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      • October 2022
      • Article

      A Structural Model of Organizational Buying for Business-to-Business Markets: Innovation Adoption with Share-of-Wallet Contracts

      By: Navid Mojir and K. Sudhir
      The paper develops the first structural model of organizational buying to study innovation diffusion in a B2B market. Our model is particularly applicable for routinized exchange relationships, whereby centralized buyers periodically evaluate and choose contracts,...  View Details
      Keywords: Organizational Buying Behavior; Healthcare Marketing; B2B Markets; B2B Innovation; New Product Diffusion; New Product Adoption; Organizations; Acquisition; Behavior; Health Care and Treatment; Marketing; Innovation and Invention
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      Mojir, Navid, and K. Sudhir. "A Structural Model of Organizational Buying for Business-to-Business Markets: Innovation Adoption with Share-of-Wallet Contracts." Journal of Marketing Research (JMR) 59, no. 5 (October 2022): 883–907.
      • 2022
      • Article

      Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing

      By: Nikhil G. Thaker, Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley and Steven J. Frank
      Integrated quality improvement (QI) and cost reduction strategies can help increase value in cancer care. We applied standard QI and TDABC methods to improve workflow efficiency and reduce costs for MRI-guided prostate brachytherapy. We constructed process maps,...  View Details
      Keywords: Brachytherapy; Quality Improvement; Prostate; Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Performance Efficiency; Health Industry
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      Thaker, Nikhil G., Rajat J. Kudchadker, James R. Incalcaterra, Tharakeswara K. Bathala, Robert S. Kaplan, Ankit Agarwal, Deborah A. Kuban, Benjamin D. Frank, Prajnan Das, Thomas W. Feeley, and Steven J. Frank. "Improving Efficiency and Reducing Costs of MRI-Guided Prostate Brachytherapy Using Time-Driven Activity-Based Costing." Brachytherapy 21, no. 1 (2022): 49–54.
      • 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...  View Details
      Keywords: Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Health Industry; India; Nepal; United States
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      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).
      • 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

      Diagnosing Quality: Learning, Amenities, and the Demand for Health Care

      By: Achyuta Adhvaryu, Emilio Gutierrez, Anant Nyshadham and Jorge Tamayo
      We study the role of amenities in increasing demand for underutilized healthcare services. We evaluate the offer of a high-amenity diagnostic consultation for cataracts with a randomized price and find that a lower price for the high-amenity consultation increases...  View Details
      Keywords: Health Care Demand; Amenities; Health Care Quality; Cataracts; Surgery; Health Care and Treatment; Demand and Consumers; Quality; Learning; Mexico
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      Adhvaryu, Achyuta, Emilio Gutierrez, Anant Nyshadham, and Jorge Tamayo. "Diagnosing Quality: Learning, Amenities, and the Demand for Health Care." Harvard Business School Working Paper, No. 21-110, March 2021.
      • February 2021 (Revised June 2021)
      • Case

      Brainlab: Imaging a MedTech Future

      By: Regina E. Herzlinger, Gregory P. Licholai and Federica Gabrieli
      Can Brainlab, a privately held firm, compete with giants like Medtronic and Amazon in delivering the Digital Operating Room of the future? The CEO is pondering solutions for secure exchange of medical information, pricing a new robotic imaging device, and reorganizing...  View Details
      Keywords: Surgery; Robotics; Health Care; Private Healthcare; Pricing; Technology Platform; Acquisition; Business Growth and Maturation; Growth and Development Strategy; Business Strategy; Corporate Strategy; Corporate Entrepreneurship; Health Care and Treatment; Health; Innovation and Invention; Innovation and Management; Innovation Strategy; Technological Innovation; Applications and Software; Information Infrastructure; Information Technology; Digital Platforms; Health Industry; Europe; Germany; Munich
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      Herzlinger, Regina E., Gregory P. Licholai, and Federica Gabrieli. "Brainlab: Imaging a MedTech Future." Harvard Business School Case 321-087, February 2021. (Revised June 2021.)
      • February 2021
      • Case

      New England Baptist Hospital: Getting Paid for Value

      By: Robert S. Kaplan, Mary Witkowski, Toby E. Emanuel and Syed S. Shehab
      New England Baptist Hospital (NEBH), a national leader in adult orthopedic care, has the lowest rate of complications and 30-day readmissions in New England, but gets paid 30% less for its surgeries than nearby institutions. NEBH introduces, with several large...  View Details
      Keywords: Healthcare; Healthcare Spending; Healthcare Innovation; Healthcare Industry; Health Care Outcomes; Health Care Delivery; Health Care Reform; Bundled Payments; Health Care and Treatment; Spending; Innovation and Invention; Value Creation; Strategy; Health Industry; North America
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      Kaplan, Robert S., Mary Witkowski, Toby E. Emanuel, and Syed S. Shehab. "New England Baptist Hospital: Getting Paid for Value." Harvard Business School Case 121-036, February 2021.
      • December 2020 (Revised May 2021)
      • Supplement

      Tales of Life-changing Innovations: Minimally Invasive | Note on the Development of Laparoscopic Surgery (B) (2000-2005)

      By: Amar Bhidé, Srikant M. Datar and Caitlin Bowler
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      Bhidé, Amar, Srikant M. Datar, and Caitlin Bowler. "Tales of Life-changing Innovations: Minimally Invasive | Note on the Development of Laparoscopic Surgery (B) (2000-2005)." Harvard Business School Supplement 321-084, December 2020. (Revised May 2021.)
      • December 2020 (Revised May 2021)
      • Technical Note

      Tales of Life-changing Innovations: Minimally Invasive | Note on the Development of Laparoscopic Surgery (through the 1990s)

      By: Amar Bhidé, Srikant M. Datar and Caitlin Bowler
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      Bhidé, Amar, Srikant M. Datar, and Caitlin Bowler. "Tales of Life-changing Innovations: Minimally Invasive | Note on the Development of Laparoscopic Surgery (through the 1990s)." Harvard Business School Technical Note 321-060, December 2020. (Revised May 2021.)
      • Article

      Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?

      By: R. S. Kaplan, F. Erhun, V.G. Narayanan, B. Mistry and K. Brayton, et al
      We use time-driven activity-based costing to estimate the cost of personnel and space for an elective coronary artery bypass graft (CABG) surgery at two U.S. hospitals, Intermountain and Baylor Heart, and Narayana Health (NH), in India. All three hospitals use modern...  View Details
      Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Organizational Structure; Performance Efficiency; India; United States
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      Kaplan, R. S., F. Erhun, V.G. Narayanan, B. Mistry, and K. Brayton, et al. "Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?" American Heart Journal 224 (June 2020): 148–155.
      • 2021
      • Working Paper

      Gastrointestinal Endoscopy: Case Histories of Significant Medical Advances

      By: Amar Bhidé, Srikant M. Datar and Katherine Stebbins
      We describe how endoscopy transformed the diagnosis of ulcers, cancerous polyps and other diseases of the alimentary canal and enabled “minimally invasive” surgeries to treat such diseases. Specifically, we chronicle how: 1) flexible glass fiber instruments in the...  View Details
      Keywords: Health Care and Treatment; Technological Innovation; Innovation Strategy; Technology Adoption; Collaborative Innovation and Invention; Innovation and Invention; Governing Rules, Regulations, and Reforms
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      Bhidé, Amar, Srikant M. Datar, and Katherine Stebbins. "Gastrointestinal Endoscopy: Case Histories of Significant Medical Advances." Harvard Business School Working Paper, No. 20-005, July 2019. (Revised May 2021.)
      • 2021
      • Working Paper

      Laparoscopy: Case Histories of Significant Medical Advances

      By: Amar Bhidé, Caitlin N. Bowler and Srikant M. Datar
      We describe how operations through laparoscopes—tubular instruments inserted into abdominal cavities—revolutionized gynecological and other surgeries inside the abdomen such as gall bladder removal. Specifically, we chronicle the: 1) foundational technologies and...  View Details
      Keywords: Health Care and Treatment; Technological Innovation; Innovation Strategy; Technology Adoption; Collaborative Innovation and Invention; Innovation and Invention; Governing Rules, Regulations, and Reforms
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      Bhidé, Amar, Caitlin N. Bowler, and Srikant M. Datar. "Laparoscopy: Case Histories of Significant Medical Advances." Harvard Business School Working Paper, No. 20-008, July 2019. (Revised May 2021.)
      • Article

      Burnout in Surgery Viewed Through the Lens of Psychological Safety

      By: Robert A. Swendiman, Amy C. Edmondson and Najjia N. Mahmoud
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      Swendiman, Robert A., Amy C. Edmondson, and Najjia N. Mahmoud. "Burnout in Surgery Viewed Through the Lens of Psychological Safety." Annals of Surgery 269, no. 2 (February 2019): 234–235.
      • April 2017
      • Supplement

      Imprimis (B)

      By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel
      This case is a supplement to Imprimis (A). It describes the company’s decision to enter into the pharmaceutical compounding business in 2013–2014. Imprimis purchased a compounded ophthalmological medication called Dropless Therapy, which was injected into patients’...  View Details
      Keywords: Healthcare; Drug Compounding; Drug Development; Pharmaceuticals; Small Business; Decision-making, Business Model; Mark Baum; Imprimis; Decision Making; Strategy; Health Care and Treatment; Policy; Pharmaceutical Industry; United States
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      Casadesus-Masanell, Ramon, Karen Elterman, and Marc Appel. "Imprimis (B)." Harvard Business School Supplement 717-496, April 2017.
      • Article

      Time-Driven Activity-Based Costing for Surgical Episodes

      By: Peter Najjar, Matt Strickland and Robert S. Kaplan
      Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services...  View Details
      Keywords: Surgery; Time-Driven Activity-Based Costing; Bundled Payments; Health Care and Treatment; Cost Management
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      Najjar, Peter, Matt Strickland, and Robert S. Kaplan. "Time-Driven Activity-Based Costing for Surgical Episodes." JAMA Surgery 152, no. 1 (January 2017): 96–97.
      • June 2016
      • Article

      When Doctors Go to Business School: Career Choices of Physician-MBAs

      By: Damir Ljuboja, Brian W. Powers, Benjamin Robbins, Robert S. Huckman, Krishna Yeshwant and Sachin Jain
      There has been substantial growth in the number of physicians pursuing Master of Business Administration (MBA) degrees over the past decade, but there is continuing debate over the utility of these programs and the career outcomes of their graduates. The authors...  View Details
      Keywords: Medical Education; MD; MBA; Physicians; Executive Education; Training; Personal Development and Career; Health Care and Treatment; Health Industry; United States
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      Ljuboja, Damir, Brian W. Powers, Benjamin Robbins, Robert S. Huckman, Krishna Yeshwant, and Sachin Jain. "When Doctors Go to Business School: Career Choices of Physician-MBAs." American Journal of Managed Care 22, no. 6 (June 2016): e196–e198.
      • December 2015
      • Article

      Task Shifting in Surgery: Lessons from an Indian Heart Hospital

      By: Budhaditya Gupta, Robert S. Huckman and Tarun Khanna
      We present a case study that illustrates task shifting, the transfer of activities from senior to junior colleagues, in the context of cardiac surgery at the Narayana Health City Cardiac Hospital (NH) in India. The case discusses the factors driving the adoption of...  View Details
      Keywords: Service Delivery; Rank and Position; Health Care and Treatment; Health Industry; India
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      Gupta, Budhaditya, Robert S. Huckman, and Tarun Khanna. "Task Shifting in Surgery: Lessons from an Indian Heart Hospital." Healthcare: The Journal of Delivery Science and Innovation 3, no. 4 (December 2015): 245–250.
      • November 2015
      • Article

      Influence of Experience and the Surgical Learning Curve on Long-term Patient Outcomes in Cardiac Surgery

      By: Bryan M. Burt, Andrew W. ElBardissi, Robert S. Huckman, Lawrence H. Cohn, Marisa W. Cevasco, James D. Rawn, Sary F. Aranki and John G. Byrne
      OBJECTIVE: We hypothesized that increased post-graduate surgical experience correlates with improved operative efficiency and long-term survival in standard cardiac surgery procedures.

      METHODS: Utilizing a prospectively collected retrospective database,...  View Details
      Keywords: Service Delivery; Value; Health Care and Treatment; Experience and Expertise; Health Industry
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      Burt, Bryan M., Andrew W. ElBardissi, Robert S. Huckman, Lawrence H. Cohn, Marisa W. Cevasco, James D. Rawn, Sary F. Aranki, and John G. Byrne. "Influence of Experience and the Surgical Learning Curve on Long-term Patient Outcomes in Cardiac Surgery." Journal of Thoracic and Cardiovascular Surgery 150, no. 5 (November 2015): 1061–1067.
      • Article

      Time-driven Activity-based Costing of Multivessel Coronary Artery Bypass Grafting across National Boundaries to Identify Improvement Opportunities: Study Protocol

      By: F. Erhun, B. Mistry, T. Platcheck, A. Milstein, V.G. Narayanan and R. S. Kaplan
      Coronary artery bypass graft (CABG) surgery is a common treatment for coronary artery disease—a disease that affects over 10% of US adults and is a major cause of morbidity and mortality. In 2005, the mean cost for a CABG procedure among Medicare beneficiaries in the...  View Details
      Keywords: Activity Based Costing and Management; Health Disorders; Health Care and Treatment; United States; India
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      Erhun, F., B. Mistry, T. Platcheck, A. Milstein, V.G. Narayanan, and R. S. Kaplan. "Time-driven Activity-based Costing of Multivessel Coronary Artery Bypass Grafting across National Boundaries to Identify Improvement Opportunities: Study Protocol." BMJ Open 5, no. 8 (2015).
      • August 2014 (Revised February 2021)
      • Case

      Hospital for Special Surgery (A)

      By: Regina E. Herzlinger and Stacy Schwartz
      Hospital for Special Surgery, a focused factory for orthopedics and joint disease, is contemplating various growth options: further growth in the United Kingdom's National Health Services, management of hospitals in the United States, and/or hospital consulting....  View Details
      Keywords: Health Care and Treatment; Nonprofit Organizations; Growth and Development Strategy; Cross-Cultural and Cross-Border Issues; Expansion; Health Industry; United Kingdom; United States
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      Herzlinger, Regina E., and Stacy Schwartz. "Hospital for Special Surgery (A)." Harvard Business School Case 315-012, August 2014. (Revised February 2021.)
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