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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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- 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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- 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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- 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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- 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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- 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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- 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
- 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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- 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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