Health Care
Health Care
Over the past several decades, HBS has built a foundation in health care research, from Clayton Christensen's application of disruptive innovations and Regina Herzlinger's concept of consumer-driven health care to Michael Porter's use of competitive strategy principles. Today our research focuses on
- how management principles and best practices from other industries can be applied;
- how the process of innovation can be improved;
- how principles of strategy and consumer choice can be utilized;
- how information technology can expand access, decrease costs, and improve quality;
- how new approaches in developing nations can impact global health.
Initiatives & Projects
The Health Care Initiative and the Social Enterprise Initiative connect students, alumni, faculty, and practitioners to ideas, resources, and opportunities for collaboration that yield innovative models for health care practice.
Health CareSocial EnterpriseRecent Publications
Allurion: Competing in the Age of GLP-1
By: Satish Tadikonda, Rajiv Lal, David Lane and Sarah Sasso
- October 2024 |
- Case |
- Faculty Research
Shantanu Gaur had built Allurion into a formidable business internationally, providing obesity patients with a less invasive option long before GLP-1 drugs became the latest craze. Selling Allurion's medical device across 60+ countries, he awaited FDA approval to bring his technology to patients in the US. As time ticked by, GLP-1 drugs came like a tsunami, seemingly conquering the weight-loss market. With approval seemingly coming soon, Gaur had to decide what his strategy should be in continuing to grow Allurion, dealing with the challenges of the GLP-1 craze, and preparing for long term success.
Greater Covid-19 Vaccine Uptake among enrollees Offered Health and Social Needs Case Management: Results from a Randomized Trial
By: Margae Knox, Elizabeth A. Hernandez, Daniel M. Brown, Jennifer Ahern, Mark D. Fleming, Crystal Guo and Amanda L. Brewster
- October 2024 |
- Article |
- Health Services Research
The CommunityConnect case management program for Medicaid beneficiaries is run by Contra Costa Health, a county safety net health system in California. Case management infrastructure modestly improved Covid-19 vaccine uptake in a population of Medicaid beneficiaries that over-represents social groups with barriers to early Covid-19 vaccination. Amidst mixed evidence on vaccination-specific incentives, leveraging trusted case managers and existing case management programs may be a valuable prevention strategy.
The Health Equity Accelerator at Boston Medical Center
By: Susanna Gallani, Mary Witkowski and Katie Sonnefeldt
- September 2024 |
- Case |
- Faculty Research
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 Equity Accelerator was formed to coordinate this strategic approach, which adopted race-based disparities as their primary focus. Over three years the Accelerator demonstrated impressive reductions in racial and ethnic disparities in health outcomes among pregnant women and patients with diabetes. These results reinforced their drive to scale their innovative approach, and set an example for other institutions nationwide. However, scaling presented significant challenges: balancing replicable and standardized “off the shelf” solutions with distributing a “methodology” to enable other institutions to identify their own solutions to inequities in their patient population.
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; Health Industry; Boston
Sky Therapeutics: Innovating in Digital Therapeutics
By: Satish Tadikonda, Olivia Reszczynski and William Marks
- August 2024 |
- Case |
- Faculty Research
Shad Faraz and Alex Youssef were intrigued by the opportunities in the relatively new area of Digital Therapeutics. Despite initial successes, early entrants had struggled with reimbursement and revenue-predictability challenges. However, venture investors still continued to be enthusiastic about the space, prompting Faraz and Youssef to dive headfirst into the world of entrepreneurship and found Sky Therapeutics. Although their decision to pursue their startup full-time was exciting, they also needed to tackle pressing questions and unique challenges around the right clinical problem to target and with what technological and behavioral mechanism. Would the digital therapeutics space flourish or flop, and how would that affect Sky's prospects?
Pioneering Pain Management: CWC Alliance Combats the Opioid Epidemic
By: Susanna Gallani, Karen L. Sedatole and Sarah Mehta
- August 2024 |
- Case |
- Faculty Research
Set in March 2024, this case is about CWC Alliance (CWC), a nonprofit working to prevent opioid addiction in the U.S. Founder Cammie Wolf Rice launched CWC in 2018 after her son, Christopher Wolf, died of a heroin overdose. Wolf’s dependence on opioids stemmed from a prescription he received at the age of 17 after several surgeries. Looking back, Rice wishes a healthcare worker had educated her and her son on the dangers of opioids before they were discharged.
CWC created the role of the Life Care Specialist (LCS)—a care coach offering an extra layer of support to patients and hospital staff by providing education, mental wellness support, and personalized alternative pain management strategies to post-operative patients. In 2020, CWC piloted the role at Grady Memorial Hospital, a busy trauma center in Atlanta, Georgia. By 2024, three LCSs worked at Grady as full-time employees. CWC is ready to expand to other hospitals, and the case finds Rice weighing the merits of several scaling strategies.
Effects of a Real-Time Information-Based Intervention on Physician Prescribing Behavior
By: Olivia Zhao and Anna D Sinaiko
- 2024 |
- Article |
- Academy of Management Best Paper Proceedings
High out-of-pocket (OOP) prices for prescription drugs create financial difficulties for patients, and cost-related underuse of medications can adversely patient health. Simultaneously, many physicians report a willingness to address affordability concerns with patients, but often do not have access to accurate estimates of OOP prices for a specific patient and medication. One proposed solution to help physicians prescribe in a more cost-conscious manner is a physician-targeted real-time price transparency intervention (called a real-time benefit tool, or RTBT) that displays patient-specific OOP price estimates at the time of prescribing. We study the implementation of an RTBT at a large health system to explore how physician prescribing behavior for diabetes medications changed after implementation. We find that the tool appeared to reinforce existing physician prescribing patterns, but those with more clinical experience with diabetes medication orders or more interactions with the tool did change their prescribing patterns. This and future evidence on this relatively new technology should help inform the future design and implementation of RTBTs.
How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?
By: Leemore S. Dafny, Kate Ho and Edward Kong
- August 2024 |
- Article |
- American Economic Journal: Economic Policy
Drug copayment coupons to reduce patient cost-sharing have become nearly ubiquitous for high-priced brand-name prescription drugs. Medicare bans such coupons on the grounds that they are kickbacks that induce utilization, but they are commonly used by commercially-insured enrollees. We estimate the causal effects of coupons for branded drugs without bioequivalent generics using variation in coupon introductions over time and comparing differential responses across enrollees in commercial and Medicare Advantage plans. Using data on net-of-rebate prices and quantities from a large Pharmacy Benefits Manager, we find that coupons increase quantity sold by 21-23% for the commercial segment relative to Medicare Advantage in the year after introduction, but do not differentially impact net-of-rebate prices, at least in the short-run. To quantify the equilibrium price effects of coupons, we employ individual-level data to estimate a discrete choice model of demand for multiple sclerosis drugs. We use our demand estimates to parameterize a model of drug price negotiations. For this category of drugs, we estimate that coupons raise negotiated prices by 8% and result in just under $1 billion in increased U.S. spending annually. Combined, the results suggest copayment coupons increase spending on couponed drugs without bioequivalent generics by up to 30 percent.
Providing Value and Equity in Medicare's Dementia Care Is a Must
By: Susanna Gallani and Lidia Moura
- July 24, 2024 |
- Article |
- Newsweek
Keywords: Health Care and Treatment
Replika AI: Alleviating Loneliness (A)
By: Shikhar Ghosh and Shweta Bagai
- July 2024 |
- Case |
- Faculty Research
Eugenia Kuyda launched Replika AI in 2017 as an empathetic digital companion to combat loneliness and provide emotional support. The platform surged in popularity during the COVID-19 pandemic, offering non-judgmental support to isolated users. By 2023, Replika boasted 10 million users, with 40% engaging in romantic partnerships with their Replikas. Kuyda's strategy of prioritizing users' emotional well-being over engagement metrics was successful: 85% users reported improved mood post-interaction. However, as users ventured into more intimate conversations with the AI, Kuyda faced a pivotal decision: Should she restrict these exchanges or embrace them as the platform's natural evolution? This choice was complicated by the need to safeguard Replika's brand, prevent misuse, while satisfying its diverse user base. The case explores the ethical boundaries of AI-human relationships and the evolving role of AI in addressing loneliness. It is suitable for courses in technology, entrepreneurship, AI, and ethics.
Aidoc: Building a Hospital-Centric AI Platform
By: Ariel D. Stern and Susan Pinckney
- June 2024 |
- Case |
- Faculty Research
In 2023, Israel-based AI health care company Aidoc evaluated its future. The company, founded in 2016, had grown from commercializing a single AI product for radiologists to a software platform that could detect 20 conditions and immediately notify care teams of critical results for priority patients. Aidoc’s products detected over 75% of common acute pathologies visible on CT scans. The company had 20 algorithms used by over 900 global hospitals and had 17 FDA clearances—the highest number of any clinical AI company at the time. The company, which had initially produced point solutions, had evolved to manage a multisided network platform that hosted its own as well as its partners’ algorithms. Aidoc had a rich history of producing highly accurate AI products, but partnership allowed it to bring more innovative products to market. The company needed to determine how to continue to grow. Should it focus more on developing highly technical AI health care solutions or on developing and managing a platform to bring other company’s products to its growing customer base?
Keywords: Business Growth and Maturation; Business Model; Business Organization; Business Startups; Disruption; Cost vs Benefits; Decision Choices and Conditions; Decisions; Private Sector; Entrepreneurial Finance; Global Range; Global Strategy; Globalized Markets and Industries; Governance Compliance; Governance Controls; Governing and Advisory Boards; Policy; Medical Specialties; AI and Machine Learning; Digital Platforms; Digital Transformation; Technology Adoption; Disruptive Innovation; Innovation and Management; Innovation Strategy; Laws and Statutes; Growth and Development Strategy; Growth Management; Distribution; Product Development; Success; Performance Efficiency; Strategic Planning; Research and Development; Risk and Uncertainty; Business Strategy; Competitive Advantage; Value Creation; Health Industry; Israel