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- September 2020
- Case
Walmart Health: Scaling During a Pandemic
By: Robert S. Huckman, Yoonjin Min and Marissa Thiel
Amidst the onset of COVID-19 pandemic in the United States, Marcus Obsborne, Vice President for Health and Wellness Transformation at Walmart was planning to scale its new health care clinic business, Walmart Health, to additional locations in Georgia and beyond....
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- 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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- June 2020
- Article
Overcoming Barriers to Early Disease Intervention
By: H. Hugo Caicedo, Daniel A. Hashimoto, Julio C. Caicedo, Alex Pentland and Gary P. Pisano
It is widely acknowledged that earlier intervention in many disease processes leads to better patient outcomes and lower treatment costs. To date, most efforts at early disease intervention have focused on "primary prevention" which focuses on preventing diseases in...
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- May 21, 2020
- Editorial
Primary Care Is Hurting: Why Aren't Private Insurers Pitching In?
By: Leemore S. Dafny and J. Michael McWilliams
Primary care clinicians are the front line for patients with suspected infection. We rely on them to diagnose, triage, and manage patients with potential or confirmed COVID infections. They are also responsible for keeping non-COVID medical conditions under control...
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- Article
Cybersecurity Features of Digital Medical Devices: An Analysis of FDA Product Summaries
By: Ariel Dora Stern, William J. Gordon, Adam B. Landman and Daniel B. Kramer
Objectives:
To more clearly define the landscape of digital medical devices subject to U.S. Food and Drug Administration (FDA) oversight, this analysis leverages publicly available regulatory documents to characterise the prevalence and trends of software and... View Details
To more clearly define the landscape of digital medical devices subject to U.S. Food and Drug Administration (FDA) oversight, this analysis leverages publicly available regulatory documents to characterise the prevalence and trends of software and... View Details
- 2019
- Book
Patient Capital: The Challenges and Promises of Long-Term Investing
By: Victoria Ivashina and Josh Lerner
There has never been a greater need for long-term investments. And it is increasingly unlikely that the public sector will be willing or able to fill the gap. Those best positioned to address the long-run needs are likely to be the pools of capital in the hands of...
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- 2019
- Article
Time-Driven Activity-Based Cost Analysis for Outpatient Anticoagulation Therapy: Direct Costs in a Primary Care Setting with Optimal Performance
By: Robert S. Kaplan, Rohit A. Bobade, Richard A. Helmers, Thomas M. Jaeger, Laura J. Odell and Derek A. Haas
Objectives: To determine how overall cost of anticoagulation therapy for warfarin compares with that of Novel Oral Anticoagulants (NOACs). Also, to demonstrate a scientific, comprehensive, and an analytical approach to estimate direct costs involved in monitoring and...
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- November 8, 2018
- Article
Transitioning Payment Models: Fee-for-Service to Value-Based Care
By: Thomas W. Feeley and Namita Seth Mohta
In a survey of the NEJM Catalyst Insights Council in July 2018, 42% of respondents say they think value-based reimbursement models will be the primary revenue model for U.S. health care. Indeed, this transition is already happening. Respondents report that a quarter of...
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- Article
Financial Analysis of Pediatric Resident Physician Primary Care Longitudinal Outpatient Experience
By: Robert S. Kaplan, Carole H. Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Vivian S. Lee and Edward B. Clark
Objective
To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in an outpatient primary care practice with or... View Details
To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in an outpatient primary care practice with or... View Details
- June 2018
- Supplement
Amil and the Health Care System in Brazil (B)
By: Regina Herzlinger, Ana Maria Malik, Ruth Costas and Priscilla Zogbi
Brazilian Managed Care Organization Amil faces a series of challenges while trying to redefine the terms of its relationship with hospitals and clinics and to implement a new health care model based on primary care and family medicine.
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- June 27, 2018
- Article
Leveraging IPU Principles in Primary Care
By: N. Jain, T.W. Feeley, K. Meisinger and T. Okanlawon
- May 2018
- Case
Kaiser Permanente Colorado: Primary Care Plus
By: Robert S. Kaplan and Mahek A. Shah
A geriatrician in Kaiser Permanente’s Colorado region is concerned with the high and growing cost of treating the elderly population. She introduces a new care model, Primary Care Plus, using an interdisciplinary team of a primary care doctor, palliative care...
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- March 2018
- Teaching Note
Twine Health
By: Robert S. Huckman and Ariel D. Stern
In late 2014, Dr. John Moore (CEO), Frank Moss (chairman), and Scott Gilroy (CTO) of Twine Health (Twine) had to resolve several challenges that threatened to restrict the widespread dissemination of its sole product, Twine. Twine was a cloud-based platform that...
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- 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...
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- February 2018
- Article
Development and Feasibility of Bundled Payments for the Multidisciplinary Treatment of Head and Neck Cancer: A Pilot Program
By: Tracy Spinks, Alexis Guzman, Beth M. Beadle, Seohyun Lee, Ron Walters, Jim Incalcaterra, Ehab Hanna, Amy Hessel, Randal Weber, Sandra Denney, Lee Newcomer and Thomas W. Feeley
Purpose:
Despite growing interest in bundled payments to reduce the costs of care, this payment method remains largely untested in cancer. This 3-year pilot tested the feasibility of a 1-year bundled payment for the multidisciplinary treatment of head and neck...
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- January 2018
- Case
Partners In Health: Costing Primary Care in Haiti
By: Robert S. Kaplan and Mahek A. Shah
Partners in Health, a global NGO focused on delivering health care to residents of rural underserved communities, conducts a project on the cost of primary care at five sites in the Central Highlands of Haiti. It devises a simple approach for tracking the resources...
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- December 2017 (Revised April 2018)
- Case
The Children's Hospital of Philadelphia: Network Strategy 2016
By: Michael E. Porter, Thomas W. Feeley and Toyin J. Okanlawon
Children’s Hospital of Philadelphia (CHOP) began as a stand-alone hospital in the heart of downtown Philadelphia in 1855. By 2016 the CHOP Care Network stretched across Pennsylvania, New Jersey, and the New York metropolitan area, providing a wide range of services...
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- March 2017
- Article
Variation in the Cost of Care for Primary Total Knee Arthroplasties
By: Derek A. Haas and Robert S. Kaplan
The study examined the cost variation across 29 high-volume U.S. hospitals for delivering a primary total knee arthroplasty without major complicating conditions. Hospital and physician personnel costs were calculated using time-driven activity-based costing....
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- February 2017 (Revised April 2018)
- Case
Oak Street Health: A New Model of Primary Care
By: Michael E. Porter, Thomas H. Lee and Meredith A. Alger
- Article
Drivers of the Variation in Prosthetic Implant Purchase Prices for Total Knee and Total Hip Arthroplasties
By: Derek A. Haas, Kevin J Bozic, Anthony M. DiGioia, Zirui Song and Robert S. Kaplan
Previous studies have documented wide variation in health-care spending and prices; however, the causes for the variation in supply purchase prices across providers are not well understood. The purpose of this study was to determine the drivers of variation in...
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