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- December 2024
- Case
Blue Cross Blue Shield of Michigan (BCBSM): The AI Journey
By: Shikhar Ghosh
In early 2024, Bill Fandrich, Executive VP and CIO of Blue Cross Blue Shield of Michigan (BCBSM), faced a critical decision about AI adoption within the organization. Fandrich had championed AI implementation at BCBSM. After successfully developing three AI... View Details
Keywords: AI; Machine Learning; Blue Cross; Automation; Digital Strategy; Digital Transformation; Generative Ai; Health Insurance; Insurance Companies; Innovation; IT Strategy; Leadership; Organizational Transformations; Technology; Non-profit; Michigan; AI and Machine Learning; Health; Health Industry; Michigan
- November 2024
- Case
Demond Martin and WellWithAll
By: Hise Gibson, Archie L. Jones and Ai-Ling Jamila Malone
This case study chronicles the transformative entrepreneurial path of Demond Martin, co-founder and CEO of WellWithAll, a health and wellness startup. Motivated by a pivotal life experience and deep concern for racial health inequities, Martin transitions from a... View Details
Keywords: Customers; Diversity; Ethnicity; Race; Health; Recruitment; Leadership Style; Management Style; Marketing; Brands and Branding; Marketing Strategy; Product Marketing; Product Launch; Product Positioning; Organizational Culture; Mission and Purpose; Relationships; Trust; Business Strategy; Competition; Competitive Strategy; Competitive Advantage; Investment; Health Industry; Health Industry; Health Industry; United States; Chicago; Boston; Atlanta; North Carolina; District of Columbia
- October 2024
- Article
Medicare Part D Protected-Class Policy Is Associated with Lower Drug Rebates
By: Pragya Kakani, Michael Anne Kyle, Amitabh Chandra and Luca Maini
Medicare Part D does not allow plans to exclude drugs in six protected classes from their formularies, which may limit plans’ ability to negotiate rebates and lead to higher spending. We estimated the association between protected-class status, US-level estimated... 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
- 2024
- Working Paper
LASH Risk and Interest Rates
By: Laura Alfaro, Saleem Bahaj, Robert Czech, Jonathan Hazell and Ioana Neamtu
We introduce a framework to understand and quantify a form of liquidity risk that we dub Liquidity After Solvency Hedging or “LASH” risk. Financial institutions take LASH risk when they hedge against losses, using strategies that lead to liquidity needs when the value... View Details
- 18 Apr 2024
- Lecture
Innovation Opportunities Created by COVID-19 Can Help: And How to Make Them Happen
The crush of patients created by COVID enabled the creation of sites for care outside the traditional hospital, such as retail pharmacies, ambulatory surgery centers, urgent care centers, telemedicine, and wireless sensors. Public policy mirrored these changes by... View Details
- March–April 2024
- Article
How Fast Should Your Company Really Grow?
By: Gary P. Pisano
Growth—in revenues and profits—is the yardstick by which the competitive fitness and health of organizations is measured. Consistent profitable growth is thus a near universal goal for leaders—and an elusive one.
To achieve that goal, companies need a growth... View Details
To achieve that goal, companies need a growth... 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
- December 2023 (Revised February 2024)
- Case
Transforming Healthcare Delivery at Karolinska University Hospital
By: Susanna Gallani, Mary Witkowski, Elena Corsi and Nikolina Jonsson
The case study examines the journey toward value-based healthcare at Karolinska University Hospital. The hospital's ambitious shift to a patient-centered care delivery model, accompanied by the construction of a new facility, encountered challenges such as high costs,... View Details
- December 12, 2023
- Article
Prices for Common Services at Quaternary vs Nonquaternary Hospitals
By: Brandon W. Yan, Maximilian J. Pany and Leemore S. Dafny
Using commercial health insurance claims data from 2017-2019, we assessed whether quaternary hospitals charged higher prices for common, unspecialized services also offered by nonquaternary hospitals. We found quaternary-hospital price premiums of 8.2 percent, on... View Details
- September 2023
- Case
Healthy.io: The Negotiation for the Medical Selfie
By: Amit Goldenberg and Kumba Sennaar
Healthy.io, an Israeli digital health company, prepares to enter the U.S. market with its chronic kidney disease test. A product safety approval is delayed, putting the company’s cash runway at risk. How should the CEO negotiate his offer to insurance companies ahead... View Details
- July 2023
- Case
DayTwo: Going to Market with Gut Microbiome (Abridged)
By: Ayelet Israeli
DayTwo is a young Israeli startup that applies research on the gut microbiome and machine learning algorithms to deliver personalized nutritional recommendations to its users in order to minimize blood sugar spikes after meals. After a first year of trial rollout in... 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
- 3 Jun 2023
- Talk
Health Care Innovation Opportunities Created by COVID-19 and How to Make Them Happen
The crush of patients created by COVID enabled the creation of sites for care outside the traditional hospital, such as retail pharmacies, ambulatory surgery centers, urgent care centers, telemedicine, and wireless sensors. Public policy mirrored these changes by... View Details
- June 2023
- Teaching Note
From Cradle to Heaven: Taikang Insurance Group
By: William C. Kirby and Noah B. Truwit
Teaching Note for HBS Case No. 320-088. The case explores the rise of Taikang Insurance Group and its quest to be a leader of one of China's fastest-growing industries. Due to China's underdeveloped social welfare state, Taikang saw an opportunity for the private... View Details
- May 2023 (Revised June 2023)
- Case
Novartis (A): Reimagining Medicine
By: Ramon Casadesus-Masanell, Claudio Feser, Karolin Frankenberger and David Redaschi
This case unfolds around the first-ever approved personalized cancer treatment, how Novartis wrapped it into a new business model design, and how Novartis scaled it. Novartis — one of the largest pharmaceutical companies in the world — is, among other ventures,... View Details
- May 2023 (Revised June 2023)
- Supplement
Novartis (B): Reimagining Medicine
By: Ramon Casadesus-Masanell, Claudio Feser, Karolin Frankenberger and David Redaschi
This case unfolds around the first-ever approved personalized cancer treatment, how Novartis wrapped it into a new business model design, and how Novartis scaled it. Novartis — one of the largest pharmaceutical companies in the world — is, among other ventures,... View Details
- May 2023 (Revised June 2023)
- Supplement
Novartis (C): Reimagining Medicine
By: Ramon Casadesus-Masanell, Claudio Feser, Karolin Frankenberger and David Redaschi
This case unfolds around the first-ever approved personalized cancer treatment, how Novartis wrapped it into a new business model design, and how Novartis scaled it. Novartis — one of the largest pharmaceutical companies in the world — is, among other ventures,... View Details
- April 24, 2023
- Article
In the COVID Era, Why Corporate Benefits Demand CEO/CFO Leadership
The expectation that employers provide their employees’ health benefits has been around since World War II. Unfortunately, although today’s employees expect employers to treat them as individuals, ease their experiences, prioritize their wellbeing, and control cost,... View Details
Keywords: COVID; COVID-19 Pandemic; CEO; Leadership; Health Insurance; Benefits; CFO; Compensation and Benefits