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    • All HBS Web  (189)
      • Faculty Publications  (51)

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      • September 2022
      • Article

      Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia

      By: Chen Wei, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak and Paul C. Zei
      Cardiac SBRT is a novel way of treating refractory ventricular tachycardia (VT) that may be less costly than catheter ablation, owing to its noninvasive, outpatient nature. We applied time-driven activity-based costing to both procedures. The direct and total...  View Details
      Keywords: Health Care and Treatment; Activity Based Costing and Management; Cost; Health Industry
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      Wei, Chen, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak, and Paul C. Zei. "Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia." Pacing and Clinical Electrophysiology 45, no. 9 (September 2022): 1005–1179.
      • August 2022
      • Article

      Trends in Remote Patient Monitoring Use in Traditional Medicare

      By: Mitchell Tang, Carter Nakamoto, Ariel Dora Stern and Ateev Mehrotra
      Remote patient monitoring (RPM), the collection by patients of physiological measurements that are automatically sent to their health care practitioners, has been touted as a promising tool for improving chronic disease management. Interest in RPM has grown because of...  View Details
      Keywords: Medicare; Remote Monitoring; Reimbursement; Health Care and Treatment; Health Industry
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      Tang, Mitchell, Carter Nakamoto, Ariel Dora Stern, and Ateev Mehrotra. "Trends in Remote Patient Monitoring Use in Traditional Medicare." JAMA Internal Medicine (August 2022).
      • Article

      Advancing Digital Health Applications: Priorities for Innovation in Real-World Evidence Generation

      By: Ariel Dora Stern, Jan Brönneke, Jörg F Debatin, Julia Hagen, Henrik Matthies, Smit Patel, Ieuan Clay, Bjoern Eskofier, Annika Herr, Kurt Hoeller, Ashley Jaksa, Daniel B Kramer, Mattias Kyhlstedt, Katherine T Lofgren, Nirosha Mahendraratnam, Holger Muehlan, Simon Reif, Lars Riedemann and Jennifer C Goldsack
      In 2019, Germany passed the Digital Healthcare Act, which, among other things, created a “Fast-Track” regulatory and reimbursement pathway for digital health applications in the German market. The pathway explicitly provides for flexibility in how researchers can...  View Details
      Keywords: Digital Health; Health Care and Treatment; Technological Innovation
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      Stern, Ariel Dora, Jan Brönneke, Jörg F Debatin, Julia Hagen, Henrik Matthies, Smit Patel, Ieuan Clay, Bjoern Eskofier, Annika Herr, Kurt Hoeller, Ashley Jaksa, Daniel B Kramer, Mattias Kyhlstedt, Katherine T Lofgren, Nirosha Mahendraratnam, Holger Muehlan, Simon Reif, Lars Riedemann, and Jennifer C Goldsack. "Advancing Digital Health Applications: Priorities for Innovation in Real-World Evidence Generation." Lancet Digital Health 4, no. 3 (March 2022): e200–e206.
      • March 2022
      • Article

      Assessing the Impact of the COVID-19 Pandemic on Clinician Ambulatory Electronic Health Record Use

      By: A Jay Holmgren, Lance Downing, Mitchell Tang, Christopher Sharp, Christopher Longhurst and Robert S. Huckman
      Objective: The COVID-19 pandemic changed clinician electronic health record (EHR) work in a multitude of ways. To evaluate how, we measure ambulatory clinician EHR use in the United States throughout the COVID-19 pandemic.

      Materials and Methods: We use EHR...  View Details
      Keywords: Health Care; Electronic Health Records; Productivity; COVID-19 Pandemic; Health Care and Treatment; Health Pandemics; Information Technology; Performance Productivity; United States
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      Holmgren, A Jay, Lance Downing, Mitchell Tang, Christopher Sharp, Christopher Longhurst, and Robert S. Huckman. "Assessing the Impact of the COVID-19 Pandemic on Clinician Ambulatory Electronic Health Record Use." Journal of the American Medical Informatics Association 29, no. 3 (March 2022): 453–460.
      • Article

      Costs Without Value When Treating Pediatric Behavioral Patients in the ED

      By: Marcella Jewell, Syed S. Shehab, Robert S. Kaplan, Jack Fanton and Joeli Hettler
      Pediatric Emergency Department (ED) visits have greatly increased in recent years. An academic pediatric ED that annually treats about 1,000 behavioral health patients conducted a study to assess the true cost of caring for nonacute behavioral health patients. It...  View Details
      Keywords: Costs; Value; Healthcare; Health Care and Treatment; Cost Management
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      Jewell, Marcella, Syed S. Shehab, Robert S. Kaplan, Jack Fanton, and Joeli Hettler. "Costs Without Value When Treating Pediatric Behavioral Patients in the ED." NEJM Catalyst Innovations in Care Delivery 3, no. 2 (February 2022).
      • 2022
      • Working Paper

      The Impact of Campaign Finance Rules on Candidate Selection and Electoral Outcomes: Evidence from France

      By: Nikolaj Broberg, Vincent Pons and Clémence Tricaud
      This paper investigates the effects of campaign finance rules on electoral outcomes. In French departmental and municipal elections, candidates competing in districts above 9,000 inhabitants face spending limits and are eligible for public reimbursement if they obtain...  View Details
      Keywords: Political Elections; Finance; Governing Rules, Regulations, and Reforms; Outcome or Result; France
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      Broberg, Nikolaj, Vincent Pons, and Clémence Tricaud. "The Impact of Campaign Finance Rules on Candidate Selection and Electoral Outcomes: Evidence from France." NBER Working Paper Series, No. 29805, February 2022.
      • 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...  View Details
      Keywords: Ambulatory Care; Payment Policy; Health Care and Treatment; Governing Rules, Regulations, and Reforms
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      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

      Which Markets (Don't) Drive Pharmaceutical Innovation? Evidence From U.S. Medicaid Expansions

      By: Craig Garthwaite, Rebecca Sachs and Ariel Dora Stern
      Pharmaceutical innovation policy involves managing a tradeoff between high prices for new products in the short-term and stronger incentives to develop products for the future. Prior research has documented a causal relationship between market size and pharmaceutical...  View Details
      Keywords: Pharmaceuticals; Medicaid; Innovation and Invention; Policy; Markets; Research and Development; Pharmaceutical Industry
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      Garthwaite, Craig, Rebecca Sachs, and Ariel Dora Stern. "Which Markets (Don't) Drive Pharmaceutical Innovation? Evidence From U.S. Medicaid Expansions." NBER Working Paper Series, No. 28755, May 2021.
      • 2020
      • Working Paper

      Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities

      By: David Cutler, Leemore S. Dafny, David Grabowski, Steven S. Lee and Christopher Ody
      The landscape of the U.S. healthcare industry is changing dramatically as healthcare providers expand both within and across markets. While federal antitrust agencies have mounted several challenges to same-market combinations, they have not challenged any...  View Details
      Keywords: Antitrust; Health Care and Treatment; Vertical Integration; Organizational Structure; Competition; Health Industry; United States
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      Cutler, David, Leemore S. Dafny, David Grabowski, Steven S. Lee, and Christopher Ody. "Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities." NBER Working Paper Series, No. 28305, December 2020.
      • 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...  View Details
      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
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      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.)
      • September 8, 2020
      • Article

      Allocation of COVID-19 Relief Funding to Disproportionately Black Counties

      By: Pragya Kakani, Amitabh Chandra and Sendhil Mullainathan
      This study describes correlations between the dollar amount of relief funding authorized by the US Congress to fund prevention, diagnosis, and treatment of coronavirus disease 2019 (COVID-19) and to reimburse health care entities for lost revenues, and county-level...  View Details
      Keywords: COVID-19; Health Pandemics; Resource Allocation; Demographics; Race
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      Kakani, Pragya, Amitabh Chandra, and Sendhil Mullainathan. "Allocation of COVID-19 Relief Funding to Disproportionately Black Counties." JAMA, the Journal of the American Medical Association 324, no. 10 (September 8, 2020): 1000–1003.
      • Article

      Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries

      By: Sara Gerke, Ariel D. Stern and Timo Minssen
      Reimbursement is a key challenge for many new digital health solutions, whose importance and value have been highlighted and expanded by the current COVID-19 pandemic. Germany’s new Digital Healthcare Act (Digitale–Versorgung–Gesetz or DVG) entitles all individuals...  View Details
      Keywords: COVID-19; Reimbursement; Digital Health Reforms; Health Pandemics; Health Care and Treatment; Internet and the Web; Governing Rules, Regulations, and Reforms; Germany
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      Gerke, Sara, Ariel D. Stern, and Timo Minssen. "Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries." Art. 94. npj Digital Medicine 3 (2020).
      • June 30, 2020
      • Article

      Bipartisan Tax-Free Solution to Health Care Financing: Coupling HRAs With a Public Option

      By: Regina E. Herzlinger, Richard Boxer and James Wallace
      A combination of health insurance initiatives by the presumptive 2020 Democratic and Republican presidential nominees could expand health care coverage and significantly reduce costs, without raising taxes. Along the way, the combination could revitalize private...  View Details
      Keywords: Health Care Financing; Public Option; Health Reimbursement Arrangement (HRA); Health Care and Treatment; Insurance; Cost Management
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      Herzlinger, Regina E., Richard Boxer, and James Wallace. "Bipartisan Tax-Free Solution to Health Care Financing: Coupling HRAs With a Public Option." Health Affairs Blog (June 30, 2020).
      • May–June 2020
      • Article

      The Agenda for the Next Generation of Health Care Information Technology

      By: Thomas W. Feeley, Zachary Landman and Michael E. Porter
      As the diffusion of value-based health care efforts accelerates globally, the need for interoperable information technology systems that support value-based care is essential. Such systems are needed to facilitate dramatic improvements in patient outcomes and...  View Details
      Keywords: Value-based Health Care; Health Care and Treatment; Information Technology; Integration; Performance Improvement; Performance Efficiency
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      Feeley, Thomas W., Zachary Landman, and Michael E. Porter. "The Agenda for the Next Generation of Health Care Information Technology." NEJM Catalyst Innovations in Care Delivery 1, no. 3 (May–June 2020).
      • 2019
      • Working Paper

      Thinking Outside the Box (12): The Benefits of Increased Transparency in Employer-Sponsored Health Insurance for the 180 Million Insured

      By: Regina E. Herzlinger and Barak D. Richman
      Economists have long noted that the tax exclusion of employer-sponsored insurance (ESI) caused workers to purchase health plans that differ in price and other characteristics from those they would otherwise choose for themselves. We explore the short-term and long-term...  View Details
      Keywords: After-tax Income; Consumer-driven Health Care; Health Care Costs; Health Insurance; Income Inequality; Tax Policy; Health Care and Treatment; Cost; Insurance; Income; Equality and Inequality; Taxation; Policy; United States
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      Herzlinger, Regina E., and Barak D. Richman. "Thinking Outside the Box (12): The Benefits of Increased Transparency in Employer-Sponsored Health Insurance for the 180 Million Insured." Duke Law School Public Law & Legal Theory Series, No. 2020-4, December 2019.
      • Article

      Mandate Outcomes Reporting

      By: Robert S. Kaplan and Michael E. Porter
      Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to...  View Details
      Keywords: Outcomes Reporting; Outcomes Measurement; Medicare; Medicaid; Health Care and Treatment; Outcome or Result; Measurement and Metrics
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      Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
      • 2019
      • Chapter

      Characterizing the Drug Development Pipeline for Precision Medicines

      By: Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern
      BOOK ABSTRACT: Personalized and precision medicine (PPM)—the targeting of therapies according to an individual’s genetic, environmental, or lifestyle characteristics—is becoming an increasingly important approach in health care treatment and prevention. The advancement...  View Details
      Keywords: Healthcare; Precision Medicine
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      Chandra, Amitabh, Craig Garthwaite, and Ariel Dora Stern. "Characterizing the Drug Development Pipeline for Precision Medicines." Chap. 5 in Economic Dimensions of Personalized and Precision Medicine, edited by Ernest R. Berndt, Dana P. Goldman, and John W. Rowe, 115–158. University of Chicago Press, 2019.
      • Article

      Operational Efficiency and Effective Management in the Catheterization Laboratory

      By: Grant W. Reed, Michael L. Tushman and Samir R. Kapadia
      Operational efficiency is a core business principle in which organizations strive to deliver high-quality goods or services in a cost-effective manner. This concept has become increasingly relevant to cardiac catheterization laboratories, as insurers move away from...  View Details
      Keywords: Cath Lab; Catheterization Laboratory; Health Care and Treatment; Performance Efficiency; Management; Performance Productivity; Cost Management; Health Industry
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      Reed, Grant W., Michael L. Tushman, and Samir R. Kapadia. "Operational Efficiency and Effective Management in the Catheterization Laboratory." Journal of the American College of Cardiology 72, no. 20 (November 20, 2018): 2507–2517.
      • May 2018 (Revised October 2020)
      • Supplement

      La Ribera Health Department (B): Epilogue

      By: Regina E. Herzlinger, Emer Moloney and Daniela Beyersdorfer
      The La Ribera case studies depict an innovative low cost/high quality privately financed hospital model struggling to achieve alignment with the Six Factors. It is reimbursed by the public sector in a Spanish environment whose Consumers, Structure, and Public Policy...  View Details
      Keywords: Trends And Opportunities; Government; Government Programs; Acquisition; Business Model; Business Plan; Trends; Opportunities; Government and Politics; Programs; Health Care and Treatment; Situation or Environment; Health Industry; Insurance Industry; Technology Industry; Spain
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      Herzlinger, Regina E., Emer Moloney, and Daniela Beyersdorfer. "La Ribera Health Department (B): Epilogue." Harvard Business School Supplement 318-134, May 2018. (Revised October 2020.)
      • August 2017
      • Case

      RoboTech: Storming into the U.S. Market

      By: Christopher A. Bartlett, Rachel Gordon and John J. Lafkas
      This case describes the challenges facing the CEO of a small, Singapore-based industrial robotics company that decides to diversify away from its core industrial robot business by leveraging its expertise into the medical-devices industry. It launches an innovative...  View Details
      Keywords: Market Entry and Exit; Diversification; Product Launch; Competitive Strategy; Globalized Firms and Management; Medical Devices and Supplies Industry; Technology Industry; Singapore; United States
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      Bartlett, Christopher A., Rachel Gordon, and John J. Lafkas. "RoboTech: Storming into the U.S. Market." Harvard Business School Brief Case 918-501, August 2017.
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