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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

1990
Chapter

Cost of Product and Process Complexity

By: S. Datar, R. Banker, S. Kekre and T. Mukhopadhyay

Keywords: Complexity; Cost; Product Development; Business Processes

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

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

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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

Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Activity Based Costing and Management

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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

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

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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

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

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

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

Keywords: Behavior; Cognition and Thinking; Economics

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

Keywords: Time-Driven Activity-Based Costing; Value-based Healthcare; Health Care and Treatment; Cost; Cost vs Benefits; Analysis

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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

Keywords: Service Operations; Operations; Management; Business Processes; Analysis

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

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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

Keywords: Cost; Analysis; System

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

Keywords: Accounting; Cost

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

Keywords: Cost Accounting; Cost; System

05 Jul 2006
Working Paper Summaries

Time-Driven Activity-Based Costing

Keywords: by Robert S. Kaplan & Steven R. Anderson; Financial Services

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

24 Jan 2005
Research & Ideas

Rethinking Activity-Based Costing

$0.80) for processing customer orders, $35.20 (44 by $0.80) for handling inquiries, and $40 (50 by $0.80) for performing credit checks. Once you have calculated these standard rates, you can apply them in real time to assign View Details

Keywords: by Robert S. Kaplan & Steven R. Anderson

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