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      • 2022
      • Article

      Rapid Growth of Remote Patient Monitoring Is Driven by a Small Number of Primary Care Providers

      By: Mitchell Tang, Ateev Mehrotra and Ariel Dora Stern
      Growing enthusiasm for remote patient monitoring has been motivated by the hope that it can improve care for patients with poorly controlled chronic illness. In a national commercially insured population in the U.S., we found that billing for remote patient monitoring...  View Details
      Keywords: Remote Monitoring; Medical Billing; Health Care Costs; Telehealth; Diabetes; Chronic Disease; Insurance Claims; Diseases; Primary Care Providers; COVID-19 Pandemic; Health Care and Treatment; Insurance; Cost; Health Industry; United States
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      Tang, Mitchell, Ateev Mehrotra, and Ariel Dora Stern. "Rapid Growth of Remote Patient Monitoring Is Driven by a Small Number of Primary Care Providers." Health Affairs 41, no. 9 (2022): 1248–1254.
      • Article

      Health App Policy: International Comparison of Nine Countries' Approaches

      By: Anna Essén, Ariel Dora Stern, Christoffer Bjerre Haase, Josip Car, Felix Greaves, Dragana Paparova, Steven Vandeput, Rik Wehrens and David W. Bates
      An abundant and growing supply of digital health applications (apps) exists in the commercial tech-sector, which can be bewildering for clinicians, patients, and payers. A growing challenge for the health care system is therefore to facilitate the identification of...  View Details
      Keywords: Digital Health; Apps; Health Care and Treatment; Internet and the Web; Policy; Global Range; Applications and Software
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      Essén, Anna, Ariel Dora Stern, Christoffer Bjerre Haase, Josip Car, Felix Greaves, Dragana Paparova, Steven Vandeput, Rik Wehrens, and David W. Bates. "Health App Policy: International Comparison of Nine Countries' Approaches." npj Digital Medicine 5, no. 31 (2022).
      • Article

      Supporting Value-Based Health Care—Aligning Financial and Legal Accountability

      By: Mark M. Zaki, Anupam B. Jena and Amitabh Chandra
      U.S. health care payment and delivery-system reforms have focused on improving care by making organizations accountable for outcomes, quality, and costs. Payers have supported the implementation of accountable care organizations (ACOs), bundled-payment models, and...  View Details
      Keywords: Value-based Health Care; Accountability; Health Care and Treatment; United States
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      Zaki, Mark M., Anupam B. Jena, and Amitabh Chandra. "Supporting Value-Based Health Care—Aligning Financial and Legal Accountability." New England Journal of Medicine 385, no. 11 (September 9, 2021): 965–967.
      • 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...  View Details
      Keywords: Healthcare; Healthcare Spending; Healthcare Innovation; Healthcare Industry; Health Care Outcomes; Health Care Delivery; Health Care Reform; Bundled Payments; Health Care and Treatment; Spending; Innovation and Invention; Value Creation; Strategy; Health Industry; North America
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      Kaplan, Robert S., Mary Witkowski, Toby E. Emanuel, and Syed S. Shehab. "New England Baptist Hospital: Getting Paid for Value." Harvard Business School Case 121-036, February 2021.
      • Other 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; Internet and the Web; 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).
      • 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.
      • 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.
      • 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.
      • 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.)
      • March 2015
      • Teaching Note

      CVS Health: Promoting Drug Adherence

      By: Leslie John, John Quelch and Robert Huckman
      Email mking@hbs.edu for a courtesy copy.

      This Teaching Note explains the theory of the case and teaching plan for the case: CVS Health: Promoting Drug Adherence (515010). The case finds Helena Foulkes, Executive...  View Details
      Keywords: Medication Adherence; Affordable Care Act (ACA); Marketing Strategy; Communication Strategy; Customer Value and Value Chain; Decisions; Health Care and Treatment; Goals and Objectives; Resource Allocation; Marketing Communications; Consumer Behavior; Measurement and Metrics; Service Delivery; Behavior; Motivation and Incentives; Social Issues; Information Technology; Value Creation; Health Industry; Pharmaceutical Industry; Insurance Industry; Public Relations Industry; Retail Industry; United States
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      John, Leslie, John Quelch, and Robert Huckman. "CVS Health: Promoting Drug Adherence." Harvard Business School Teaching Note 515-086, March 2015. (Email mking@hbs.edu for a courtesy copy.)
      • Article

      Better Accounting Transforms Health Care Delivery

      By: Robert S. Kaplan and Mary L. Witkowski
      The paper describes the theory and preliminary results for an action research program that explores the implications from better measurements of health care outcomes and costs. After summarizing Porter's outcome taxonomy (Porter 2010), we illustrate how to use process...  View Details
      Keywords: Activity Based Costing and Management; Research; Health Care and Treatment; Health Industry
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      Kaplan, Robert S., and Mary L. Witkowski. "Better Accounting Transforms Health Care Delivery." Accounting Horizons 28, no. 2 (June 2014): 365–383.
      • September 2011
      • Article

      How to Solve the Cost Crisis in Health Care

      By: Robert S. Kaplan and Michael E. Porter
      Existing health care costing systems have serious flaws that make it impossible to measure costs accurately at the individual patient and medical condition level. This gap has severely limited meaningful cost reduction throughout the system. The paper describes a new...  View Details
      Keywords: Cost; Health Care and Treatment; Measurement and Metrics; Service Delivery; Outcome or Result; Quality; Health Industry
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      Kaplan, Robert S., and Michael E. Porter. "How to Solve the Cost Crisis in Health Care." Harvard Business Review 89, no. 9 (September 2011): 47–64.
      • March 2011
      • Article

      What Do Dividends Tell Us About Earnings Quality

      By: Douglas Skinner and Eugene F. Soltes
      Over the past 30 years, there have been significant changes in the distribution of earnings (cross-sectional variation has increased, with increasing left skewness) as well as in corporate payout policy, with many fewer firms paying dividends and the emergence of stock...  View Details
      Keywords: Distribution; Business Earnings; Change; Policy; Stocks; Investment Return; Performance Consistency; Quality
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      Skinner, Douglas, and Eugene F. Soltes. "What Do Dividends Tell Us About Earnings Quality." Review of Accounting Studies 16, no. 1 (March 2011).
      • August 2010 (Revised March 2012)
      • Case

      The UCLA Medical Center: Kidney Transplantation

      By: Michael E. Porter, Jennifer F Baron, Jacob Mathew Chacko and Robin Jian Tang
      In 2010, organ transplantation remained among the few sets of medical conditions in the U.S. for which bundled payments were a dominant reimbursement model, and for which patient health outcomes were universally measured and reported. In 1986, UCLA Medical Center was...  View Details
      Keywords: Insurance; Health Care and Treatment; Health Disorders; Measurement and Metrics; Outcome or Result; Competitive Strategy; Integration; Health Industry; California
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      Porter, Michael E., Jennifer F Baron, Jacob Mathew Chacko, and Robin Jian Tang. "The UCLA Medical Center: Kidney Transplantation." Harvard Business School Case 711-410, August 2010. (Revised March 2012.)
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