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• Case | HBS Case Collection | May 2018

  Kaiser Permanente Colorado: Primary Care Plus

  Robert S. Kaplan and Mahek A. Shah

  A gerontologist in Kaiser Permanente’s Colorado region is concerned with the high and growing cost of treating the elderly population. She introduces a new care model, Primary Care Plus, using an interdisciplinary team of a primary care doctor, palliative care specialist, nurse coordinator, clinical pharmacy specialist, and behavioral and social service specialists. The team focuses on the highest-risk patients to see if the new, pro-active care model can improve patient, family, and provider satisfaction and lower Kaiser Permanente’s total cost of care for this patient segment.

  Keywords: Primary Health Care, Elderly Patients, Integrated Practice Unit, Interdisciplinary Care; Health Care and Treatment; Health Industry; United States; Colorado;

  Citation:

  Kaplan, Robert S., and Mahek A. Shah. "Kaiser Permanente Colorado: Primary Care Plus." Harvard Business School Case 118-053, May 2018.  View Details

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• Article | JAMA, the Journal of the American Medical Association

  Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

  Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman

  The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with billing and insurance activities at a large academic health care center that had a certified EHR system. The center enjoyed economies of scale by concentrating its bill paying functions within a single, dedicated unit. The study found that costs for processing a single bill ranged from $20 for a primary care visit, about 20% of revenues, up to $215 for an inpatient surgical procedure. The high costs were not caused by wasteful, inefficient processes, duplicate or redundant tasks, or the inappropriate use of high-wage personnel to perform low-skilled tasks. Rather, they were driven by the heterogeneous payment requirements across the multiple payers and health plans contracting with the academic health center.

  Keywords: Health Care and Treatment; Cost Management; Insurance; Problems and Challenges;

  Citation:

  Tseng, Phillip, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah, and Kevin A. Schulman. "Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System." JAMA, the Journal of the American Medical Association 319, no. 7 (February 20, 2018): 691–697.  View Details

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• Case | HBS Case Collection | January 2018

  Partners In Health: Costing Primary Care in Haiti

  Robert S. Kaplan and Mahek A. Shah

  Partners in Health, a global NGO focused on delivering health care to residents of rural underserved communities, conducts a project on the cost of primary care at five sites in the Central Highlands of Haiti. It devises a simple approach for tracking the resources used by patients being treated for diverse medical conditions, as an input to a time-driven activity-based costing model. The results show considerable cost diversity across the five sites, but organizational leaders differ on the interpretation and action implications of the findings.

  Keywords: Global health; public health; Health Care and Treatment; Activity Based Costing and Management; Cost Accounting; Rural Scope; Health Industry; Haiti;

  Citation:

  Kaplan, Robert S., and Mahek A. Shah. "Partners In Health: Costing Primary Care in Haiti." Harvard Business School Case 118-051, January 2018.  View Details

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