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• Article | NEJM Catalyst Innovations in Care Delivery | July–August 2020

  Assessing the Value of Pediatric Aerodigestive Care

  Robert S. Kaplan, Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher and Evan Propst

  Leaders at six hospitals conducted a research study to assess and compare the health outcomes and costs of pediatric aerodigestive care. Four of the hospitals delivered care with an integrated practice unit (IPU) while two delivered care traditionally, with isolated specialists. The study used time-driven activity-based costing as a tool to measure and compare costs across the six sites. The results demonstrate that the four IPU sites improved clinical outcomes and had lower costs of care.

  Keywords: Time-Driven Activity-Based Costing; value-based health care; integrated practice unit; Health Care and Treatment; Cost Management; Performance Improvement;

  Citation:

  Kaplan, Robert S., Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher, and Evan Propst. "Assessing the Value of Pediatric Aerodigestive Care." NEJM Catalyst Innovations in Care Delivery 4, no. 1 (July–August 2020).  View Details

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• Article | International Journal of Pediatric Otorhinolaryngology

  Quantifying the Benefits from a Care Coordination Program for Tracheostomy Placement in Neonates

  Christen Caloway, Alisa Yamasaki, Kevin M. Callans, Mahek Shah, Robert S. Kaplan and Christopher Hartnick

  Value-based care models are becoming instrumental in structuring clinical care delivery in our healthcare climate. Our objective was to determine the value associated with implementation of a Family-Centered Care Coordination (FCCC) program for neonates undergoing tracheostomy.

  Keywords: family-centered care; value-based healthcare; Time-Driven Activity-Based Costing; Health Care and Treatment; Value; Activity Based Costing and Management;

  Citation:

  Caloway, Christen, Alisa Yamasaki, Kevin M. Callans, Mahek Shah, Robert S. Kaplan, and Christopher Hartnick. "Quantifying the Benefits from a Care Coordination Program for Tracheostomy Placement in Neonates." International Journal of Pediatric Otorhinolaryngology 134 (July 2020).  View Details

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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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