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- July 2021
- Article
Medical Debt in the U.S., 2009–2020
By: Raymond 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
Kluender, Raymond, Neale Mahoney, Francis Wong, and Wesley Yin. "Medical Debt in the U.S., 2009–2020." JAMA, the Journal of the American Medical Association 326, no. 3 (July 2021): 250–256.
- 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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Keywords:
Ambulatory Care;
Payment Policy;
Health Care and Treatment;
Governing Rules, Regulations, and Reforms
Nabi, Junaid, and Robert S. Kaplan. "The CMS New Rule on Ambulatory Surgical Centers Earns Only Partial Credit." Health Affairs Blog (June 2, 2021).
- Article
Mandate Outcomes Reporting
By: Robert S. Kaplan and Michael E. Porter
Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to...
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Keywords:
Outcomes Reporting;
Outcomes Measurement;
Medicare;
Medicaid;
Health Care and Treatment;
Outcome or Result;
Measurement and Metrics
Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
- July 2019
- Article
Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements
By: Derek A. Haas, Xiaoran Zhang, Robert S. Kaplan and Zirui Song
In 2016, the Centers for Medicare & Medicaid Services (CMS) launched its first mandatory bundled payment program, the Comprehensive Care for Joint Replacement (CJR) model, by randomizing metropolitan statistical areas (MSAs) into the payment model. The paper analyzed...
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Keywords:
Medicare;
Medicaid;
Bundled Payments;
Health Care and Treatment;
Cost Management;
Performance Evaluation;
Outcome or Result
Haas, Derek A., Xiaoran Zhang, Robert S. Kaplan, and Zirui Song. "Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements." JAMA Internal Medicine 179, no. 7 (July 2019): 924–931.
- February 2019
- Article
Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending
By: Leemore S. Dafny
There is limited empirical evidence about the impact of for-profit health insurers on various outcomes. I study the effects of conversions to for-profit status by Blue Cross Blue Shield (BCBS) affiliates in 11 states, spanning 28 geographic markets. I find both the...
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Keywords:
Health Insurance;
Medical Loss Ratio;
Blue Cross;
Corporate Governance;
Health;
Insurance;
For-Profit Firms;
Insurance Industry;
United States
Dafny, Leemore S. "Does It Matter If Your Health Insurer Is For Profit? Effects of Ownership on Premiums, Insurance Coverage, and Medical Spending." American Economic Journal: Economic Policy 11, no. 1 (February 2019): 222–265.
- August 2017
- Case
CareMore Health System
By: Robert S. Huckman and Brian W. Powers
CareMore Health System—a physician-founded care delivery system and health plan—had developed and refined an innovative care model for at-risk seniors enrolled in Medicare managed care (i.e., Medicare Advantage) plans. CareMore's President, Sachin Jain, and his...
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Keywords:
Health Care Delivery;
Health Insurance;
Medicare;
Medicaid;
Managed Care;
Extensivist;
Social Determinants Of Health;
Health Care and Treatment;
Insurance;
Business Model;
Growth and Development Strategy;
Decision Choices and Conditions;
Health Industry;
United States
Huckman, Robert S., and Brian W. Powers. "CareMore Health System." Harvard Business School Case 618-008, August 2017.
- August 2017
- Supplement
CareMore Health System (B)
By: Robert S. Huckman and Brian W. Powers
This supplement to “CareMore Health System (A)” discusses the company's early experience introducing its managed Medicaid model in the Des Moines, Iowa, market. It also provides an update on the Memphis program discussed in the (A) case.
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Keywords:
Health Care Delivery;
Health Insurance;
Medicare;
Medicaid;
Managed Care;
Extensivist;
Social Determinants Of Health;
Health Care and Treatment;
Insurance;
Business Model;
Growth and Development Strategy;
Health Industry;
United States
Huckman, Robert S., and Brian W. Powers. "CareMore Health System (B)." Harvard Business School Supplement 618-009, August 2017.
- February 2012 (Revised June 2013)
- Case
Moving to Universal Coverage: Health Care Reform in Massachusetts
By: Michael E. Porter and Jennifer F Baron
State health care reform in Massachusetts has involved a phased process, focusing first on coverage expansion and then turning to delivery system innovation and cost containment. In 2006, the state adopted an individual mandate to obtain health care coverage which,...
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Porter, Michael E., and Jennifer F Baron. "Moving to Universal Coverage: Health Care Reform in Massachusetts." Harvard Business School Case 712-466, February 2012. (Revised June 2013.)
- April 2008 (Revised May 2008)
- Case
Commonwealth Care Alliance: Elderly and Disabled Care
By: Michael E. Porter and Jennifer F Baron
Individuals enrolled in both Medicare and Medicaid, known as dual eligibles, are among the highest-cost beneficiaries in the US. Commonwealth Care Alliance, a small nonprofit insurer and care delivery system in Massachusetts, operated under a public demonstration...
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Keywords:
Programs;
Public Sector;
Alliances;
Policy;
Age;
Service Delivery;
Value;
Health Care and Treatment;
Welfare;
Insurance Industry;
Health Industry;
Massachusetts
Porter, Michael E., and Jennifer F Baron. "Commonwealth Care Alliance: Elderly and Disabled Care." Harvard Business School Case 708-502, April 2008. (Revised May 2008.)
- Article
Cross Country: They'd Sooner Fix Medicaid
By: Tom Coburn and Regina Herzlinger
Coburn, Tom, and Regina Herzlinger. "Cross Country: They'd Sooner Fix Medicaid." Wall Street Journal (May 18, 2006).
- August 2, 2005
- Article
Medicine for Medicaid
By: R. E. Herzlinger
Herzlinger, R. E. "Medicine for Medicaid." Wall Street Journal (August 2, 2005), A10.