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- 2022
- Working Paper
Post-market Surveillance of Software Medical Devices: Evidence from Regulatory Data
By: Alexander O. Everhart and Ariel D. Stern
Medical devices increasingly include software components, which facilitate remote patient monitoring. The introduction of software into previously analog medical devices as well as innovation in software-driven devices may introduce new safety concerns—all the more so...
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- December 2022
- Article
Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition
By: Anna Paula Beck da Silva Etges, Richard D. Urman, Anne Geubelle, Robert Kaplan and Carisi Anne Polanczyk
This communication announces the International Cost Standard Set Program. Its goal is to establish global standardized frameworks for measuring the costs of treating specific clinical conditions. A scientific committee, including 16 international healthcare cost...
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- November 2022
- Case
The Battle Among Channels for Marketing Pharmaceuticals: UpScript, Pharmacy Benefit Managers, and Direct-to-Consumer Sales
By: Regina E. Herzlinger and Tiffany Farrell
Can an online pharmacy both improve the quality and speed of care for patients who need branded drugs and stabilize profits for pharmaceutical manufacturers? UpScript, after years spent achieving legal and regulatory compliance and simultaneous technological innovation...
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- October 2022
- Case
Lyra Health: Transforming Mental Health
By: Rembrand Koning and Nicole Keller
In January 2022, Lyra Health was deciding between several different alternatives to grow the business. Founded in 2015, Lyra Health, was a digital mental health platform that combined technology with human therapists and coaches to deliver high quality mental health...
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- October 2022
- Case
mPharma: Scaling Access to Affordable Primary Care in Africa
By: Regina E. Herzlinger and Ben Creo
mPharma CEO Greg Rockson is attempting to create the largest pan-African primary healthcare company. He must evaluate a three-year strategy potentially involving three key components: a rapid and extensive expansion of the company's network of 600 retail pharmacies in...
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Keywords:
Africa;
Pharmaceutical Companies;
Pharmacy Benefit Manager;
Health Care;
Health Care And Treatment;
Health Care Costs;
Health Care Delivery;
Health Care Entrepreneurship;
Telehealth;
Health Equity;
Corporate Strategy;
Social Entrepreneurship;
Equity;
Growth and Development Strategy;
Expansion;
Product Launch;
Customer Value and Value Chain;
Social Enterprise;
Multinational Firms and Management;
Health Industry;
Health Industry;
Africa
- June 2022
- Article
A New Initiative to Track HIV Resource Allocation and Costs
By: 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, Joshua Musinguzi and Robert S. Kaplan
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: Michael Nurok, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes and Robert S. Kaplan
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: 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...
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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 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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