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- June 2024
- Article
Enhancing Value and Well-Being: The Basket of Motivators Framework for Aligning Neurology Clinical Practices with Performance Outcomes
By: Peter N. Hadar, Susanna Gallani and Lidia Moura
Physician burnout, which is prevalent in neurology, has accelerated in recent years. While multifactorial, a major contributing factor to burnout is a payment model that rewards volume over quality, leaving physicians overburdened and unfulfilled. The aim of this...
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Keywords:
Compensation and Benefits;
Personal Development and Career;
Well-being;
Motivation and Incentives
Hadar, Peter N., Susanna Gallani, and Lidia Moura. "Enhancing Value and Well-Being: The Basket of Motivators Framework for Aligning Neurology Clinical Practices with Performance Outcomes." Neurology: Clinical Practice 14, no. 1 (June 2024).
- February 2024
- Article
Representation and Extrapolation: Evidence from Clinical Trials
By: Marcella Alsan, Maya Durvasula, Harsh Gupta, Joshua Schwartzstein and Heidi L. Williams
This article examines the consequences and causes of low enrollment of Black patients in clinical
trials. We develop a simple model of similarity-based extrapolation that predicts that evidence is
more relevant for decision-making by physicians and patients when it...
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Keywords:
Representation;
Racial Disparity;
Health Testing and Trials;
Race;
Equality and Inequality;
Innovation and Invention;
Pharmaceutical Industry
Alsan, Marcella, Maya Durvasula, Harsh Gupta, Joshua Schwartzstein, and Heidi L. Williams. "Representation and Extrapolation: Evidence from Clinical Trials." Quarterly Journal of Economics 139, no. 1 (February 2024): 575–635.
- January 2024
- Background Note
Evaluating Innovations in the Organization of Primary Care: What Type of Innovation Is It and How Well Does It Align with the Six Factors?
By: Regina E. Herzlinger and James Wallace
How can we evaluate if innovative health care ventures can do good—benefit society—and do well—become financially viable? This question is the topic of the first module in the Innovating in Health Care course book.
This note and "Health Stop (A): What Type... View Details
This note and "Health Stop (A): What Type... View Details
- December 4, 2023
- Comment
The Great Resignation, Employment, and Wages in Health Care
By: Amitabh Chandra and Louis-Jonas Heizlsperger
Notwithstanding concerns about staffing levels and burnout in health care, federal wage and employment data does not support the suggestion that a COVID-19 pandemic-related spike in quitting has had an enduring impact for hospitals or physician offices. Employment in...
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Chandra, Amitabh, and Louis-Jonas Heizlsperger. "The Great Resignation, Employment, and Wages in Health Care." NEJM Catalyst (December 4, 2023).
- 2023
- Article
Dynamic HTA for Digital Health Solutions: Opportunities and Challenges for Patient-Centered Evaluation
By: Jan B. Brönneke, Annika Herr, Simon Reif and Ariel D. Stern
Germany’s 2019 Digital Healthcare Act (Digitale-Versorgung-Gesetz, or DVG) created a number of opportunities for the digital transformation of the health care delivery system. Key among these was the creation of a reimbursement pathway for patient-centered digital...
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Keywords:
Digital Transformation;
Applications and Software;
Product Development;
Insurance;
Policy;
Health Industry;
Germany
Brönneke, Jan B., Annika Herr, Simon Reif, and Ariel D. Stern. "Dynamic HTA for Digital Health Solutions: Opportunities and Challenges for Patient-Centered Evaluation." International Journal of Technology Assessment in Health Care 39, no. 1 (2023).
- November 2023
- Article
Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients with Hypertension
By: Mitchell Tang, Carter Nakamoto, Ariel Dora Stern, Jose Zubizarreta, Felippe Marcondes, Lori Uscher-Pines, Lee Schwamm and Ateev Mehrotra
Background: Remote patient monitoring (RPM) is a promising tool for improving chronic disease management. Use of RPM for hypertension monitoring is growing rapidly, raising concerns about increased spending. However, the effects of RPM are still...
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Tang, Mitchell, Carter Nakamoto, Ariel Dora Stern, Jose Zubizarreta, Felippe Marcondes, Lori Uscher-Pines, Lee Schwamm, and Ateev Mehrotra. "Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients with Hypertension." Annals of Internal Medicine 176, no. 11 (November 2023): 1465–1475.
- November 2023
- Article
Federated Electronic Health Records for the European Health Data Space
By: René Raab, Arne Küderle, Anastasiya Zakreuskaya, Ariel Dora Stern, Jochen Klucken, Georgios Kaissis, Daniel Rueckert, Susanne Boll, Roland Eils, Harald Wagener and Bjoern Eskofier
The European Commission's draft for the European Health Data Space (EHDS) aims to empower citizens to access their personal health data and share it with physicians and other health-care providers. It further defines procedures for the secondary use of electronic...
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Keywords:
Analytics and Data Science;
Cybersecurity;
Information Management;
Knowledge Sharing;
Knowledge Use and Leverage;
Health Industry
Raab, René, Arne Küderle, Anastasiya Zakreuskaya, Ariel Dora Stern, Jochen Klucken, Georgios Kaissis, Daniel Rueckert, Susanne Boll, Roland Eils, Harald Wagener, and Bjoern Eskofier. "Federated Electronic Health Records for the European Health Data Space." Lancet Digital Health 5, no. 11 (November 2023): e840–e847.
- October 2023
- Article
What Does the Inflation Reduction Act Mean for Patients and Physicians?
By: Amitabh Chandra and Benedic Ippolito
The debate around prescription drug measures in the recently passed U.S. Inflation Reduction Act (IRA), which limit some patients’ out-of-pocket costs, has not fully addressed their effect on physicians and patients via their effect on payers. Reducing patients’ costs...
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Chandra, Amitabh, and Benedic Ippolito. "What Does the Inflation Reduction Act Mean for Patients and Physicians?" NEJM Catalyst Innovations in Care Delivery 4, no. 10 (October 2023).
- 2023
- Article
Evidence from the First Shared Medical Appointments (SMAs) Randomised Controlled Trial in India: SMAs Increase the Satisfaction, Knowledge, and Medication Compliance of Patients with Glaucoma
By: Nazlı Sönmez, Kavitha Srinivasan, Rengaraj Venkatesh, Ryan W. Buell and Kamalini Ramdas
In Shared Medical Appointments (SMAs), patients with similar conditions meet the physician together and each receives one-on-one attention. SMAs can improve outcomes and physician productivity. Yet privacy concerns have stymied adoption. In physician-deprived nations,...
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Sönmez, Nazlı, Kavitha Srinivasan, Rengaraj Venkatesh, Ryan W. Buell, and Kamalini Ramdas. "Evidence from the First Shared Medical Appointments (SMAs) Randomised Controlled Trial in India: SMAs Increase the Satisfaction, Knowledge, and Medication Compliance of Patients with Glaucoma." e0001648. PLoS Global Public Health 3, no. 7 (2023).
- Summer 2023
- Article
Do Policies to Increase Access to Treatment for Opioid Use Disorder Work?
By: Eric Barrette, Leemore S. Dafny and Karen Shen
Even among commercially insured individuals, opioid use disorder is undertreated in the United States: nearly half receive no treatment within six months of a new diagnosis. Using a difference-in-differences specification exploiting the extension of insurance parity...
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Keywords:
Opioid Treatment;
Medication-assisted Treatment;
Substance Use Disorder;
Private Insurance;
Insurance;
Health Care and Treatment
Barrette, Eric, Leemore S. Dafny, and Karen Shen. "Do Policies to Increase Access to Treatment for Opioid Use Disorder Work?" American Journal of Health Economics 9, no. 3 (Summer 2023): 297–330.
- 2023
- Article
Conduit Incentives: Eliciting Cooperation from Workers Outside of Managers' Control
By: Susanna Gallani
Can managers use monetary incentives to elicit cooperation from workers they cannot reward for their efforts? I study “conduit incentives,” an innovative incentive design, whereby managers influence bonus-ineligible workers’ effort by offering bonus-eligible employees...
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Keywords:
Organizational Behavior Modification;
Peer Monitoring;
Persistence Of Performance Improvements;
Crowding Out;
Implicit Incentives;
Compensation;
Healthcare;
Social Pressure;
Image Motivation;
Incentives;
Motivation;
Performance;
Behavior;
Motivation and Incentives;
Compensation and Benefits;
Governing Rules, Regulations, and Reforms;
Organizational Culture;
Health Industry;
California
Gallani, Susanna. "Conduit Incentives: Eliciting Cooperation from Workers Outside of Managers' Control." Accounting Review 93, no. 3 (2023): 1–28.
- December 2022
- Article
Collaborative Rooming: An Innovative Pilot Project to Overcome Primary Care Challenges
By: Gagandeep Singh, Jill G. Lenhart, Richard A. Helmers, Michele Renee Eberlee, Heather Costley, Joel B. Roberts and Robert S. Kaplan
Primary care physicians are overburdened with growing complexities and increasing expectations for primary care visits. To meet expectations, primary care physicians must multitask during visits and spend extra hours in the office for charting, billing, and...
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Singh, Gagandeep, Jill G. Lenhart, Richard A. Helmers, Michele Renee Eberlee, Heather Costley, Joel B. Roberts, and Robert S. Kaplan. "Collaborative Rooming: An Innovative Pilot Project to Overcome Primary Care Challenges." Wisconsin Medical Journal 121, no. 4 (December 2022): 306–309.
- Article
Surgeons and Administrators Co-Creating Value
By: Michael Nurok, Thoralf Sundt, Robert S. Kaplan and Bruce Gewertz
Most hospitals have arms-length relationships with physicians, viewing them as people they must ‘‘manage,’’ not as potentially valuable strategic partners. But surgeons make clinical decisions every day that have great influence on both patient outcomes and hospital...
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Keywords:
Value-based Health Care;
Collaboration;
Healthcare Administration;
Health Care and Treatment;
Management;
Strategy;
Value Creation
Nurok, Michael, Thoralf Sundt, Robert S. Kaplan, and Bruce Gewertz. "Surgeons and Administrators Co-Creating Value." Annals of Surgery 274, no. 6 (December 2021).
- 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
Identifying the effect of physicians’ skills on health outcomes is a challenging task due to the nonrandom sorting between physicians and hospitals. We overcome this challenge by exploiting a Colombian government program that randomly assigned 2,126 physicians to 618...
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Keywords:
Physicians' Health Skills;
Health Birth Outcomes;
Birthing Outcomes;
Experimental Evidence;
Health Care and Treatment;
Competency and Skills;
Outcome or Result;
Health Industry;
Colombia
Guarin, Arlen, Christian Posso, Estefania Saravia, and Jorge Tamayo. "The Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes." Harvard Business School Working Paper, No. 22-015, February 2021. (Revised November 2021.)
- 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...
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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.
- 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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Keywords:
Time-Driven Activity-Based Costing;
Cost Accounting;
Health Care and Treatment;
Health Industry;
India;
Nepal;
United States
Xue, Jiayin, 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. "A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal." NEJM Catalyst Innovations in Care Delivery 2, no. 9 (September 2021).
- 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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Keywords:
Hospital;
Hospital Management;
Hospitals—administration;
Health Care;
Health Care Industry;
Health Care Investment;
Health Care Operations;
Health Pandemics;
Health Care and Treatment;
Operations;
Performance Improvement;
Investment;
Health Industry;
United States
Herzlinger, Regina E., and Barak D. Richman. "Preparing Hospitals for the Next Pandemic." Harvard Business Review Digital Articles (June 10, 2021).
- June 2021
- Case
uBiome
By: Thomas R. Eisenmann and Olivia Graham
uBiome provided clinical tests that sequenced the DNA of human microbiome samples, providing data on health conditions directly to consumers or to prescribing physicians. Founded in 2012, the San Francisco-based startup raised $105 million from top-tier venture capital...
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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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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).
- 2021
- Working Paper
Regulatory Approval and Expanded Market Size
By: Benjamin Berger, Amitabh Chandra and Craig Garthwaite
Regulatory review of new medicines is often viewed as a hindrance to innovation by increasing the hurdle to bring products to market. However, a more complete accounting of regulation must also account for its potential market expanding effects through quality...
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Keywords:
New Medicines;
Regulatory Approval;
Health Care and Treatment;
Research and Development;
Governing Rules, Regulations, and Reforms;
Markets;
Expansion;
Pharmaceutical Industry
Berger, Benjamin, Amitabh Chandra, and Craig Garthwaite. "Regulatory Approval and Expanded Market Size." NBER Working Paper Series, No. 28889, June 2021.