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• Article | American Heart Journal

  Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?

  R. S. Kaplan, F. Erhun, V.G. Narayanan, B. Mistry and K. Brayton, et al

  We use time-driven activity-based costing to estimate the cost of personnel and space for an elective coronary artery bypass graft (CABG) surgery at two U.S. hospitals, Intermountain and Baylor Heart, and Narayana Health (NH), in India. All three hospitals use modern management methods to achieve excellent patient outcomes. We use variance analysis to remove the effect of differential prices paid for personnel and space at the three hospitals. NH, even at U.S. price levels, retains a cost advantage over the two U.S. hospitals by shifting tasks to less-credentialed and/or less-experienced personnel, supervised by highly-skilled personnel, a practice facilitated by NH’s high annual CABG volume. NH offsets some of its task downshifting cost savings by having lower-skilled employees spend more time counseling patients and their families for in-hospital and home recovery. NH’s cost-saving practices could be captured by U.S. hospitals by relaxing hospital and health professional licensing regulations, encouraging greater family participation in inpatient care, and performing complex surgeries in high-volume regional centers of excellence.

  Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Organizational Structure; Performance Efficiency; India; United States;

  Citation:

  Kaplan, R. S., F. Erhun, V.G. Narayanan, B. Mistry, and K. Brayton, et al. "Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?" American Heart Journal 224 (June 2020): 148–155.  View Details

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• Case | HBS Case Collection | January 2018 (Revised December 2019)

  A United States Citizen Working Abroad

  V.G. Narayanan and Shawn O'Brien

  Citation:

  Narayanan, V.G., and Shawn O'Brien. "A United States Citizen Working Abroad." Harvard Business School Case 118-056, January 2018. (Revised December 2019.)  View Details

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• Case | HBS Case Collection | November 2019

  Celebrity Fashions Limited (A)

  V.G. Narayanan, Tanvi Deshpande and Shreya Ramachandran

  In May 2017 in Chennai, India, the chairman of Celebrity Fashions doubted whether the company could last until the end of the year. Venkatesh Rajagopal had found that the company, a readymade garment manufacturing and exporter he founded in 1989, was having a hard time financially. It had been dealing with declining revenues for the past five years, and its losses had tripled between 2014 and 2016. A slowdown in factory plant processes in 2006 and the value of the rupee against the dollar, as well as wage arrears, contributed to the financial problem. Rajagopal’s son, Vidyuth, had recently joined the company after moving roles both within Celebrity and its sister company, Indian Terrain, and organizations elsewhere. In 2017, as joint managing director, he was convinced he would be able to turn the company around. Vidyuth, along with the independent director Venky appointed, identified the problems. There were communication gaps on the factory floor, and this caused lags in the shipments of garments and pushed up costs of production. The financial problems had confused some employees, and others were not aware of them at all. The leadership team was not communicating effectively. Would Celebrity be able to cut operational costs, and would Vidyuth be able to get the buy-in from his team to transform the company and protect his family business?

  Keywords: turnarounds; Operations; Management; Financial Condition; Problems and Challenges; Communication; Organizational Change and Adaptation; Transformation; Apparel and Accessories Industry; Manufacturing Industry;

  Citation:

  Narayanan, V.G., Tanvi Deshpande, and Shreya Ramachandran. "Celebrity Fashions Limited (A)." Harvard Business School Case 120-053, November 2019.  View Details

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