource. We study a Bayesian individual for whom computing posterior beliefs is... View Details
Kominers, Scott Duke, Xiaosheng Mu, and Alexander Peysakhovich. "Paying (for) Attention: The Impact of Information Processing Costs on Bayesian Inference." Working Paper, February 2016.
- April 2021
- Article
Utilizing Time-driven Activity-based Costing to Determine Open Radical Cystectomy and Ileal Conduit Surgical Episode Cost Drivers
By: Janet Baack Kukreja, Mohamed A. Seif, Marissa W. Merry, James R. Incalcaterra, Ashish M. Kamat, Colin P. Dinney, Jay B. Shah, Thomas W. Feeley and Neema Navai
Objectives
Patients undergoing radical cystectomy represent a particularly resource-intensive patient population. Time-driven activity based costing (TDABC) assigns time to events and then costs are based on the people involved in providing care for specific... View Details
Patients undergoing radical cystectomy represent a particularly resource-intensive patient population. Time-driven activity based costing (TDABC) assigns time to events and then costs are based on the people involved in providing care for specific... View Details
Keywords: Time-Driven Activity-Based Costing; Value-based Healthcare; Health Care and Treatment; Cost; Cost vs Benefits; Analysis
Kukreja, Janet Baack, Mohamed A. Seif, Marissa W. Merry, James R. Incalcaterra, Ashish M. Kamat, Colin P. Dinney, Jay B. Shah, Thomas W. Feeley, and Neema Navai. "Utilizing Time-driven Activity-based Costing to Determine Open Radical Cystectomy and Ileal Conduit Surgical Episode Cost Drivers." Urologic Oncology: Seminars and Original Investigations 39, no. 4 (April 2021).
- September 1995 (Revised March 2023)
- Background Note
Process Fundamentals
By: Ann E. Gray and James Leonard
This note provides an introduction for a course or module covering the basic elements of production or service operations and how processes are managed. Begins by discussing the activities that take place in a "process." Analysis tools such as the process flow diagram... View Details
Gray, Ann E., and James Leonard. "Process Fundamentals." Harvard Business School Background Note 696-023, September 1995. (Revised March 2023.)
- 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).
- December 1994
- Background Note
Cost System Analysis
By: Robert S. Kaplan
Describes six characteristics of cost systems: standard vs. actual costs; job-order vs. process costing; variable vs. full costs; disaggregate vs. aggregate cost accumulation; and specific vs. average rates for labor and overhead. A rewritten version of an earlier... View Details
Kaplan, Robert S. "Cost System Analysis." Harvard Business School Background Note 195-181, December 1994.
- 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.)
- 05 Jul 2006
- Working Paper Summaries
Time-Driven Activity-Based Costing
- September 2004 (Revised January 2006)
- Tutorial
Introduction to Cost Accounting Systems
By: David F. Hawkins, V.G. Narayanan, Jacob Cohen and Michele Jurgens
Covers the basics of cost system design, demonstrating in a clear, step-by-step fashion how costs are assigned to cost objects. Key concepts include direct and indirect costs, two-stage allocation, cost pools, and cost drivers. Also provides a brief review of several... View Details
- January 2020
- Article
Using Time-Driven Activity-Based Costing to Demonstrate Value in Perioperative Care: Recommendations and Review from the Society for Perioperative Assessment and Quality Improvement
By: O. Allin, R. D. Urman, A. F. Edwards, J. D. Blitz, K. J. Pfeifer, T. W. Feeley and A. M. Bader
A shift in health care payment models from volume toward value-based incentives will require deliberate input into systems development from both perioperative clinicians and administrators to ensure appropriate recognition of the value of all services... View Details
Keywords: Value-based Health Care; Outcomes; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost Management; Value; Activity Based Costing and Management
Allin, O., R. D. Urman, A. F. Edwards, J. D. Blitz, K. J. Pfeifer, T. W. Feeley, and A. M. Bader. "Using Time-Driven Activity-Based Costing to Demonstrate Value in Perioperative Care: Recommendations and Review from the Society for Perioperative Assessment and Quality Improvement." Journal of Medical Systems 44, no. 1 (January 2020).
- 2013
- Working Paper
The Impact of Conformance and Experiential Quality on Healthcare Cost and Clinical Performance
By: Claire Senot, Aravind Chandrasekaran, Peter T. Ward and Anita L. Tucker
The quality of operational processes is an important driver of performance in hospitals. In particular, processes that reliably deliver both evidence-based and patient-centered care, which we call conformance and experiential quality, respectively, have been argued to... View Details
Keywords: Healthcare; Experiential Quality; Conformance Quality; Clinical Outcomes; Cost Efficiency; Quality; Service Operations; Health Care and Treatment; Performance; Outcome or Result; Health Industry
Senot, Claire, Aravind Chandrasekaran, Peter T. Ward, and Anita L. Tucker. "The Impact of Conformance and Experiential Quality on Healthcare Cost and Clinical Performance." Harvard Business School Working Paper, No. 14-024, September 2013.