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Publications

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    • All HBS Web  (341)
      • Faculty Publications  (65)

      Healthcare Costs Remove Healthcare Costs →

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      • 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

      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; Pharmaceutical 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.
      • 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).
      • 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).
      • 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.
      • Article

      Time-Driven Activity-Based Costing in Breast Cancer Care Delivery

      By: Navraj S. Nagra, Elena Tsangaris, Jessica Means, Michael J. Hassett, Laura S. Dominici, Jennifer R. Bellon, Justin Broyles, Robert S. Kaplan, Thomas W. Feeley and Andrea L. Pusic
      We used time-driven activity-based costing (TDABC) to calculate the complete cost of breast cancer care—initial treatment planning, chemotherapy, radiation therapy, surgical resection and reconstruction, and ancillary services (psychosocial oncology, physical therapy....  View Details
      Keywords: Healthcare; Time-Driven Activity-Based Costing; Health Care and Treatment; Cost
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      Nagra, Navraj S., Elena Tsangaris, Jessica Means, Michael J. Hassett, Laura S. Dominici, Jennifer R. Bellon, Justin Broyles, Robert S. Kaplan, Thomas W. Feeley, and Andrea L. Pusic. "Time-Driven Activity-Based Costing in Breast Cancer Care Delivery." Annals of Surgical Oncology 29, no. 1 (January 2022): 510–521.
      • May 2021
      • Article

      Value-Based Healthcare in Urology: A Collaborative Review

      By: Chanan Reitblat, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh and Boris Gershman
      Context:
      In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and...  View Details
      Keywords: Value-based Healthcare; Integrated Practice Units; Outcome Measurement; Time-Driven Activity-Based Costing; Health Care and Treatment; Value; Cost Management; Strategy; Outcome or Result; Measurement and Metrics
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      Reitblat, Chanan, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh, and Boris Gershman. "Value-Based Healthcare in Urology: A Collaborative Review." European Urology 79, no. 5 (May 2021): 571–585.
      • 2021
      • Working Paper

      Diagnosing Quality: Learning, Amenities, and the Demand for Health Care

      By: Achyuta Adhvaryu, Emilio Gutierrez, Anant Nyshadham and Jorge Tamayo
      We study the role of amenities in increasing demand for underutilized healthcare services. We evaluate the offer of a high-amenity diagnostic consultation for cataracts with a randomized price and find that a lower price for the high-amenity consultation increases...  View Details
      Keywords: Health Care Demand; Amenities; Health Care Quality; Cataracts; Surgery; Health Care and Treatment; Demand and Consumers; Quality; Learning; Mexico
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      Adhvaryu, Achyuta, Emilio Gutierrez, Anant Nyshadham, and Jorge Tamayo. "Diagnosing Quality: Learning, Amenities, and the Demand for Health Care." Harvard Business School Working Paper, No. 21-110, March 2021.
      • 2021
      • Government Testimony

      How Health Care Consolidation Is Contributing to Higher Prices and Spending, and Reforms That Could Bolster Antitrust Enforcement and Preserve and Promote Competition in Health Care Markets

      By: Leemore S. Dafny
      Reforms to antitrust law and enforcement can help to address rising healthcare prices and spending.  View Details
      Keywords: Antitrust Law; Health Care and Treatment; Consolidation; Price; Spending; Cost Management; Governing Rules, Regulations, and Reforms; Competition; United States
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      Dafny, Leemore S. "How Health Care Consolidation Is Contributing to Higher Prices and Spending, and Reforms That Could Bolster Antitrust Enforcement and Preserve and Promote Competition in Health Care Markets." Government Testimony, Washington, DC, United States, April 2021.
      • Article

      Ten Year Sunset Rule for Healthcare Regulation Is a Nonstarter and Discouragement to Post-COVID-19 Investment

      By: Regina E. Herzlinger and Eugene Schneller
      U.S. healthcare delivery has not benefitted from the same productivity growth as many other service industries, such as bricks and mortar retailing, a loss that has gravely diminished cost control and access. Regulatory capture, which creates barriers to venture...  View Details
      Keywords: Health Care; COVID-19; Regulation; Health Care and Treatment; Health Pandemics; Governing Rules, Regulations, and Reforms; Investment
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      Herzlinger, Regina E., and Eugene Schneller. "Ten Year Sunset Rule for Healthcare Regulation Is a Nonstarter and Discouragement to Post-COVID-19 Investment." Journal of Health Care Finance 47, no. 4 (Spring 2021). (Special Commentary.)
      • March 2021 (Revised January 2022)
      • Case

      Philips: Redefining Telehealth

      By: Regina E. Herzlinger, Alec Petersen, Natalie Kindred and Sara M. McKinley
      As one of the world’s largest healthcare companies, Philips sought to reach beyond the walls of the hospital and expand its hospital-to-home program to gain future competitive advantage through technology solutions combining predictive analytics with care delivery. By...  View Details
      Keywords: Health Care; Philips; Visicu; Telemedicine; eICU; Accountable Care Organization; ACO; Bundled Payment; Hospital To Home; Patient Monitoring Devices; Home Health Care; Health Care and Treatment; Communication Technology; Quality; Safety; Performance Productivity; Performance Capacity; Performance Efficiency; Consumer Behavior; Emerging Markets; Health Industry; Telecommunications Industry; Netherlands
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      Herzlinger, Regina E., Alec Petersen, Natalie Kindred, and Sara M. McKinley. "Philips: Redefining Telehealth." Harvard Business School Case 321-135, March 2021. (Revised January 2022.) (As companion reading for this case, see: Regina E. Herzlinger and Charles Huang. "Note on Bundled Payment in Health Care," HBS Background Note 312-032.)
      • 2021
      • Other Unpublished Work

      As Healthcare Costs Escalate, A New George and Regi Herzlinger Industry Award Shines a Spotlight on Innovation Education

      By: Regina E. Herzlinger
      The winners of the first ever CAHME/George and Regi Herzlinger Innovation Education Award have just been announced. Regi Herzlinger explains why rewarding, supporting, and encouraging innovation education is so critical to solving the challenges of our industry.  View Details
      Keywords: Health Care and Treatment; Management; Innovation and Invention; Education
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      "As Healthcare Costs Escalate, A New George and Regi Herzlinger Industry Award Shines a Spotlight on Innovation Education." Commission on Accreditation of Healthcare Management Education (CAHME), March 2021.
      • January 2021
      • Case

      Value-Based Insurance Design at Onex

      By: Joshua Schwartzstein, Amitabh Chandra and Amram Migdal
      The operating executives of Health and Benefits for Onex Partners, Megan Jackson Frye and Sam Camens, faced a challenge: Healthcare costs for employees of Onex’s portfolio companies were continuing to rise above the consumer price index, reflecting broader trends...  View Details
      Keywords: Decision Making; Cost vs Benefits; Decision Choices and Conditions; Decisions; Finance; Behavioral Finance; Insurance; Health; Health Care and Treatment; Human Resources; Compensation and Benefits; Markets; Demand and Consumers; Consumer Behavior; Social Psychology; Behavior; Interests; Motivation and Incentives; Perception; Health Industry; Insurance Industry; North America; United States
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      Schwartzstein, Joshua, Amitabh Chandra, and Amram Migdal. "Value-Based Insurance Design at Onex." Harvard Business School Case 921-023, January 2021.
      • November 2020 (Revised April 2021)
      • Case

      Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care

      By: Trevor Fetter and Kira Seiger
      This case describes the increasing investment by private equity (PE) firms in patient care and other healthcare services. The case focuses on investments in physician staffing firms and roll-up strategy investments in physician practice management (PPM). Included in...  View Details
      Keywords: Business Ventures; Acquisition; Mergers and Acquisitions; Business Model; Change; Disruption; Fluctuation; Trends; Customers; Customer Value and Value Chain; Ethics; Fairness; Finance; Equity; Insurance; Private Equity; Geography; Geographic Scope; Health; Health Care and Treatment; Markets; Demand and Consumers; Supply and Industry; Industry Structures; Ownership; Ownership Type; Private Ownership; Relationships; Agency Theory; Business and Community Relations; Business and Shareholder Relations; Business and Stakeholder Relations; Networks; Strategy; Competition; Consolidation; Expansion; Integration; Horizontal Integration; Vertical Integration; Value; Value Creation; Health Industry; Insurance Industry; United States
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      Fetter, Trevor, and Kira Seiger. "Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care." Harvard Business School Case 321-049, November 2020. (Revised April 2021.)
      • Article

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

      By: 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...  View Details
      Keywords: Family-centered Care; Value-based Healthcare; Time-Driven Activity-Based Costing; Health Care and Treatment; Value; Activity Based Costing and Management
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      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).
      • January 2, 2020
      • Article

      Medicare for All or Public Option: Can Either Heal Health Care?

      By: Regina E. Herzlinger and James Wallace
      The United States has serious health care problems: More than 27 million uninsured people, costs that are growing faster than income, and a staggering $37 trillion of unfunded liabilities in the Medicare program. Perhaps most alarming: The US ranks lowest among...  View Details
      Keywords: Healthcare; Public Option; Medicare; Health Care and Treatment; Insurance; Cost Management; Problems and Challenges; United States
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      Herzlinger, Regina E., and James Wallace. "Medicare for All or Public Option: Can Either Heal Health Care?" Harvard Business School Working Knowledge (January 2, 2020).
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