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- 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.
- Working Paper
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." NBER Working Paper Series, No. 30575, October 2022. (Revise and resubmit, Quarterly Journal of Economics.)
- 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.
- May 2021
- Case
Inclusive Innovation at Mass General Brigham
By: Katherine Baldiga Coffman and Olivia Hull
Massachusetts General Brigham (MGB) Chief Innovation Officer Christopher Coburn had overseen a period of exciting transformation and growth in healthcare innovation at MGB. In November 2019, the health system was the largest recipient of National Institutes of Health...
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Keywords:
Inclusion;
Innovation;
Invention;
Gender;
Business Startups;
Investment Funds;
Private Equity;
Health Care and Treatment;
Innovation Strategy;
Technological Innovation;
Intellectual Property;
Copyright;
Patents;
Research;
Research and Development;
Diversification;
Technology;
Health Industry;
Massachusetts;
Boston
Coffman, Katherine Baldiga, and Olivia Hull. "Inclusive Innovation at Mass General Brigham." Harvard Business School Case 921-006, May 2021.
- May 2021
- Article
Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency
By: J. Hart, K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels and S.D. Halpern
Background: Clinicians’ use of choice architecture, or how they present options, systematically influences the choices made by patients and their surrogate decision makers. However, clinicians may incompletely understand this influence....
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Keywords:
Choice Architecture;
Health Care and Treatment;
Interpersonal Communication;
Decision Choices and Conditions;
Competency and Skills
Hart, J., K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels, and S.D. Halpern. "Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency." BMJ Quality & Safety 30, no. 5 (May 2021).
- May 2021
- Article
Making Doctors Effective Managers and Leaders: A Matter of Health and Well-Being
By: Lisa Rotenstein, Robert S. Huckman and Christine K. Cassel
The COVID-19 crisis has forced physicians to make daily decisions that require knowledge and skills they did not acquire as part of their biomedical training. Physicians are being called upon to be both managers—able to set processes and structures—and leaders—capable...
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Rotenstein, Lisa, Robert S. Huckman, and Christine K. Cassel. "Making Doctors Effective Managers and Leaders: A Matter of Health and Well-Being." Academic Medicine 96, no. 5 (May 2021).
- April 2021
- Article
Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models
By: Susanna Gallani, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar and Frank Opelka
Modern medicine is undergoing a transformation that involves innovative surgical approaches, increased medical treatment options, clinical care pathways that require collaboration beyond hospital walls, and health data captured by electronic health records and other...
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Keywords:
Physician Compensation;
Surgeons;
Health Care and Treatment;
Business Model;
Compensation and Benefits
Gallani, Susanna, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar, and Frank Opelka. "Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models." Bulletin of the American College of Surgeons 106, no. 4 (April 2021): 33–39.
- March 2021
- Article
Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care
Scope-of-practice regulations, including prescribing limits and supervision requirements, may influence the propensity of providers to form care teams. Therefore, policy makers need to understand the effect of both team-based care and provider type on clinical...
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Keywords:
Disease Management;
Team-based Care;
Health Care and Treatment;
Groups and Teams;
Performance
Pany, Maximilian J., Lucy Chen, Bethany Sheridan, and Robert S. Huckman. "Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care." Health Affairs 40, no. 3 (March 2021): 435–444.
- February 2021
- Article
Assessment of Electronic Health Record Use Between U.S. and Non-U.S. Health Systems
By: A Jay Holmgren, Lance Downing, David W. Bates, Tait D. Shanafelt, Arnold Milstein, Christopher Sharp, David Cutler, Robert S. Huckman and Kevin A. Schulman
Importance: Understanding how the electronic health record (EHR) system changes clinician work, productivity, and well-being is critical. Little is known regarding global variation in patterns of use.
Objective: To provide insights into which EHR... View Details
Objective: To provide insights into which EHR... View Details
Keywords:
Electronic Health Records;
Health Care and Treatment;
Online Technology;
Health Industry;
Information Technology Industry
Holmgren, A Jay, Lance Downing, David W. Bates, Tait D. Shanafelt, Arnold Milstein, Christopher Sharp, David Cutler, Robert S. Huckman, and Kevin A. Schulman. "Assessment of Electronic Health Record Use Between U.S. and Non-U.S. Health Systems." JAMA Internal Medicine 181, no. 2 (February 2021): 251–259.
- November 2020 (Revised April 2021)
- Case
Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care
By: Trevor Fetter and Kira Seiger
This case describes the increasing investment by private equity (PE) firms in patient care and other healthcare services. The case focuses on investments in physician staffing firms and roll-up strategy investments in physician practice management (PPM). Included in...
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Keywords:
Business Ventures;
Acquisition;
Mergers and Acquisitions;
Business Model;
Change;
Disruption;
Fluctuation;
Trends;
Customers;
Customer Value and Value Chain;
Ethics;
Fairness;
Finance;
Equity;
Insurance;
Private Equity;
Geography;
Geographic Scope;
Health;
Health Care and Treatment;
Markets;
Demand and Consumers;
Supply and Industry;
Industry Structures;
Ownership;
Ownership Type;
Private Ownership;
Relationships;
Agency Theory;
Business and Community Relations;
Business and Shareholder Relations;
Business and Stakeholder Relations;
Networks;
Strategy;
Competition;
Consolidation;
Expansion;
Integration;
Horizontal Integration;
Vertical Integration;
Value;
Value Creation;
Health Industry;
Insurance Industry;
United States
Fetter, Trevor, and Kira Seiger. "Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care." Harvard Business School Case 321-049, November 2020. (Revised April 2021.)
- October 2020
- Article
Task Selection and Workload: A Focus on Completing Easy Tasks Hurts Long-Term Performance
By: Diwas S. KC, Bradley R. Staats, Maryam Kouchaki and Francesca Gino
How individuals manage, organize, and complete their tasks is central to operations management. Recent research in operations focuses on how under conditions of increasing workload individuals can decrease their service time, up to a point, in order to complete work...
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Keywords:
Healthcare;
Knowledge Work;
Discretion;
Workload;
Employees;
Health Care and Treatment;
Decision Making;
Performance Effectiveness;
Performance Productivity
KC, Diwas S., Bradley R. Staats, Maryam Kouchaki, and Francesca Gino. "Task Selection and Workload: A Focus on Completing Easy Tasks Hurts Long-Term Performance." Management Science 66, no. 10 (October 2020).
- August 2020
- Article
Do Physician Incentives Increase Patient Medication Adherence?
By: Edward Kong, John Beshears, David Laibson, Brigitte Madrian, Kevin Volpp, George Loewenstein, Jonathan Kolstad and James J. Choi
We conducted a randomized experiment (911 primary care practices and 8,935 nonadherent patients) to test the effect of paying physicians for increasing patient medication adherence in three drug classes: diabetes medication, antihypertensives, and statins. We measured...
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Keywords:
Health Economics;
Medication Adherence;
Physician Payment Incentives;
Primary Care;
Quality Improvement;
Health Care and Treatment;
Motivation and Incentives;
Behavior
Kong, Edward, John Beshears, David Laibson, Brigitte Madrian, Kevin Volpp, George Loewenstein, Jonathan Kolstad, and James J. Choi. "Do Physician Incentives Increase Patient Medication Adherence?" Health Services Research 55, no. 4 (August 2020): 503–511.