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- 2022
- Article
A New Initiative to Track HIV Resource Allocation and Costs
By: Robert S. Kaplan, Ryan McBain, AK Nandakumar, Michael Ruffner, Carlyn Mann, Mai Hijazi, Susanna Baker, Linden Morrison, Kalipso Chalkidou, Shufang Zhang, Iris Semini, Fern Terris-Prestholt, Steven Forsythe, Sarah Byakika and Joshua Musinguzi
In early 2020, several global health institutions – including the Global Fund to Fight AIDS, Tuberculosis and Malaria; Joint United Nations Program on HIV/AIDS (UNAIDS); United States Agency for International Development; and Office of the Global AIDS Coordinator at...
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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: Robert S. Kaplan, Michael Nurok, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab and Alain Combes
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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- September, 2022
- Article
Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia
By: Robert S. Kaplan, Chen Wei, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, 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...
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- September, 2022
- Article
The Impact of Financial Assistance Programs on Health Care Utilization: Evidence from Kaiser Permanente
By: Alyce S. Adams, Raymond Kluender, Neale Mahoney, Jinglin Wang, Francis Wong and Wesley Yin
Most hospitals have financial assistance programs for low-income patients. We use administrative data from Kaiser Permanente to study the effects of financial assistance on health care utilization. Using a regression discontinuity design based on an income threshold...
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- June 2022
- Teaching Plan
Lifebank Nigeria
By: Brian Trelstad, Pippa Tubman Armerding and Wale Lawal
The aspiration of addressing maternal deaths in Nigeria, which were mostly caused by blood shortages, led Temie Giwa-Tubosun to found LifeBank in 2015. LifeBank developed an online platform that enabled hospitals to connect and purchase blood from local blood banks and...
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- May 2022
- Article
Variance Analysis: New Insights from Health Care Applications
By: Robert S. Kaplan and Susanna Gallani
We use a health care application to illustrate how variance analysis can be used to benchmark costs across similar service delivery sites. Variances for personnel costs, typically the largest cost component in service organizations, are calculated for price, quantity,...
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- March 2022 (Revised August 2022)
- Case
DaVita Responds to COVID
By: Susanna Gallani and David Lane
Early in August 2021, DaVita CEO Javier Rodriguez was assessing the ongoing impact of the COVID-19 pandemic on his firm, which provided life-sustaining kidney dialysis to roughly 240,000 people. Effective infection control practices and information sharing had ensured...
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Keywords:
COVID-19 Pandemic;
Change Management;
Communication;
Talent and Talent Management;
Fairness;
Values and Beliefs;
Corporate Accountability;
Health Care and Treatment;
Health Pandemics;
Human Resources;
Employee Relationship Management;
Retention;
Wages;
Working Conditions;
Leadership Style;
Crisis Management;
Organizational Culture;
Health Industry;
United States
- March 2022
- Case
Natura: Weathering the Pandemic at Brazil's Cosmetic Giant
By: Brian Trelstad, Pedro Levindo and Carla Larangeira
Brazil's Natura, a purpose-driven, multi-brand cosmetics group, closed the acquisition of iconic rival Avon just before the COVID-19 pandemic hit. The deal more than doubled Natura's revenues to over $7 billion and cemented its position as Latin America's biggest...
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Keywords:
COVID-19 Pandemic;
ESG Reporting;
Acquisition;
Customer Focus and Relationships;
Decision Making;
Social Entrepreneurship;
Environmental Sustainability;
Environmental Management;
Climate Change;
Ethics;
Moral Sensibility;
Values and Beliefs;
Global Strategy;
Corporate Governance;
Health Pandemics;
Human Resources;
Human Capital;
Crisis Management;
Growth and Development Strategy;
Marketing;
Distribution Channels;
Supply Chain;
Corporate Social Responsibility and Impact;
Mission and Purpose;
Organizational Culture;
Customer Ownership;
Relationships;
Business and Community Relations;
Business and Stakeholder Relations;
Networks;
Partners and Partnerships;
Science-Based Business;
Reputation;
Human Needs;
Social Issues;
Strategy;
Equality and Inequality;
Beauty and Cosmetics Industry;
Brazil;
Latin America
- March 5, 2022
- Article
Hospital Capacity Shortages: An SEC-Backed Transparency “PULL” Will Open Beds Faster Than a “PUSH” by HHS
In the new normal of ongoing pandemics, hospital bed shortages will continue. Healthcare innovation expert and author of the upcoming book Innovating in Healthcare: Creating Breakthrough Services, Products, and Business Models (Wiley, 2023, 978-1119543008), HBS...
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- Article
A 680,000-Person Megastudy of Nudges to Encourage Vaccination in Pharmacies
By: Katherine L. Milkman, Linnea Gandhi, Mitesh S. Patel, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Jonathan E. Bogard, Ilana Brody, Christopher F. Chabris, Edward Chang, Gretchen B. Chapman, Jennifer E. Dannals, Noah J. Goldstein, Amir Goren, Hal Hershfield, Alex Hirsch, Jillian Hmurovic, Samantha Horn, Dean Karlan, Ariella S. Kristal, Cait Lamberton, Michael N. Meyer, Allison H. Oakes, Maurice E. Schweitzer, Maheen Shermohammed, Jaochim H. Talloen, Caleb Warren, Ashley Whillans, Kuldeep N. Yadav, Julian J. Zlatev, Ron Berman, Chalanda N. Evans, Rahul Ladhania, Jens Ludwig, Nina Mazar, Sendhil Mullainathan, Christopher K. Snider, Jann Spiess, Eli Tsukayama, Lyle Ungar, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
Encouraging vaccination is a pressing policy problem. To assess whether text-based reminders can encourage pharmacy vaccination and what kinds of messages work best, we conducted a megastudy. We randomly assigned 689,693 Walmart pharmacy patients to receive one of 22...
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- 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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- 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...
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- January 2022
- Supplement
Somatus: Value-Based Kidney Care (B)
By: Ariel D. Stern, Robert S. Huckman and Sarah Mehta
Set in early 2020, this (B) case provides an update to the (A) case (no. 622-009) and provides additional context regarding the challenges facing Somatus.
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- January 2022
- Case
Somatus: Value-Based Kidney Care (A)
By: Ariel D. Stern, Robert S. Huckman and Sarah Mehta
When Dr. Ikenna Okezie founded Somatus, a value-based kidney care provider, his goal had been nothing short of transforming kidney care delivery in the United States. Rather than relying on dialysis, a costly and intensive treatment for late-stage kidney disease, the...
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- 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,...
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- January–February 2022
- Article
Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board
By: Robert S. Kaplan, Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman and Michael-Anne Browne
The U.S. Military Health System spends about $50 billion annually through its TRICARE health plans to provide care to 9.6 million active duty service members, retirees, and their families. TRICARE, historically, has used the predominant U.S. fee-for-service payment...
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- November–December 2021
- Article
Successfully Implementing TDABC in Health-Care Provider Organizations
By: Susanna Gallani and Gregory Sabin
This article describes some of the common obstacles that challenge the success of TDABC implementation in health-care provider organizations and suggests potential remedies and preventive measures.
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- 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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- November 2021
- Article
Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing
By: Tyler R. McClintock, David F. Friedlander, Aiden Y. Feng, Mahek A. Shah, Daniel J. Pallin, Steven L. Chang, Angela M. Bader, Thomas W. Feeley, Robert S. Kaplan and George E. Haleblian
Objective. To characterize full cycle of care costs for managing an acute ureteral stone using time-driven activity-based costing.
Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
Methods. We defined all phases of care for patients presenting with an acute ureteral stone and built an... View Details
- October 26, 2021
- Article
Value Chain Management to Implement Post-COVID-19 Health Care Strategy: The COVID-19 Crisis Has Created Areas of Innovation That Should Be Embraced by Health Care Leaders
By: Michael E. Porter, Junaid Nabi and Thomas H. Lee
Health care organizations must learn from what has worked during the COVID-19 crisis. Leaders have found that while they cannot do everything, they must define and manage the sequence of activities required to deliver high-value care.
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