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Health Care

Health Care

    • February 2015
    • Supplement

    The Affordable Care Act (A): Legislative Strategy in the House of Representatives

    By: Joseph L. Bower and Michael Norris

    In early 2009, the Obama administration and the Democratically-led Congress began working on what would eventually become the Affordable Care Act. The (A) case in this series discusses the legislative strategy in the House of Representatives, where three different committees each had jurisdiction over health care legislation.

    • February 2015
    • Supplement

    The Affordable Care Act (A): Legislative Strategy in the House of Representatives

    By: Joseph L. Bower and Michael Norris

    In early 2009, the Obama administration and the Democratically-led Congress began working on what would eventually become the Affordable Care Act. The (A) case in this series discusses the legislative strategy in the House of Representatives, where three different committees each had jurisdiction over health care legislation.

    • Blog Post

    Innovation in Health Care Education: A Call to Action

    By: Regina E. Herzlinger, Vasant Kumar, Kevin Schulman and Karen Staman

    Health care administration educators are at a crossroads: the health care sector is rife with inefficiencies, erratic quality, unequal access, and sky-high costs, complex problems which call for innovative solutions, and yet, according to our content analysis of top U.S. health administration schools and a recent article in the Lancet, our educational systems focus their curricula on isolated,theoretical subjects, such as analytics and quantitative problem solving, rather than the team-oriented, practical problem-solving skills required for innovation. All too often, when graduates of these programs enter the workforce, they find themselves unequipped to meet the challenges for innovation of 21st century health care.

    • Blog Post

    Innovation in Health Care Education: A Call to Action

    By: Regina E. Herzlinger, Vasant Kumar, Kevin Schulman and Karen Staman

    Health care administration educators are at a crossroads: the health care sector is rife with inefficiencies, erratic quality, unequal access, and sky-high costs, complex problems which call for innovative solutions, and yet, according to our content analysis of top U.S. health administration schools and a recent article in the Lancet, our...

    • December 2014
    • Article

    No Margin, No Mission? A Field Experiment on Incentives for Public Services Delivery

    By: Nava Ashraf, Oriana Bandiera and B. Kelsey Jack

    A substantial body of research investigates the effect of pay for performance in firms, yet less is known about the effect of non-financial rewards, especially in organizations that hire individuals to perform tasks with positive social spillovers. We conduct a field experiment in which agents recruited by a public health organization to sell condoms are randomly allocated to four groups. Agents in the control group are hired as volunteers, whereas agents in the three treatment groups receive, respectively, a small monetary margin on each pack sold, a large margin, and a non-financial reward. The analysis yields three main findings. First, non-financial rewards are more effective at eliciting effort than either financial rewards or the volunteer contract and are also the most cost-effective of the four schemes. Second, non-financial rewards leverage intrinsic motivation and, contrary to existing laboratory evidence, financial incentives do not appear to crowd it out. Third, the responses to both types of incentives are stronger when their relative value is higher. Indeed, financial rewards are effective at motivating the poorest agents, and non-financial rewards are more effective when the peer group is larger. Overall, the findings demonstrate the power of non-financial rewards to motivate agents in settings where there are limits to the use of financial incentives.

    • December 2014
    • Article

    No Margin, No Mission? A Field Experiment on Incentives for Public Services Delivery

    By: Nava Ashraf, Oriana Bandiera and B. Kelsey Jack

    A substantial body of research investigates the effect of pay for performance in firms, yet less is known about the effect of non-financial rewards, especially in organizations that hire individuals to perform tasks with positive social spillovers. We conduct a field experiment in which agents recruited by a public health organization to sell...

    • August 2001 (Revised January 2015)
    • Case

    SonoSite: A View Inside

    By: Clayton Christensen and Jeremy Dann

    After its spin-off from one of the world's largest ultrasound makers, Sonosite attempts to popularize a new kind of handheld ultrasound units. Sonosite needs to decide if it should focus on new markets that will value the portability and ease of use of its products, or if it should evolve its offerings so that they appeal to radiologists and cardiologists, the largest purchasers of ultrasound systems.

    • August 2001 (Revised January 2015)
    • Case

    SonoSite: A View Inside

    By: Clayton Christensen and Jeremy Dann

    After its spin-off from one of the world's largest ultrasound makers, Sonosite attempts to popularize a new kind of handheld ultrasound units. Sonosite needs to decide if it should focus on new markets that will value the portability and ease of use of its products, or if it should evolve its offerings so that they appeal to radiologists and...

    • March 2014 (Revised December 2014)
    • Case

    Vision 2020: Takeda and the Vaccine Business

    By: John A. Quelch and Margaret L. Rodriguez

    In 2014, Yasuchika Hasegawa was orchestrating the transformation of Takeda from a Japanese pharmaceutical company with a global footprint into a global company with a Japanese heritage. A 33-year veteran of Takeda, Hasegawa-san was appointed president of Takeda in 2003 and chief executive in 2009. By 2013, Takeda was in the midst of implementing its new Vision 2020 plan, a strategic plan for the evolving global corporation, which included developing a global vaccine business.

    • March 2014 (Revised December 2014)
    • Case

    Vision 2020: Takeda and the Vaccine Business

    By: John A. Quelch and Margaret L. Rodriguez

    In 2014, Yasuchika Hasegawa was orchestrating the transformation of Takeda from a Japanese pharmaceutical company with a global footprint into a global company with a Japanese heritage. A 33-year veteran of Takeda, Hasegawa-san was appointed president of Takeda in 2003 and chief executive in 2009. By 2013, Takeda was in the midst of implementing...

    • August 2015 (Revised August 2015)
    • Case

    Hoag Orthopedic Institute

    By: Robert S. Kaplan and Jonathan Warsh

    Two groups of orthopedic surgeons form a joint venture with a community hospital to establish Hoag Orthopedic Institute, a for-profit hospital and two ambulatory service centers. By controlling and integrating all aspects of the patients' medical treatment, the physicians deliver superior outcomes, which they communicate with an annual public outcomes report. They also introduce bundled payment contracts with three insurers for orthopedic surgeries, and join a multi-hospital study for applying time-driven activity-based costing to identify process improvement and cost reduction opportunities. The case concludes with HOI leaders examining several options for expansion and growth.

    • August 2015 (Revised August 2015)
    • Case

    Hoag Orthopedic Institute

    By: Robert S. Kaplan and Jonathan Warsh

    Two groups of orthopedic surgeons form a joint venture with a community hospital to establish Hoag Orthopedic Institute, a for-profit hospital and two ambulatory service centers. By controlling and integrating all aspects of the patients' medical treatment, the physicians deliver superior outcomes, which they communicate with an annual public...

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 Care
Social Enterprise

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 Care
Social Enterprise

Recent Publications

Creating Workplaces Free of Forever Chemicals

By: Joseph G. Allen, Heather A. Henrikson and Michael W. Toffel
  • April 8, 2025 |
  • Article |
  • Harvard Business Review Digital Articles
Forever chemicals are toxic and widely used in buildings and yet they remain on the rise globally with little regulation to control them. In the United States, for example, Environmental Protection Agency (EPA) regulations currently cover only forever chemicals in water—and only six of the more than 10,000. But organizations have a responsibility and role to play in eliminating them from workplaces in the same way they might have asbestos in years past. At Harvard University and several corporations, leaders are following a simple, two-part playbook: Demand transparency from suppliers and avoid entire classes of chemicals.
Keywords: Occupational Health; Safety Regulations; Regulation; Working Conditions; Governing Rules, Regulations, and Reforms; Safety; Health
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Allen, Joseph G., Heather A. Henrikson, and Michael W. Toffel. "Creating Workplaces Free of Forever Chemicals." Harvard Business Review Digital Articles (April 8, 2025).

Niramai: An AI Solution to Save Lives

By: Rembrand Koning, Maria P. Roche and Kairavi Dey
  • March 2025 |
  • Case |
  • Faculty Research
Founded in 2017, Niramai developed Thermalytix, a breast cancer screening tool. Thermalytix used a high-resolution thermal sensing device and machine learning algorithms to analyze thermal images and detect tumors. Its patented solution leveraged big data analytics, AI, and ML for reliable, early, and accurate breast cancer screening. Early clinical trials showed that the solution was equal to or, in some instances, more accurate than mammography available in India. The team was elated that they had developed an effective, low-cost, easier-to-use, non-invasive, and less painful solution for patients. As Manjunath considered the next phase of Niramai’s growth, she wondered if it was time to raise another round of funds and conduct a new, comprehensive clinical study. Should the trial be conducted in the U.S., where it would be significantly more expensive but with the possibility of an exponentially higher payout if the trials were successful? Or should they raise a smaller round now, do a larger trial in a populous developing country such as Indonesia, and focus on lower-to-middle-income countries?
Keywords: Entrepreneurship; AI and Machine Learning; Technology Adoption; Health Care and Treatment; Technology Industry; Health Industry; Asia; India; South Asia
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Koning, Rembrand, Maria P. Roche, and Kairavi Dey. "Niramai: An AI Solution to Save Lives." Harvard Business School Case 725-439, March 2025.

Expert Patients’ Use of Avoidable Health Care

By: Amitabh Chandra, Pragya Kakani and Simone Matecna
  • 2025 |
  • Working Paper |
  • Faculty Research
We measure whether expert patients – those trained as physicians and nurses – have fewer emergency department visits and the reasons for these differences. Relative to similar patients physicians and nurses had 19.8% and 5.1% fewer ED visits, principally due to fewer avoidable visits. The differences in avoidable visits between physicians and other patients were largest for diagnoses commonly requiring prescriptions, which physicians often self-prescribed. Our results suggest that improving access to prescriptions for acute symptoms, more than improving patient education, may reduce avoidable health care.
Keywords: Health Care and Treatment; Service Delivery; Health Industry
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Chandra, Amitabh, Pragya Kakani, and Simone Matecna. "Expert Patients’ Use of Avoidable Health Care." NBER Working Paper Series, No. 33573, March 2025.

Abiomed: Clinical Trials and Tribulations

By: Satish Tadikonda, Faith Robertson and William Marks
  • February 2025 |
  • Case |
  • Faculty Research
After receiving 510(k) clearance for the Impella 2.5 device, Abiomed had proceeded to conduct a premarket approval (PMA) process as well to prove clinical superiority, earn greater protection, and extend commercial runway. However, in the middle of the clinical trial required as part of the PMA process, CEO Michael Minogue got word that the independent Data Safety Monitoring Board (DSMB) had called for the early termination of the trial. His 2010 scramble to determine how to proceed had massive implications for the company, requiring the company to publicly disclose the termination of the trial, potentially restart the entire trial, and potentially affect the commercial and regulatory success of the device he was convinced was saving many lives. Minogue had conviction that the DSMB was wrong, but how would he chart a path forward?
Keywords: Corporate Disclosure; Governing Rules, Regulations, and Reforms; Health Testing and Trials; Medical Devices and Supplies Industry
Citation
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Tadikonda, Satish, Faith Robertson, and William Marks. "Abiomed: Clinical Trials and Tribulations." Harvard Business School Case 825-096, February 2025.

Abiomed: A Change of Heart

By: Satish Tadikonda, Faith Robertson and William Marks
  • February 2025 |
  • Case |
  • Faculty Research
After acquiring Impella CardioSystems AG in May 2005, Abiomed Inc., a company focused on cardiac care, ran into a dilemma. Its Impella 2.5 device was approved for use in the European Union, but CEO Michael Minogue had seemingly bet the company's future on the ability to quickly get the device regulatory clearance in the U.S. by the FDA. Doing this would require the FDA agreeing to let the device be cleared by the 510(k) pathway, as opposed to the much more complex premarket approval (PMA) process. After submitting the 510(k) request to the FDA in 2007, Abiomed was told they must proceed instead by the PMA process, meaning patients could not widely access the life-saving device for potentially many years, and cutting a major revenue source for Abiomed that was needed to justify the acquisition. Now Minogue must decide what to do and whether to fight the FDA or acquiesce and find other ways to keep the company going.
Keywords: Mergers and Acquisitions; Governing Rules, Regulations, and Reforms; Health Care and Treatment; Business and Government Relations; Medical Devices and Supplies Industry; European Union; United States
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Tadikonda, Satish, Faith Robertson, and William Marks. "Abiomed: A Change of Heart." Harvard Business School Case 825-011, February 2025.

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
  • February 2025 |
  • Article |
  • Health Services Research
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 comprehensive EMR data from patients who visited the Mayo Clinic of Arizona Emergency Department (ED) between October 6, 2018 and December 31, 2019. Primary outcomes are patient length of stay (LOS) in the ED, number of diagnostic imaging tests ordered during a patient encounter, and patients' return with admission to the ED within 72 h. The association between outcomes and physician batch tendency was measured using a multivariable linear regression controlling for various covariates.
Data Sources and Analytic Sample: The Mayo Clinic of Arizona Emergency Department recorded approximately 50,836 visits, all randomly assigned to physicians during the study period. After excluding rare complaints, we were left with an analytical sample of 43,299 patient encounters.
Principal Findings: Findings show that having a physician with a batch tendency 1 standard deviation (SD) greater than the average physician was associated with a 4.5% increase in ED LOS (p < 0.001). It was also associated with a 14.8% (0.2 percentage points) decrease in the probability of a 72-h return with admission (p < 0.001), implying that batching may lead to more comprehensive evaluations, reducing the need for short-term revisits. A batch tendency 1SD greater than that of the average physician was also associated with an additional 8 imaging tests ordered per 100 patient encounters (p < 0.001), suggesting that batch ordering may be leading to tests that would not have been otherwise ordered had the physician waited for the results from one test before placing their next order.
Conclusions: This study highlights the considerable impact of physicians' diagnostic test ordering strategies on ED efficiency and patient care. The results also highlight the need to develop guidelines to optimize ED test ordering practices.
Keywords: Health Care; Operations Management; Productivity; Health Care and Treatment; Operations; Outcome or Result; Resource Allocation; Health Industry; United States
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Jameson, Jacob C., Soroush Saghafian, Robert S. Huckman, and Nicole Hodgson. "Variation in Batch Ordering of Imaging Tests in the Emergency Department and the Impact on Care Delivery." Health Services Research 60, no. 1 (February 2025).

Gavi and the 'Next' Pandemic

By: Tarun Khanna and Kerry Herman
  • January 2025 (Revised March 2025) |
  • Case |
  • Faculty Research
In 2025, CEO Dr. Sania Nishtar and her team consider the lessons the Global Alliance for Vaccine and Immunizations (GAVI) learned from the pandemic. GAVI successfully brought COVID-19 vaccines to large swaths of the undeveloped and under-developed world by pooling countries’ needs and deploying innovative financing instruments to procure vaccines. Once COVID was identified as a pandemic, in the face of a raft of financial and logistical challenges, Gavi quickly mobilized to add procuring COVID-19 vaccines for low- and middle-income countries to its regular vaccine and immunization efforts. Now in the aftermath of the pandemic, Nishtar is assessing how to best embed into Gavi’s operational DNA the many innovative solutions developed during the pandemic-related chaos of securing and delivering vaccines, while she and her team prepare for what unknowns may come next.
Keywords: Developing Countries and Economies; Financial Instruments; Health Care and Treatment; Health Pandemics; Crisis Management; Success; Pharmaceutical Industry; Africa
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Khanna, Tarun, and Kerry Herman. "Gavi and the 'Next' Pandemic." Harvard Business School Case 725-351, January 2025. (Revised March 2025.)

Summer Health: Raising an AI-First Company?

By: Jeffrey J. Bussgang, Sarah Mehta and Maxim Pike Harrell
  • January 2025 |
  • Case |
  • Faculty Research
In October 2023, Summer Health CEO Ellen DaSilva arrived at a defining juncture for her pediatric telehealth startup. Founded in 2021, Summer Health offered parents rapid access to licensed pediatricians via text message. DaSilva, an experienced telehealth executive, launched the company after struggling to reach dependable after-hours care for her children. As her startup grew, the advent of mainstream generative Artificial Intelligence (AI) prompted Summer Health’s leadership to consider how they might incorporate the technology into the company’s platform and capabilities set. Following a partnership with AI company OpenAI, Summer Health’s engineering team developed a pilot to create a new AI medical note summarization tool that proved highly useful to pediatricians. As DaSilva looked forward, she considered whether to integrate AI more deeply at Summer Health, even at the expense of her current product roadmap and company priorities.
Keywords: AI and Machine Learning; Technology Adoption; Entrepreneurship; Leadership; Business Startups; Health Care and Treatment; Business Strategy; Health Industry; Telecommunications Industry; United States
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Bussgang, Jeffrey J., Sarah Mehta, and Maxim Pike Harrell. "Summer Health: Raising an AI-First Company?" Harvard Business School Case 825-083, January 2025.

Innovations in Evaluating Ambulatory Costs of Cystic Fibrosis Care: A Comparative Study Across Multidisciplinary Care Centers in Ireland and the United States

By: Emma Brady, Ryan C. Perkins, Kate Cullen, Gregory S. Sawicki, Robert S. Kaplan and Gerardine Doyle
  • February 2025 |
  • Article |
  • NEJM Catalyst Innovations in Care Delivery
Lead clinicians at two large pediatric cystic fibrosis (CF) centers in the United States and Ireland measured and compared their ambulatory care costs. The clinicians selected three strata of patients (0–11 months, 1–5 years, and 6–17 years of age). Process maps were developed for each of the age cohorts at each site, and the costs of ambulatory care—with emphasis on routine CF clinic visits—were measured utilizing time-driven activity-based costing (TDABC). Variance analysis was applied to identify the components of cost variation between the two sites. The quantity variance showed that clinicians in Ireland spent 108% more time with patients than at the U.S. site; the skill mix variance showed the U.S. site with a 49% higher personnel cost mix, and the price (rate) variance showed that U.S. personnel had a 31% higher compensation level. The costing and variance analysis provided organizationally relevant insights into the distinctive features of each site’s CF care delivery processes and how costs could be reduced without adverse impact on patient outcomes.
Keywords: Health Care and Treatment; Cost; Service Delivery; Resource Allocation; Health Industry
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Brady, Emma, Ryan C. Perkins, Kate Cullen, Gregory S. Sawicki, Robert S. Kaplan, and Gerardine Doyle. "Innovations in Evaluating Ambulatory Costs of Cystic Fibrosis Care: A Comparative Study Across Multidisciplinary Care Centers in Ireland and the United States." NEJM Catalyst Innovations in Care Delivery 6, no. 2 (February 2025).

The VideaHealth AI Factory: CEO Florian Hillen on Speed, Scale, and Innovation (A)

By: Tsedal Neeley, Levi Stroud, Ruth Page and Dave Habeeb
  • January 2025 |
  • Case |
  • Faculty Research
Pre-abstract: This multimedia case should be assigned to students in advance of class. Instructors should consider the timing of making the (B) Case videos available to students, as they may reveal key case details.

Abstract: Florian Hillen, co-founder and CEO of VideaHealth, a startup using artificial intelligence (AI) to detect dental conditions on x-rays, spent the early years of his company laying the groundwork for an AI factory. This AI factory, designed to rapidly build and iterate on new AI products, was central to Hillen's vision of giving VideaHealth a competitive edge in the market. VideaHealth’s AI technology aspires to detect dental conditions on x-rays with a level of accuracy and consistency that would resonate with the needs of both individual dentists and Dental Service Organizations (DSOs). Yet, the puzzle remained: how precise and reliable would the AI's performance need to be to earn the trust of practitioners, enhance patient care, and seamlessly integrate into clinical workflows? The exact threshold of success was unclear, challenging Hillen to ensure the AI factory could continuously refine the technology to improve decision-making in dental practices.
Keywords: Diagnostics; Organization Design; Change Management; Disruption; Transformation; Health Care and Treatment; AI and Machine Learning; Technology Adoption; Technological Innovation; Management Style; Organizational Culture; Success; Technology Industry; Health Industry; United States
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Neeley, Tsedal, Levi Stroud, Ruth Page, and Dave Habeeb. "The VideaHealth AI Factory: CEO Florian Hillen on Speed, Scale, and Innovation (A)." Harvard Business School Multimedia/Video Case 425-720, January 2025.
More Publications

Faculty

Michael E. Porter
Regina E. Herzlinger
Robert S. Kaplan
Robert S. Huckman
Amy C. Edmondson
Richard G. Hamermesh
John A. Quelch
Amitabh Chandra
Alvin E. Roth
Leemore S. Dafny
Tarun Khanna
James E. Austin
→See All

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Harvard Business Publishing

    • December 9, 2020
    • Article

    Give Employees Cash to Purchase Their Own Insurance

    By: Regina E. Herzlinger and Barak D. Richman
    • February 2025
    • Case

    Abiomed: Clinical Trials and Tribulations

    By: Satish Tadikonda, Faith Robertson and William Marks
→More Harvard Business Publishing
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