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- March 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 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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Keywords:
Hospital Capacity;
Access To Care;
Health Pandemics;
Health Care and Treatment;
Performance Capacity;
Planning
Herzlinger, Regina E. "Hospital Capacity Shortages: An SEC-Backed Transparency “PULL” Will Open Beds Faster Than a “PUSH” by HHS." Healthcare Business Today (March 5, 2022).
- 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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Keywords:
Time-Driven ABC;
Health Care Costs;
Activity Based Costing and Management;
Health Care and Treatment
Yang, Alan, Andy Hung-Yi Lee, Joseph W. Kopp, Katherine D. Rose, Adam M. Licurse, Philip D. Anderson, and Robert S. Kaplan. "Time-Driven Activity-Based Cost Comparison of Treating Five Acute, Low-Severity Conditions." NEJM Catalyst (February 8, 2022).
- 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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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).
- 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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Keywords:
Business Startups;
Disruption;
Entrepreneurship;
Health;
Health Care and Treatment;
Health Disorders;
Medical Specialties;
Innovation and Invention;
Disruptive Innovation;
Management;
Strategy;
Business Strategy;
Value;
Value Creation;
Health Industry;
United States;
Virginia
Stern, Ariel D., Robert S. Huckman, and Sarah Mehta. "Somatus: Value-Based Kidney Care (B)." Harvard Business School Supplement 622-045, January 2022.
- 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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Keywords:
Business Startups;
Disruption;
Entrepreneurship;
Health;
Health Care and Treatment;
Health Disorders;
Medical Specialties;
Innovation and Invention;
Disruptive Innovation;
Management;
Strategy;
Business Strategy;
Value;
Value Creation;
Health Industry;
United States;
Virginia
Stern, Ariel D., Robert S. Huckman, and Sarah Mehta. "Somatus: Value-Based Kidney Care (A)." Harvard Business School Case 622-009, January 2022.
- 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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Keywords:
Brachytherapy;
Quality Improvement;
Prostate;
Time-Driven Activity-Based Costing;
Cost Accounting;
Health Care and Treatment;
Performance Efficiency;
Health Industry
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.
- 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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Kaplan, Robert S., Paul R. Schaettle, Vivian S. Lee, Michael D. Parkinson, Gregory H. Gorman, and Michael-Anne Browne. "Mobilizing the U.S. Military’s TRICARE Program for Value-Based Care: A Report From the Defense Health Board." Military Medicine 187, nos. 1-2 (January–February 2022): 12–16.
- 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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Keywords:
Time-Driven Activity-Based Costing;
Implementation;
Health Care and Treatment;
Activity Based Costing and Management
Gallani, Susanna, and Gregory Sabin. "Successfully Implementing TDABC in Health-Care Provider Organizations." Cost Management 35, no. 6 (November–December 2021): 29–33. (Commissioned Article.)
- 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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Keywords:
Value-based Health Care;
Collaboration;
Healthcare Administration;
Health Care and Treatment;
Management;
Strategy;
Value Creation
Nurok, Michael, Thoralf Sundt, Robert S. Kaplan, and Bruce Gewertz. "Surgeons and Administrators Co-Creating Value." Annals of Surgery 274, no. 6 (December 2021).
- 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
Keywords:
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Cost;
Activity Based Costing and Management
McClintock, Tyler R., 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. "Determining Variable Costs in the Acute Urolithiasis Cycle of Care Through Time-driven Activity-based Costing." Urology 157 (November 2021): 107–113.
- 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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Keywords:
COVID-19 Pandemic;
Value-based Health Care;
Value Chain;
Health Pandemics;
Health Care and Treatment;
Management;
Strategy
Porter, Michael E., Junaid Nabi, and Thomas H. Lee. "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." DOI: 10.1056/CAT.21.0302. NEJM Catalyst (October 26, 2021).
- Article
Supporting Value-Based Health Care—Aligning Financial and Legal Accountability
By: Mark M. Zaki, Anupam B. Jena and Amitabh Chandra
U.S. health care payment and delivery-system reforms have focused on improving care by making organizations accountable for outcomes, quality, and costs. Payers have supported the implementation of accountable care organizations (ACOs), bundled-payment models, and...
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Zaki, Mark M., Anupam B. Jena, and Amitabh Chandra. "Supporting Value-Based Health Care—Aligning Financial and Legal Accountability." New England Journal of Medicine 385, no. 11 (September 9, 2021): 965–967.
- Article
Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected
By: Maximilian J. Pany, Michael E. Chernew and Leemore S. Dafny
Concern about high hospital prices for commercially insured patients has motivated several proposals to regulate these prices. Such proposals often limit regulations to highly concentrated hospital markets. Using a large sample of 2017 US commercial insurance claims,...
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Keywords:
Health Care Providers;
Hospitals;
Insurance Market Regulation;
Price Regulation;
Markets;
Health Care and Treatment;
Cost;
Quality;
Insurance;
Price;
Governing Rules, Regulations, and Reforms
Pany, Maximilian J., Michael E. Chernew, and Leemore S. Dafny. "Regulating Hospital Prices Based on Market Concentration Is Likely to Leave High-Price Hospitals Unaffected." Health Affairs 40, no. 9 (September 2021): 1386–1394.
- 2021
- Working Paper
The Impact of Financial Assistance Programs on Health Care Utilization
By: Alyce S. Adams, Raymond Kluender, Neale Mahoney, Jinglin Wang, Francis Wong and Wesley Yin
Most hospitals and managed care organizations have financial assistance programs that aim to reduce financial burdens and improve health care access for low-income patients. We use administrative data from Kaiser Permanente to study the effects of financial assistance...
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Keywords:
Healthcare;
Utilization;
Financial Assistance;
Health Care and Treatment;
Finance;
Programs;
Outcome or Result
Adams, Alyce S., Raymond Kluender, Neale Mahoney, Jinglin Wang, Francis Wong, and Wesley Yin. "The Impact of Financial Assistance Programs on Health Care Utilization." Harvard Business School Working Paper, No. 22-045, September 2021. (NBER Working Paper Series, No. 29227, September 2021.)
- August 2021
- Case
Yummy: Delivering Value to Venezuela
By: Ayelet Israeli, Jenyfeer Martinez Buitrago and Carla Larangeira
By June 2021, Yummy had become Venezuela’s first and largest food delivery app and last-mile logistics company. In Caracas, the nation’s capital, Yummy held a 55% market share, while operations in other cities had already started to take place, including in three of...
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Keywords:
Internet and the Web;
Health Pandemics;
Business Startups;
Growth and Development Strategy;
Expansion
Israeli, Ayelet, Jenyfeer Martinez Buitrago, and Carla Larangeira. "Yummy: Delivering Value to Venezuela." Harvard Business School Case 522-034, August 2021.
- July 2021 (Revised October 2021)
- Case
Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care
By: Robert S. Kaplan, Navraj S. Nagra and Syed S. Shehab
Dr. Andrea Pusic, breast cancer reconstruction surgeon, wants to extend outcomes measurement beyond traditional surgical metrics of infections, complications, and survival rates. The case describes her development of a new mobile phone app, which collects patients’...
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- July 2021
- Article
Medical Debt in the U.S., 2009–2020
By: Ray Kluender, Neale Mahoney, Francis Wong and Wesley Yin
Importance: Medical debt is an increasing concern in the US, yet there is limited understanding of the amount and distribution of medical debt, and its association with health care policies.
Objective: To measure the amount of medical debt nationally and by... View Details
Objective: To measure the amount of medical debt nationally and by... View Details
Kluender, Ray, Neale Mahoney, Francis Wong, and Wesley Yin. "Medical Debt in the U.S., 2009–2020." JAMA, the Journal of the American Medical Association 326, no. 3 (July 2021): 250–256.
- Article
Regulatory, Legal, and Market Aspects of Smart Wearables for Cardiac Monitoring
By: Jan Benedikt Brönneke, Jennifer Müller, Konstantinos Mouratis, Julia Hagen and Ariel Dora Stern
In the area of cardiac monitoring, the use of digitally driven technologies is on the rise. While the development of medical products is advancing rapidly, allowing for new use-cases in cardiac monitoring and other areas, regulatory and legal requirements that govern...
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Keywords:
Wearables;
Regulatory Changes;
Medical Technology;
Medical Devices;
Market Access;
Market Entry and Exit;
Information Technology;
Health Care and Treatment;
Governing Rules, Regulations, and Reforms;
United States;
Germany;
Belgium
Brönneke, Jan Benedikt, Jennifer Müller, Konstantinos Mouratis, Julia Hagen, and Ariel Dora Stern. "Regulatory, Legal, and Market Aspects of Smart Wearables for Cardiac Monitoring." Sensors 21, no. 14 (July 2021).
- June 2021
- Article
Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative
By: Casey J. Allen, Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala and Matthew H.G. Katz
We used national administrative data to assess multiple domains of value associated with enhanced recovery pathways for patients undergoing pancreatic surgery. Value metrics included in-hospital mortality, complication rates, length of stay (LOS), 30-day readmission...
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Keywords:
Value-based Health Care;
Health Care and Treatment;
Analytics and Data Science;
Outcome or Result;
Measurement and Metrics;
Performance Improvement
Allen, Casey J., Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala, and Matthew H.G. Katz. "Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative." Journal of Surgical Research 262 (June 2021): 115–120.