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      • Faculty Publications  (39)

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      New Marketplace Survey: Payers and Providers Remain Far Apart
      Consumer-Driven Health Care: Implications for Providers, Payers, and Policymakers
      → Search All HBS Web
      • January 2021
      • Case

      Hester Pharmaceuticals (A): A Pricing Dilemma

      By: Dante Roscini and John Masko
      In August 2019, the leadership of Hester Pharmaceuticals (Hester) had a problem. Italy promised to be a key market for their new breakthrough oncology drug Akrozumab, but for almost two years, its single-payer healthcare system had been unable to agree with Hester on a...  View Details
      Keywords: Macroeconomics; Trade; Price; Global Range; Global Strategy; Globalized Markets and Industries; Health Care and Treatment; Patents; Monopoly; Negotiation; Business and Government Relations; Risk and Uncertainty; Human Needs; Business Strategy; Commercialization; Pharmaceutical Industry; Italy
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      Roscini, Dante, and John Masko. "Hester Pharmaceuticals (A): A Pricing Dilemma." Harvard Business School Case 721-001, January 2021.
      • Article

      Want to See the Future of Digital Health Tools? Look to Germany

      By: Ariel Dora Stern, Henrik Matthies, Julia Hagen, Jan B. Brönneke and Jörg F. Debatin
      A new law will make it easier to introduce and determine the benefits of new tools. Perhaps its most important provisions are its formalization of “prescribable applications,” which include standard software, SaaS, and mobile as well as browser-based apps, and the...  View Details
      Keywords: Health Care and Treatment; Transformation; Online Technology; Technological Innovation; Germany
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      Stern, Ariel Dora, Henrik Matthies, Julia Hagen, Jan B. Brönneke, and Jörg F. Debatin. "Want to See the Future of Digital Health Tools? Look to Germany." Harvard Business Review (website) (December 2, 2020).
      • 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...  View Details
      Keywords: Antitrust; Health Care and Treatment; Vertical Integration; Organizational Structure; Competition; Health Industry; United States
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      Cutler, David, Leemore S. Dafny, David Grabowski, Steven S. Lee, and Christopher Ody. "Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities." NBER Working Paper Series, No. 28305, December 2020.
      • Article

      Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries

      By: Sara Gerke, Ariel D. Stern and Timo Minssen
      Reimbursement is a key challenge for many new digital health solutions, whose importance and value have been highlighted and expanded by the current COVID-19 pandemic. Germany’s new Digital Healthcare Act (Digitale–Versorgung–Gesetz or DVG) entitles all individuals...  View Details
      Keywords: Covid-19; Reimbursement; Digital Health Reforms; Health Pandemics; Health Care and Treatment; Online Technology; Governing Rules, Regulations, and Reforms; Germany
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      Gerke, Sara, Ariel D. Stern, and Timo Minssen. "Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries." Art. 94. npj Digital Medicine 3 (2020).
      • Article

      Using the Balanced Scorecard for Successful Health Care M&A Integration

      By: Robert S. Kaplan
      The failure of merged organizations to achieve stated goals is commonplace. In health care, the challenge is exacerbated by the industry’s third-party payer system and multiple stakeholders, especially the physicians in the merging entities. This article describes how...  View Details
      Keywords: Health Care and Treatment; Mergers and Acquisitions; Integration; Balanced Scorecard
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      Kaplan, Robert S. "Using the Balanced Scorecard for Successful Health Care M&A Integration." NEJM Catalyst (May 21, 2020).
      • Working Paper

      Rebates in the Pharmaceutical Industry: Evidence from Medicines Sold in Retail Pharmacies in the U.S.

      By: Pragya Kakani, Michael Chernew and Amitabh Chandra
      Rising list prices are often used to illustrate the burden of prescription drug spending, but payers routinely negotiate rebates from manufacturers that generate differences between list and net prices. List prices are easily available and affect patient cost-sharing,...  View Details
      Keywords: Pharmaceuticals; Rebates; Health Care and Treatment; Markets; Price; Analysis; Pharmaceutical Industry
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      Kakani, Pragya, Michael Chernew, and Amitabh Chandra. "Rebates in the Pharmaceutical Industry: Evidence from Medicines Sold in Retail Pharmacies in the U.S." NBER Working Paper Series, No. 26846, March 2020.
      • Article

      Europe's Alternative to Medicare for All; Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System

      By: Regina E. Herzlinger and Bacchus Barua
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      Herzlinger, Regina E., and Bacchus Barua. "Europe's Alternative to Medicare for All; Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System." Wall Street Journal (April 17, 2019).
      • Winter 2019
      • Article

      Value-based Health Care: Lessons for the Anesthesiologist

      By: J.A. Martin, B.L. Potter, T.F. Flanagan and T.W. Feeley
      At one point or another in our life, we all become consumers of the health care industry. Indeed, health care affects everyone and encompasses a diverse set of services from childbirth, to illness prevention, to the management of chronic disease and end-of-life care....  View Details
      Keywords: Value-based Health Care; Anesthesiologists; Health Care and Treatment; Value; Cost Management; Problems and Challenges; Health Industry; United States
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      Martin, J.A., B.L. Potter, T.F. Flanagan, and T.W. Feeley. "Value-based Health Care: Lessons for the Anesthesiologist." International Anesthesiology Clinics 57, no. 1 (Winter 2019): 63–80.
      • January 2019 (Revised June 2019)
      • Technical Note

      U.S. Commercial Health Insurance Industry

      By: Susanna Gallani, Mary Witkowski and Harry B. Wolberg
      This note describes the role of commercial payers in the U.S. healthcare industry. We begin with a review of the historical evolution of commercial payers and their role in the market, from the beginning to the Affordable Care Act and beyond. Every wave of reforms in...  View Details
      Keywords: Health Care and Treatment; Insurance; Governing Rules, Regulations, and Reforms; Organizational Change and Adaptation; Health Industry; Insurance Industry; United States
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      Gallani, Susanna, Mary Witkowski, and Harry B. Wolberg. "U.S. Commercial Health Insurance Industry." Harvard Business School Technical Note 119-064, January 2019. (Revised June 2019.)
      • October 2018 (Revised August 2019)
      • Case

      Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?

      By: Leemore Dafny
      In July 2017, CEO Kevin Tabb of Boston's Beth Israel Deaconess Medical Center announced his plan to consolidate 11 Massachusetts hospitals under a common management structure. These hospitals collectively generated $5 billion in patient revenue and 25% of...  View Details
      Keywords: Beth Israel Deaconess; Lahey; Partners; Health Care; Hospitals; Payers; Providers; Anti-trust; Health Care Regulation; Mergers and Acquisitions; Health Care and Treatment; Market Design; Duopoly and Oligopoly; Negotiation; Consolidation; Competition; Health Industry; Massachusetts; Boston
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      Dafny, Leemore. "Beth Israel Deaconess: Consolidating to Strengthen, or to Stave Off, Competition?" Harvard Business School Case 319-026, October 2018. (Revised August 2019.)
      • Article

      Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

      By: Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman
      The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with...  View Details
      Keywords: Health Care and Treatment; Cost Management; Insurance; Problems and Challenges
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      Tseng, Phillip, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah, and Kevin A. Schulman. "Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System." JAMA, the Journal of the American Medical Association 319, no. 7 (February 20, 2018): 691–697.
      • January 2018 (Revised June 2018)
      • Case

      Medtronic: Navigating a Shifting Healthcare Landscape

      By: Robert S. Kaplan, Michael E. Porter, Thomas W. Feeley and Alee Hernandez
      Medtronic is adapting its strategy to changes in healthcare competition and payments. It has decided to develop new relationships with payers, hospitals, and physicians to become more accountable for patient outcomes and total costs. The case describes new forms of...  View Details
      Keywords: Value Based Health Care; Bundled Payments; Health Care and Treatment; Cost Management; Value Creation; Supply Chain Management; Customer Value and Value Chain; Health Industry; Medical Devices and Supplies Industry; United States; Netherlands
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      Kaplan, Robert S., Michael E. Porter, Thomas W. Feeley, and Alee Hernandez. "Medtronic: Navigating a Shifting Healthcare Landscape." Harvard Business School Case 718-471, January 2018. (Revised June 2018.)
      • September 2017 (Revised December 2017)
      • Case

      Intermountain Healthcare: Pursuing Precision Medicine

      By: Richard G. Hamermesh, Kathy E. Giusti, Robert S. Huckman and Julia Kelley
      Headquartered in Salt Lake City, Intermountain Healthcare operates 23 hospitals and hundreds of clinics in Utah and Idaho and provides insurance to approximately 850,000 patients through its insurance arm, SelectHealth. In 2013, Intermountain, known for its commitment...  View Details
      Keywords: Precision Medicine; Healthcare; Innovation; Cancer; Cancer Research; Health Care; Technology; Health Care and Treatment; Innovation Leadership; Disruptive Innovation; Entrepreneurship; Decision Choices and Conditions; Health Industry; Insurance Industry; Utah; United States; North America
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      Hamermesh, Richard G., Kathy E. Giusti, Robert S. Huckman, and Julia Kelley. "Intermountain Healthcare: Pursuing Precision Medicine." Harvard Business School Case 818-018, September 2017. (Revised December 2017.)
      • May 11, 2017
      • Article

      Good Riddance to Big Insurance Mergers

      By: Leemore S. Dafny
      Federal judges issued preliminary injunctions halting mergers of four of the five largest U.S. health insurers. These decisions provide more precedent to support challenges of mergers between competitors in health care markets—whether payers or providers.  View Details
      Keywords: Mergers and Acquisitions; Insurance; Health Care and Treatment; Health Industry; Insurance Industry
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      Dafny, Leemore S. "Good Riddance to Big Insurance Mergers." New England Journal of Medicine 376, no. 19 (May 11, 2017): 1804–1806.
      • Article

      Time-Driven Activity-Based Costing for Surgical Episodes

      By: Peter Najjar, Matt Strickland and Robert S. Kaplan
      Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services...  View Details
      Keywords: Surgery; Time-driven Activity-based Costing; Bundled Payments; Health Care and Treatment; Cost Management
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      Najjar, Peter, Matt Strickland, and Robert S. Kaplan. "Time-Driven Activity-Based Costing for Surgical Episodes." JAMA Surgery 152, no. 1 (January 2017): 96–97.
      • December 2016
      • Article

      Health Care Needs Real Competition

      By: Leemore S. Dafny and Thomas H. Lee
      The U.S. health care system is inefficient, unreliable, and crushingly expensive. There is no shortage of proposed solutions, but central to the best of them is the idea that health care needs more competition. In other sectors, competition improves quality and...  View Details
      Keywords: Competition; Health Care and Treatment; Health Industry; United States
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      Dafny, Leemore S., and Thomas H. Lee. "Health Care Needs Real Competition." Harvard Business Review 94, no. 12 (December 2016): 76–87.
      • Article

      Value-based Healthcare: Implications for Thyroid Cancer

      By: A.K. Ying, T.W. Feeley and M. E. Porter
      Today's delivery of care to thyroid cancer patients is complex, and costly, with uneven outcomes that can be improved. The incidence of thyroid cancer is rising and requires coordinated, multidisciplinary care with high volume centers that is not always available in...  View Details
      Keywords: Bundled Reimbursement; Healthcare Reform; Integrated Practice Units; Outcomes; Patient-reported Outcomes; Thyroid Cancer; Health Care and Treatment; Cost; Information Technology; Value
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      Ying, A.K., T.W. Feeley, and M. E. Porter. "Value-based Healthcare: Implications for Thyroid Cancer." International Journal of Endocrine Oncology 3, no. 2 (May 2016): 115–129. (e-Pub 4/2016.)
      • October 2015 (Revised July 2017)
      • Case

      OMV Petrom: Investment as Partnership—When It Takes Three to Tango

      By: Dante Roscini, Emer Maloney and Daniela Beyersdorfer
      Petrom was privatized by the Romanian state in 2004 and acquired by Austrian oil company OMV, with the state retaining a 20.6% stake in the company. The situation was particularly challenging for the foreign investor since the sector in which the company operated was...  View Details
      Keywords: Partners and Partnerships; Privatization; Acquisition; Foreign Direct Investment; Cross-Cultural and Cross-Border Issues; Business and Government Relations; Energy Industry; Austria; Romania
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      Roscini, Dante, Emer Maloney, and Daniela Beyersdorfer. "OMV Petrom: Investment as Partnership—When It Takes Three to Tango." Harvard Business School Case 716-035, October 2015. (Revised July 2017.)
      • Article

      Comparative Costs of Advanced Proton and Photon Radiation Therapies: Lessons from Time-driven Activity-based Costing in Head and Neck Cancer

      By: Nikhil G. Thaker, Steven J. Frank and Thomas W. Feeley
      Time-driven activity-based costing (TDABC) is an innovative costing tool in healthcare that can be used to directly compare the true cost of competing technologies over the full care cycle. Rather than only comparing therapeutic effectiveness over a limited number of...  View Details
      Keywords: Head And Neck Cancer; Imrt; Proton Therapy; Time-driven Abc; Technology; Activity Based Costing and Management; Medical Specialties
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      Thaker, Nikhil G., Steven J. Frank, and Thomas W. Feeley. "Comparative Costs of Advanced Proton and Photon Radiation Therapies: Lessons from Time-driven Activity-based Costing in Head and Neck Cancer." Journal of Comparative Effectiveness Research 4, no. 4 (2015): 297–301.
      • July 2015
      • Case

      Uncharted Play (A)

      By: Shikhar Ghosh and Ali Huberlie
      The case recounts the process of launching an early stage venture, from idea conception through initial efforts to validate the concept, followed by product launch, and fund raising. It emphasizes the Customer Value Proposition of the business model, and asks – Who is...  View Details
      Keywords: Early Stage; Female Protagonist; Value Proposition; Team Building; Founders' Agreements; Start-up; Entrepreneurship; Business Model; Business Startups; Sports; United States; North America; Nigeria; Africa
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      Ghosh, Shikhar, and Ali Huberlie. "Uncharted Play (A)." Harvard Business School Case 816-018, July 2015.
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      Consumer-Driven Health Care: Implications for Providers, Payers, and Policymakers
      → Search All HBS Web
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