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Publications

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    • All HBS Web  (1,453)
      • Faculty Publications  (262)

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      • 2023
      • Article

      Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital

      By: Ricardo Bertoglio Cardoso, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges and Carisi Anne Polanczyk
      The COVID-19 pandemic raised awareness of the need to better understand where and how patient-level costs are incurred in health care organizations. This study used time-driven activity-based costing to estimate COVID-19 patient-level hospital costs in a Brazilian...  View Details
      Keywords: Health Care and Treatment; Cost; Health Industry; Brazil
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      Cardoso, Ricardo Bertoglio, Miriam Allein Zago Marcolino, Milena Soriano Marcolino, Camila Felix Fortis, Leila Beltrami Moreira, Ana Paula Coutinho, Nadine Oliveira Clausell, Junaid Nabi, Robert S. Kaplan, Ana Paula Beck da Silva Etges, and Carisi Anne Polanczyk. "Comparison of COVID-19 Hospitalization Costs across Care Pathways: A Patient-level Time-driven Activity-based Costing Analysis in a Brazilian Hospital." BMC Health Services Research 23, no. 198 (2023).
      • January 23, 2023
      • Article

      Digital Public Health Interventions at Scale: The Impact of Social Media Advertising on Beliefs and Outcomes Related to COVID Vaccines

      By: Susan Athey, Kristen Grabarz, Michael Luca and Nils Wernerfelt
      Public health organizations increasingly use social media advertising campaigns in pursuit of public health goals. In this paper, we evaluate the impact of about $40 million of social media advertisements that were run and experimentally tested on Facebook and...  View Details
      Keywords: COVID-19 Pandemic; Public Health; Vaccines; Social Media; Advertising; Power and Influence; Health Care and Treatment
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      Athey, Susan, Kristen Grabarz, Michael Luca, and Nils Wernerfelt. "Digital Public Health Interventions at Scale: The Impact of Social Media Advertising on Beliefs and Outcomes Related to COVID Vaccines." e2208110120. Proceedings of the National Academy of Sciences 120, no. 5 (January 23, 2023).
      • December 2022
      • Article

      Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition

      By: Anna Paula Beck da Silva Etges, Richard D. Urman, Anne Geubelle, Robert Kaplan and Carisi Anne Polanczyk
      This communication announces the International Cost Standard Set Program. Its goal is to establish global standardized frameworks for measuring the costs of treating specific clinical conditions. A scientific committee, including 16 international healthcare cost...  View Details
      Keywords: Time-Driven Activity-Based Costing; Value-based Health Care; Cost; Health Care and Treatment; Activity Based Costing and Management; Health Industry
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      da Silva Etges, Anna Paula Beck, Richard D. Urman, Anne Geubelle, Robert Kaplan, and Carisi Anne Polanczyk. "Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition." Journal of Comparative Effectiveness Research 11, no. 17 (December 2022): 1219–1223.
      • October 2022
      • Case

      Cost Plus Drugs

      By: Alexander MacKay and James Barnett
      In September 2022, Mark Cuban Cost Plus Drugs Company CEO Alex Oshmyansky considered the future of the company. Cost Plus Drugs was a retailer for more than 340 generic oral medications, selling their drugs at significantly lower prices than typical pharmacies....  View Details
      Keywords: Business Ventures; Decision Making; Entrepreneurship; Ethics; Health; Markets; Social Enterprise; Society; Strategy; Health Care and Treatment; Business Divisions; Factories, Labs, and Plants; Health Industry; Health Industry; United States; Texas
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      MacKay, Alexander, and James Barnett. "Cost Plus Drugs." Harvard Business School Case 723-362, October 2022.
      • October 2022
      • Case

      mPharma: Scaling Access to Affordable Primary Care in Africa

      By: Regina E. Herzlinger and Ben Creo
      mPharma CEO Greg Rockson is attempting to create the largest pan-African primary healthcare company. He must evaluate a three-year strategy potentially involving three key components: a rapid and extensive expansion of the company's network of 600 retail pharmacies in...  View Details
      Keywords: Africa; Pharmaceutical Companies; Pharmacy Benefit Manager; Health Care; Health Care And Treatment; Health Care Costs; Health Care Delivery; Health Care Entrepreneurship; Telehealth; Health Equity; Corporate Strategy; Social Entrepreneurship; Equity; Growth and Development Strategy; Expansion; Product Launch; Customer Value and Value Chain; Social Enterprise; Multinational Firms and Management; Health Industry; Health Industry; Africa
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      Herzlinger, Regina E., and Ben Creo. "mPharma: Scaling Access to Affordable Primary Care in Africa." Harvard Business School Case 323-033, October 2022.
      • June 2022
      • Article

      A New Initiative to Track HIV Resource Allocation and Costs

      By: Ryan McBain, AK Nandakumar, Michael Ruffner, Carlyn Mann, Mai Hijazi, Susanna Baker, Linden Morrison, Kalipso Chalkidou, Shufang Zhang, Iris Semini, Fern Terris-Prestholt, Steven Forsythe, Sarah Byakika, Joshua Musinguzi and Robert S. Kaplan
      In early 2020, several global health institutions – including the Global Fund to Fight AIDS, Tuberculosis and Malaria; Joint United Nations Program on HIV/AIDS (UNAIDS); United States Agency for International Development; and Office of the Global AIDS Coordinator at...  View Details
      Keywords: Activity Based Costing; HIV; Cost; Health Care; Healthcare; Health Care and Treatment; Activity Based Costing and Management; Resource Allocation; Health Industry; Africa
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      McBain, Ryan, AK Nandakumar, Michael Ruffner, Carlyn Mann, Mai Hijazi, Susanna Baker, Linden Morrison, Kalipso Chalkidou, Shufang Zhang, Iris Semini, Fern Terris-Prestholt, Steven Forsythe, Sarah Byakika, Joshua Musinguzi, and Robert S. Kaplan. "A New Initiative to Track HIV Resource Allocation and Costs." Bulletin of the World Health Organization 100, no. 6 (June 2022): 358–358A.
      • October 2022
      • Article

      It’s Not Just the Prices: Time-Driven Activity-Based Costing for Initiation of Veno-Venous Extracorporeal Membrane Oxygenation at Three International Sites—A Case Review

      By: Michael Nurok, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes and Robert S. Kaplan
      The United States spends more for intensive care units (ICUs) than do other high-income countries. We used time-driven activity-based costing (TDABC) to analyze ICU costs for initiation of extracorporeal membrane oxygenation (ECMO) for respiratory failure to estimate...  View Details
      Keywords: Healthcare; Cost; Time-Driven ABC; Health Care and Treatment; Cost Management; Activity Based Costing and Management; Health Industry
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      Nurok, Michael, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes, and Robert S. Kaplan. "It’s Not Just the Prices: Time-Driven Activity-Based Costing for Initiation of Veno-Venous Extracorporeal Membrane Oxygenation at Three International Sites—A Case Review." Anesthesia & Analgesia 135, no. 4 (October 2022): 711–718.
      • September 2022
      • Article

      Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia

      By: Chen Wei, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak and Paul C. Zei
      Cardiac SBRT is a novel way of treating refractory ventricular tachycardia (VT) that may be less costly than catheter ablation, owing to its noninvasive, outpatient nature. We applied time-driven activity-based costing to both procedures. The direct and total...  View Details
      Keywords: Health Care and Treatment; Activity Based Costing and Management; Cost; Health Industry
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      Wei, Chen, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak, and Paul C. Zei. "Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia." Pacing and Clinical Electrophysiology 45, no. 9 (September 2022): 1005–1179.
      • September 2022
      • Article

      Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities

      By: Leemore Dafny, Christopher Ody and Teresa Rokos
      The federal Anti-Kickback Statute prohibits biopharmaceutical manufacturers from directly covering Medicare enrollees’ out-of-pocket spending for the drugs they manufacture, but manufacturers may donate to independent patient assistance charities and earmark donations...  View Details
      Keywords: Cost Sharing; Prescription Drugs; Drug Spending; Medicare; Dual Eligibility; Cost; Health Care and Treatment; Philanthropy and Charitable Giving; Pharmaceutical Industry
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      Dafny, Leemore, Christopher Ody, and Teresa Rokos. "Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities." Health Affairs 41, no. 9 (September 2022).
      • 2022
      • Article

      Rapid Growth of Remote Patient Monitoring Is Driven by a Small Number of Primary Care Providers

      By: Mitchell Tang, Ateev Mehrotra and Ariel Dora Stern
      Growing enthusiasm for remote patient monitoring has been motivated by the hope that it can improve care for patients with poorly controlled chronic illness. In a national commercially insured population in the U.S., we found that billing for remote patient monitoring...  View Details
      Keywords: Remote Monitoring; Medical Billing; Health Care Costs; Telehealth; Diabetes; Chronic Disease; Insurance Claims; Diseases; Primary Care Providers; COVID-19 Pandemic; Health Care and Treatment; Insurance; Cost; Health Industry; United States
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      Tang, Mitchell, Ateev Mehrotra, and Ariel Dora Stern. "Rapid Growth of Remote Patient Monitoring Is Driven by a Small Number of Primary Care Providers." Health Affairs 41, no. 9 (2022): 1248–1254.
      • August, 2022
      • Article

      Billing and Insurance-Related Administrative Costs: A Cross-National Analysis

      By: Barak D. Richman, Robert S. Kaplan, Japees Kohli, Dennis Purcell, Mahek Shah, Igna Bonfrer, Brian Golden, Rosemary Hannam, Will Mitchell, Daniel Cehic, Garry Crispin and Kevin A. Schulman
      Billing and insurance-related costs are a significant source of wasteful health care spending in Organization for Economic Cooperation and Development nations, but these administrative burdens vary across national systems. We executed a microlevel accounting of these...  View Details
      Keywords: Health Care Costs; Administrative Costs; Cost; Health Care and Treatment; Health Industry
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      Richman, Barak D., Robert S. Kaplan, Japees Kohli, Dennis Purcell, Mahek Shah, Igna Bonfrer, Brian Golden, Rosemary Hannam, Will Mitchell, Daniel Cehic, Garry Crispin, and Kevin A. Schulman. "Billing and Insurance-Related Administrative Costs: A Cross-National Analysis." Health Affairs 41, no. 8 (August, 2022): 1098–1106.
      • July 1, 2022
      • Editorial

      New Transparency Rule Helps Rein in Health Care Costs

      By: Regina E. Herzlinger and Cynthia A. Fisher
      Over the last year, consumer prices have grown 60% faster than wages. Employers can help their employees contend with this high inflation by addressing a long-running source: health care costs.  View Details
      Keywords: Healthcare Costs; Consumer Prices; Inflation and Deflation; Wages; Health Industry
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      Herzlinger, Regina E., and Cynthia A. Fisher. "New Transparency Rule Helps Rein in Health Care Costs." Boston Herald (July 1, 2022).
      • Winter 2022
      • Article

      Determinants of Small Business Reopening Decisions After COVID Restrictions Were Lifted

      By: Dylan Balla-Elliott, Zoë B. Cullen, Edward L. Glaeser, Michael Luca and Christopher Stanton
      The COVID-19 pandemic led to dramatic economic disruptions, including government-imposed restrictions that temporarily shuttered millions of American businesses. We use a nation-wide survey of thousands of small business owners to establish three main facts about...  View Details
      Keywords: COVID-19; Demand Forecasting; Reopening; Health Pandemics; Government Administration; Small Business
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      Balla-Elliott, Dylan, Zoë B. Cullen, Edward L. Glaeser, Michael Luca, and Christopher Stanton. "Determinants of Small Business Reopening Decisions After COVID Restrictions Were Lifted." Journal of Policy Analysis and Management 41, no. 1 (Winter 2022): 278–317.
      • July, 2022
      • Article

      Telehealth Visits After Shoulder Surgery: Higher Patient Satisfaction and Lower Costs

      By: Evan A. O'Donnell, Jillian E. Haberli, Andres Muniz Martinez, Daniel Yagoda, Robert S. Kaplan and Jon J.P. Warner
      Purpose and Methods: The study compared the cost of telemedicine visits with in-person clinic visits for routine follow-up after common shoulder surgeries. It also evaluated the safety and patient experience with telemedicine visits. Time-driven activity-based costing...  View Details
      Keywords: Telehealth; Patient Satisfaction; Health Care and Treatment; Communication Technology; Health Industry
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      O'Donnell, Evan A., Jillian E. Haberli, Andres Muniz Martinez, Daniel Yagoda, Robert S. Kaplan, and Jon J.P. Warner. "Telehealth Visits After Shoulder Surgery: Higher Patient Satisfaction and Lower Costs." Journal of the American Academy of Orthopedic Surgeons Global Research and Reviews 6, no. 7 (July, 2022).
      • May 2022
      • Article

      Variance Analysis: New Insights from Health Care Applications

      By: Robert S. Kaplan and Susanna Gallani
      We use a health care application to illustrate how variance analysis can be used to benchmark costs across similar service delivery sites. Variances for personnel costs, typically the largest cost component in service organizations, are calculated for price, quantity,...  View Details
      Keywords: Variance Analysis; Benchmarking; Time-Driven Activity-Based Costing; Health Care; Activity Based Costing and Management; Health Care and Treatment; Service Delivery; Service Industry
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      Kaplan, Robert S., and Susanna Gallani. "Variance Analysis: New Insights from Health Care Applications." Issues in Accounting Education 37, no. 2 (May 2022): 27–36.
      • February 8, 2022
      • Article

      Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions

      By: Alan Yang, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson and Robert S. Kaplan
      In 2017, patients made 145 million visits to emergency departments (EDs), generating $76.3 billion in charges. About a third of ED visits, however, were for conditions that were treatable in lower-resourced settings. We used time-driven activity-based costing (TDABC)...  View Details
      Keywords: Time-Driven ABC; Health Care Costs; Activity Based Costing and Management; Health Care and Treatment
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      Yang, Alan, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson, and Robert S. Kaplan. "Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions." NEJM Catalyst (February 8, 2022).
      • Article

      Costs Without Value When Treating Pediatric Behavioral Patients in the ED

      By: Marcella Jewell, Syed S. Shehab, Robert S. Kaplan, Jack Fanton and Joeli Hettler
      Pediatric Emergency Department (ED) visits have greatly increased in recent years. An academic pediatric ED that annually treats about 1,000 behavioral health patients conducted a study to assess the true cost of caring for nonacute behavioral health patients. It...  View Details
      Keywords: Costs; Value; Healthcare; Health Care and Treatment; Cost Management
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      Jewell, Marcella, Syed S. Shehab, Robert S. Kaplan, Jack Fanton, and Joeli Hettler. "Costs Without Value When Treating Pediatric Behavioral Patients in the ED." NEJM Catalyst Innovations in Care Delivery 3, no. 2 (February 2022).
      • 2022
      • Article

      Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing

      By: Nikhil G. Thaker, Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley and Steven J. Frank
      Integrated quality improvement (QI) and cost reduction strategies can help increase value in cancer care. We applied standard QI and TDABC methods to improve workflow efficiency and reduce costs for MRI-guided prostate brachytherapy. We constructed process maps,...  View Details
      Keywords: Brachytherapy; Quality Improvement; Prostate; Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Performance Efficiency; Health Industry
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      Thaker, Nikhil G., Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley, and Steven J. Frank. "Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing." Brachytherapy 21, no. 1 (2022): 49–54.
      • January–February 2022
      • Article

      Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board

      By: Robert S. Kaplan, Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman and Michael-Anne Browne
      The U.S. Military Health System spends about $50 billion annually through its TRICARE health plans to provide care to 9.6 million active duty service members, retirees, and their families. TRICARE, historically, has used the predominant U.S. fee-for-service payment...  View Details
      Keywords: Military Health System; Value-based Healthcare; Health Care and Treatment; United States
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      Kaplan, Robert S., Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman, and Michael-Anne Browne. "Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board." Military Medicine 187, nos. 1-2 (January–February 2022): 12–16.
      • January 2022
      • Article

      Rejections Make the Heart Grow Fonder: The Benefits of Articulating Risks When Declining Social Invitations

      By: Ashley Whillans, Anne Wilson and Tobias Schlager (Shared Authorship)
      Across six studies (N=3,591), we explore the interpersonal consequences of COVID-19 risk communication when rejecting social invitations. In Study 1, consumers underestimate the benefits and overestimate the social costs of explicitly rejecting social invitations for...  View Details
      Keywords: COVID; Social Invitations; Interpersonal Perception; Health Pandemics; Risk and Uncertainty; Interpersonal Communication
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      Whillans, Ashley, Anne Wilson, and Tobias Schlager (Shared Authorship). "Rejections Make the Heart Grow Fonder: The Benefits of Articulating Risks When Declining Social Invitations." Journal of the Association for Consumer Research 7, no. 1 (January 2022): 124–132.
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