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- March 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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- 2021
- Working Paper
The Health Costs of Cost-Sharing
By: Amitabh Chandra, Evan Flack and Ziad Obermeyer
We use the design of Medicare’s prescription drug benefit program to demonstrate three facts about the health consequences of cost-sharing. First, we show that an as-if-random increase of 33.6% in out-of-pocket price (11.0 percentage points (p.p.) change in...
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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
Hospital Allocation and Racial Disparities in Health Care
By: Amitabh Chandra, Pragya Kakani and Adam Sacarny
We develop a simple framework to measure the role of hospital allocation in racial disparities in health care and use it to study Black and white Medicare patients who are treated for heart attacks—a condition where virtually everyone receives care, hospital care is...
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- September 2, 2020
- Article
How to Pay for Public Option Without Tax Hike
By: Regina E. Herzlinger and Richard Boxer
A “Public Option” for health insurance that uses Medicare provider pricing and is administered by private insurers whose overall pricing conforms to GAAP will attain important, bi-partisan goals. For the Democrats, its lower costs will enable enrollment of the...
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- June 30, 2020
- Article
Bipartisan Tax-Free Solution to Health Care Financing: Coupling HRAs With a Public Option
By: Regina E. Herzlinger, Richard Boxer and James Wallace
A combination of health insurance initiatives by the presumptive 2020 Democratic and Republican presidential nominees could expand health care coverage and significantly reduce costs, without raising taxes. Along the way, the combination could revitalize private...
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- January 2, 2020
- Article
Medicare for All or Public Option: Can Either Heal Health Care?
By: Regina E. Herzlinger and James Wallace
- January 2, 2020
- Article
Changes in Quality of Care After Hospital Mergers and Acquisitions
By: Nancy Dean Beaulieu, Leemore S. Dafny, B. E. Landon, Jesse Dalton, Ifedayo Kuye and J. Michael McWilliams
Background: The hospital industry has consolidated substantially during the past two decades and at an accelerated pace since 2010. Multiple studies have shown that hospital mergers have led to higher prices for commercially insured patients, but research about effects...
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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 2019
- Article
A Review of Bundled Payments in Total Joint Replacement
By: Olivia Manickas-Hill, Kevin J. Bozic and Thomas W. Feeley
The Bundled Payments for Care Improvement (BPCI) initiative, developed by the U.S. Center for Medicare & Medicaid Innovation, aims to reduce health care expenditures while maintaining or improving patient outcomes.
Several published reports evaluating the impact... View Details
Several published reports evaluating the impact... View Details
- 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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- Article
Economic Principles for Medicare Reform
By: Amitabh Chandra and Craig Garthwaite
In this article, we develop an economic framework for Medicare reform that highlights trade-offs that reform proposals should grapple with but often ignore. Central to our argument is a tension in administratively set prices, which may improve short-term efficiency but...
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- October 10, 2019
- Article
The Case for the Public Option Over Medicare for All
By: Regina E. Herzlinger and Richard Boxer
- 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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- February 2019
- Article
Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending
By: David Cutler, Jonathan Skinner, Ariel Dora Stern and David Wennberg
There is considerable controversy about the causes of regional variations in health care expenditures. Using vignettes from patient and physician surveys linked to fee-for-service Medicare expenditures, this study asks whether patient demand-side factors or physician...
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- Article
Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated
By: Christopher Ody, Lucy Msall, Leemore S. Dafny, David Grabowski and David Cutler
Medicare’s Hospital Readmissions Reduction Program (HRRP) has been credited with lowering risk-adjusted readmission rates for targeted conditions at general acute care hospitals. However, these reductions appear to be illusory or overstated. This is because a...
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- February 2018
- Case
Health Savings Accounts: Enabling Consumer Participation
By: Regina E. Herzlinger and James Wallace
Health savings accounts (HSAs), a creation of the 2003 Medicare Modernization Act, had become an integral part of the drive toward consumer-driven health care. Coupled with high-deductible health plans, HSAs allowed consumers to directly control a significant part of...
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- 2017
- Working Paper
Developing Novel Drugs
By: Joshua Krieger, Danielle Li and Dimitris Papanikolaou
We analyze firms' decisions to invest in incremental and radical innovation, focusing specifically on pharmaceutical research. We develop a new measure of drug novelty that is based on the chemical similarity between new drug candidates and existing drugs. We show that...
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- 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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