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- October 2022
- Article
It’s Not Just the Prices: Time-Driven Activity-Based Costing for Initiation of Veno-Venous Extracorporeal Membrane Oxygenation at Three International Sites—A Case Review
By: Michael Nurok, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes and Robert S. Kaplan
The United States spends more for intensive care units (ICUs) than do other high-income countries. We used time-driven activity-based costing (TDABC) to analyze ICU costs for initiation of extracorporeal membrane oxygenation (ECMO) for respiratory failure to estimate...
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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...
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- August 3, 2022
- Article
How Will Amazon Approach U.S. Primary Care?
By: Robert S. Huckman and Bradley Staats
Amazon has a playbook for reinventing businesses that it enters. It includes simplifying processes, experimenting to determine which new approaches work best, and continuously recombining its existing assets to come up with a better way to do things. It is likely to...
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- April 2022
- Teaching Note
CVS Health: Prescription for Transformation
By: Rosabeth Moss Kanter and Catarina Martinez
In 2021, new CEO Karen Lynch (named the most powerful woman in business) considered the next transformation phase for CVS Health (a Fortune 5 corporate giant). The 2018 acquisition of Aetna insurance brought her to the company as part of its long evolution from a...
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Keywords:
Health;
COVID-19 Pandemic;
Primary Care;
Leadership;
Change Management;
Women Executives;
Retail;
Pharmacy;
Pharmacy Benefit Manager;
Clinical Trials;
Vaccination;
Acquisition;
Innovation and Invention;
Transformation;
Retail Industry;
Pharmaceutical Industry;
Health Industry;
United States
- February 8, 2022
- Article
Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions
By: Alan Yang, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson and Robert S. Kaplan
In 2017, patients made 145 million visits to emergency departments (EDs), generating $76.3 billion in charges. About a third of ED visits, however, were for conditions that were treatable in lower-resourced settings. We used time-driven activity-based costing (TDABC)...
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- 2022
- Working Paper
Understanding Rural Households' Time Use in a Developing Setting: Validating a Low-Cost Time Use Module
By: Erica M Field, Rohini Pande, Natalia Rigol, Simone G. Schaner, Elena M. Stacy and Charity M. Troyer Moore
Time use data facilitate deeper understanding of individual labor supply choices, especially for women, who are more likely to engage in unpaid care and home production. However, traditional time use data collection methods are time-consuming, expensive and susceptible...
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- November 2021 (Revised December 2021)
- Case
Praava Health: A New Model for Bangladesh
By: Michael Chu
Launched in Dhaka, Bangladesh, in 2018, Praava Health (‘Praava’) delivered high-quality in-clinic primary and specialist care, backed by its own high quality diagnostic laboratories, imaging and pharmacy. Praava was founder Sylvana Sinha’s response to what she saw as a...
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- 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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- Article
A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor's Appointment
By: Katherine L. Milkman, Mitesh S. Patel, Linnea Gandhi, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via...
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Keywords:
Vaccination;
COVID-19;
Nudge;
Influenza;
Field Experiment;
Health;
Communication Strategy;
Behavior
- 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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- 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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- February 2021 (Revised March 2022)
- Case
Marvin: A Personalized Telehealth Approach to Mental Health
By: Regina E. Herzlinger, Eshani Sharma, Andrew Nguyen, Thomas Arsenault, Carin-Isabel Knoop and Julia Kelley
More than one third of Americans were said to suffer some type of behavioral health ailment at some point in their lifetime, with many people requiring chronic therapy or intervention. Despite significant clinical needs, access to reliable treatment has been difficult...
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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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- September 17, 2020
- Article
Protecting Vulnerable Older Patients during the Pandemic
By: Umar Ikram, Susanna Gallani, Jose F. Figueroa and Thomas W. Feeley
Older people (70 years and older) with multiple chronic conditions have the highest risk of being hospitalized and dying from COVID-19. The recent COVID-19 pandemic has highlighted how a strong primary care system can play an important role in protecting this group of...
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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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- 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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- July 2019 (Revised May 2020)
- Supplement
Piramal e-Swasthya (C): A New Name, Bigger Scope, and Public-Private Partnerships
By: Rosabeth Moss Kanter and Joyce J. Kim
In 2010, Anand Piramal acquired the Health Management Research Institute (HMRI), a healthcare venture, and merged it with his original digital healthcare startup Piramal e-Swasthya (PeS), so that PeS became Piramal Swasthya. After acquiring HMRI, Piramal Swasthya...
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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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