Other Article | NEJM Catalyst

My Favorite Slide: The Entrepreneurial Gap Applied to Health Care

by Robert S. Kaplan and Robert Simons


Value-based health care increases physicians’ accountability for patient outcomes. Many have resisted, claiming that patient outcomes are influenced by many forces outside their control, such as patient’s compliance with post-acute and rehab care. The difference between accountability and control is an “entrepreneurial gap,” evoking the HBS definition of entrepreneurs as those who pursue opportunities—internally and externally—without regard to the resources they currently control. The creative tension generated by the entrepreneurial gap of holding physicians responsible for patient outcomes, motivates more integrated patient care that delivers superior patient outcomes at a lower total cost.

Keywords: Health Care and Treatment; Outcome or Result; Motivation and Incentives;


Kaplan, Robert S., and Robert Simons. "My Favorite Slide: The Entrepreneurial Gap Applied to Health Care." NEJM Catalyst (March 8, 2017). (Blog Post.)