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- 2021
- Working Paper
The Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes
By: Arlen Guarin, Christian Posso, Estefania Saravia and Jorge Tamayo
We estimate the effect of physicians on health outcomes by exploiting a Colombian government program that randomly assigns newly graduated physicians to hospitals across the country. Using administrative data from the program, vital statistics records, and individual...
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- Article
A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal
By: Jiayin Xue, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg and Kevin Schulman
U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital...
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- Article
Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected
By: Maximilian J. Pany, Michael E. Chernew and Leemore S. Dafny
Concern about high hospital prices for commercially insured patients has motivated several proposals to regulate these prices. Such proposals often limit regulations to highly concentrated hospital markets. Using a large sample of 2017 US commercial insurance claims,...
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- Article
The Economic Consequences of Bankruptcy Reform
By: Tal Gross, Ray Kluender, Feng Liu, Matthew J. Notowidigdo and Jialan Wang
A more generous consumer bankruptcy system provides greater insurance against financial risks but may also raise the cost of credit. We study this trade-off using the 2005 Bankruptcy Abuse Prevention and Consumer Protection Act (BAPCPA), which increased the costs of...
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- June 2021
- Teaching Plan
Karin Vinik at South Lake Hospital
Teaching Plan for HBS Case Nos. 320-071, 320-072, 320-073, and 320-074.
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- June 10, 2021
- Article
Preparing Hospitals for the Next Pandemic
By: Regina E. Herzlinger and Barak D. Richman
The COVID-19 epidemic response has shown that the U.S. is blessed with heroic physicians and other health care providers, researchers, and facilities. But it has also revealed a health care system that was woefully unprepared for the surge of pandemic patients. In the...
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- Article
The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit
By: Junaid Nabi and Robert S. Kaplan
The Centers of Medicare and Medicaid Services (CMS) recently announced that it will be removing more...
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- June 2021
- Article
Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative
By: Casey J. Allen, Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala and Matthew H.G. Katz
We used national administrative data to assess multiple domains of value associated with enhanced recovery pathways for patients undergoing pancreatic surgery. Value metrics included in-hospital mortality, complication rates, length of stay (LOS), 30-day readmission...
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- 2021
- Working Paper
The Great Unequalizer: Initial Health Effects of COVID-19 in the United States
By: Marcella Alsan, Amitabh Chandra and Kosali I. Simon
We measure inequities from the COVID-19 pandemic on mortality and hospitalizations in the United States during the early months of the outbreak. We discuss challenges in measuring health outcomes and health inequality, some of which are specific to COVID-19 and others...
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- May 26, 2021
- Article
The Challenge of Rebuilding U.S. Domestic Supply Chains
By: Willy C. Shih, Robert S. Huckman and James Wyner
Massachusetts-based Shawmut scrambled to expand production to meet the soaring demand for N95 masks and hospital gowns during the pandemic. Its experience illustrates a crucial point that policymakers should take to heart: Once a country loses its industrial commons...
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- May 2021
- Supplement
Paul Levy: Confronting a 'Corporate Campaign' (B)
By: James K. Sebenius and Isaac Silberberg
Paul Levy, CEO of the Beth Israel Deaconess Medical Center hospital is faced with a formidable negotiation campaign to unionize staff at BIDMC. Armed only with his personal blog, does Paul stand a chance against the union's multi-million dollar organizing budget?
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- April 2021
- Article
Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models
By: Susanna Gallani, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar and Frank Opelka
Modern medicine is undergoing a transformation that involves innovative surgical approaches, increased medical treatment options, clinical care pathways that require collaboration beyond hospital walls, and health data captured by electronic health records and other...
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- March 2021
- Case
Philips: Redefining Telehealth
By: Regina E. Herzlinger, Natalie Kindred, Sara M. McKinley and Alec Petersen
Would the advent of global payment models and ACOs create sufficient demand for a telemedicine offering covering the care continuum, from hospitals to the home? This was the decision facing Royal Philips Electronics (Philips), the Netherlands-based producer of...
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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
- Article
A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018
By: J. Chirenda, B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison and R. S. Kaplan
Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and...
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- February 2021
- Case
New England Baptist Hospital: Getting Paid for Value
By: Robert S. Kaplan, Mary Witkowski, Toby E. Emanuel and Syed S. Shehab
New England Baptist Hospital (NEBH), a national leader in adult orthopedic care, has the lowest rate of complications and 30-day readmissions in New England, but gets paid 30% less for its surgeries than nearby institutions. NEBH introduces, with several large...
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- January 2021
- Supplement
Karin Vinik at South Lake Hospital (B)-(D)
By: Joseph L. Badaracco and Kim B. Clark
- Article
Resilience vs. Vulnerability: Psychological Safety and Reporting of Near Misses with Varying Proximity to Harm in Radiation Oncology
By: Palak Kundu, Olivia Jung, Amy C. Edmondson, Nzhde Agazaryan, John Hegde, Michael Steinberg and Ann Raldow
Background
Psychological safety, a shared belief that interpersonal risk taking is safe, is an important determinant of incident reporting. However, how psychological safety affects near-miss reporting is unclear, as near misses contain contrasting cues that... View Details
Psychological safety, a shared belief that interpersonal risk taking is safe, is an important determinant of incident reporting. However, how psychological safety affects near-miss reporting is unclear, as near misses contain contrasting cues that... View Details
- Article
Value of New Performance Information in Healthcare: Evidence from Japan
By: Susanna Gallani, Takehisa Kajiwara and Ranjani Krishnan
Mandatory measurement and disclosure of outcome measures are commonly used policy tools in
healthcare. The effectiveness of such disclosures relies on the extent to which the new information produced by the mandatory system is internalized by the healthcare...
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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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- November 2020 (Revised February 2021)
- Case
CommonSpirit Health: Integrating a Merger of Equals
By: Robert S. Huckman, Hise Gibson and Nicole Gilmore
Soon after closing the 2019 merger of Catholic Health Initiatives (CHI) and Dignity Health to create CommonSpirit Health, Lloyd Dean and Kevin Lofton--jointly appointed to the role of CEO--must make several operational and strategic decisions related to the integration...
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