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- November 2021
- Case
Hitting Home: Amazon and Mary's Place
By: Paul M. Healy, Debora L. Spar and Amy Klopfenstein
In 2020, Amazon, the $386 billion online retail behemoth, built an eight-story shelter for women and families experiencing homelessness on its expanding headquarters in Seattle, Washington. The shelter, operated in partnership with a non-profit organization known as...
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- July 2021
- Article
Medical Debt in the U.S., 2009–2020
By: Ray Kluender, Neale Mahoney, Francis Wong and Wesley Yin
Importance: Medical debt is an increasing concern in the US, yet there is limited understanding of the amount and distribution of medical debt, and its association with health care policies.
Objective: To measure the amount of medical debt nationally and by... View Details
Objective: To measure the amount of medical debt nationally and by... View Details
- June 15, 2021
- Article
Cutting the Gordian Knot of Employee Health Care Benefits and Costs: A Corporate Model Built on Employee Choice
By: Regina E. Herzlinger and Barak D. Richman
President Joe Biden’s promise to give every American access to affordable health insurance is well-intentioned, but his plan’s policy elements—a public option, a permanent expanded tax credit—require congressional approval and would expend significant political and...
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- March 2021 (Revised July 2021)
- Case
Aledade
By: Regina E. Herzlinger, Samyukta Mullangi and Nicholas Samonas
To truly supercharge growth, should Aledade take a step back and focus on product development?
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- 2020
- Working Paper
Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities
By: David Cutler, Leemore S. Dafny, David Grabowski, Steven S. Lee and Christopher Ody
The landscape of the U.S. healthcare industry is changing dramatically as healthcare providers expand both within and across markets. While federal antitrust agencies have mounted several challenges to same-market combinations, they have not challenged any...
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- 2020
- Working Paper
Bankruptcy and the COVID-19 Crisis
By: Jialan Wang, Jeyul Yang, Benjamin Iverson and Ray Kluender
We examine the impact of the COVID-19 economic crisis on business and consumer bankruptcies in the United States using real-time data on the universe of filings. Historically, bankruptcies have closely tracked the business cycle and contemporaneous unemployment rates....
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- Article
The Impact of COVID-19 on Small Business Outcomes and Expectations
By: Alexander Bartik, Marianne Bertrand, Zoë B. Cullen, Edward L. Glaeser, Michael Luca and Christopher Stanton
To explore the impact of COVID on small businesses, we conducted a survey of more than 5,800 small businesses between March 28 and April 4, 2020. Several themes emerged. First, mass layoffs and closures had already occurred—just a few weeks into the crisis. Second, the...
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- Article
Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries
By: Sara Gerke, Ariel D. Stern and Timo Minssen
Reimbursement is a key challenge for many new digital health solutions, whose importance and value have been highlighted and expanded by the current COVID-19 pandemic. Germany’s new Digital Healthcare Act (Digitale–Versorgung–Gesetz or DVG) entitles all individuals...
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- July–September 2020
- Article
Innovation Contest: Effect of Perceived Support for Learning on Participation
By: Olivia Jung, Andrea Blasco and Karim R. Lakhani
Background: Frontline staff are well positioned to conceive improvement opportunities based on first-hand knowledge of what works and does not work. The innovation contest may be a relevant and useful vehicle to elicit staff ideas. However, the success of the...
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- July 2020
- Article
Lessons from the Impact of Price Regulation on the Pricing of Anticancer Drugs in Germany
By: Victoria D. Lauenroth, Aaron S. Kesselheim, Ameet Sarpatwari and Ariel Dora Stern
Worldwide spending on prescription drugs has increased dramatically in recent years. Although this increase has been particularly pronounced in the U.S., it remains largely unaddressed there. In Europe, however, different approaches to regulating drug prices have been...
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- Article
Sustainability, Business, and Health
By: George Serafeim, Amanda M. Rischbieth and Howard K. Koh
The coronavirus disease 2019 (COVID-19) pandemic has demonstrated that response demands involvement from every sector of society. As a major example, some businesses have stepped up in ways previously unimaginable. Garment companies have repurposed production to face...
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- 2020
- Working Paper
Spreading the Health: Americans' Estimated and Ideal Distributions of Death and Health(care)
By: Sorapop Kiatpongsan and Michael I. Norton
The 2010 Patient Protection and Affordable Care Act intensified debates over the role of government in the distribution of healthcare. A nationally-representative sample of Americans reported their estimated and ideal distributions of healthcare (unmet need for...
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- Article
Association of the Meaningful Use Electronic Health Record Incentive Program with Health Information Technology Venture Capital Funding
By: Samuel Lite, William J. Gordon and Ariel Dora Stern
IMPORTANCE
Although the Health Information Technology for Economic and Clinical Health (HITECH) Act has accelerated electronic health record (EHR) adoption since its passage, clinician satisfaction with EHRs remains low, and the association of HITECH with... View Details
Although the Health Information Technology for Economic and Clinical Health (HITECH) Act has accelerated electronic health record (EHR) adoption since its passage, clinician satisfaction with EHRs remains low, and the association of HITECH with... View Details
- 2020
- Chapter
Health Care Markets a Decade After the ACA: Bigger, but Probably Not Better
By: Leemore S. Dafny
Love it or hate it, the Affordable Care Act (ACA) embraced and extended the role of private markets in financing and delivering health care in the United States. Ten years after the ACA’s passage, it is unclear whether health care markets are better (along a range of...
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- 2020
- Working Paper
Cutting the Gordian Knot of Employee Health Care Benefits and Costs: A Corporate Model Built on Employee Choice
By: Regina E. Herzlinger and Barak D. Richman
The U.S. employer-based health insurance tax exclusion created a system of employer-sponsored insurance (ESI) with limited insurance choices and transparency that may lock employed households into health plans that are costlier or different from those they prefer to...
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- November 19, 2019
- Article
The Unexpected Benefits of Pursuing a Passion Outside of Work
By: Jon M. Jachimowicz, Joyce He and Julian Arango
We are often told to pursue work we’re passionate about. But, for many people, this simply isn’t feasible. Not every job affords the possibility of doing what you love. And people care deeply about many different things—not all of which will be how they want to earn a...
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- July 2019
- Article
The Impact of Price Regulation on the Availability of New Drugs in Germany
By: Ariel Dora Stern, Felicitas Pietrulla, Annika Herr, Aaron S. Kesselheim and Ameet Sarpatwari
The 2011 German Pharmaceutical Market Restructuring Act (“AMNOG”) subjected branded, non-rare disease drugs to price regulation based on an assessment of their clinical benefit. Assessment outcomes range from “major added benefit” to “less benefit than the appropriate...
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- March 2019
- Article
A Time-Driven Activity-Based Costing Analysis of Emergency Department Scribes
By: Robert S. Kaplan, Heather A. Heaton, David M. Nestler, William J. Barry, Richard A. Helmers, Mustafa Y. Sir, Deepi G. Goyal, Derek A. Haas and Annie T. Sadosty
Objectives: To apply time-driven activity-based costing (TDABC) methodology to determine emergency medicine physician documentation costs with and without scribes.
Methods: Two research assistants shadowed attending physicians for a total of 64 hours in the... View Details
Methods: Two research assistants shadowed attending physicians for a total of 64 hours in the... View Details
- January 2019 (Revised June 2019)
- Technical Note
U.S. Commercial Health Insurance Industry
By: Susanna Gallani, Mary Witkowski and Harry B. Wolberg
This note describes the role of commercial payers in the U.S. healthcare industry. We begin with a review of the historical evolution of commercial payers and their role in the market, from the beginning to the Affordable Care Act and beyond. Every wave of reforms in...
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- 2018
- Chapter
The Orphan Drug Act at 35: Observations and an Outlook for the Twenty-First Century
By: Nicholas Bagley, Benjamin Berger, Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern
On the 35th anniversary of the adoption of the Orphan Drug Act (ODA), we describe the enormous changes in the markets for therapies for rare diseases that have emerged over recent decades. The most prominent example is the fact that the profit-maximizing price of new...
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