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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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Keywords:
Time-Driven Activity-Based Costing;
Value-based Health Care;
Cost;
Health Care and Treatment;
Activity Based Costing and Management;
Health Industry
da Silva Etges, Anna Paula Beck, Richard D. Urman, Anne Geubelle, Robert Kaplan, and Carisi Anne Polanczyk. "Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition." Journal of Comparative Effectiveness Research 11, no. 17 (December 2022): 1219–1223.
- 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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Wei, Chen, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak, and Paul C. Zei. "Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia." Pacing and Clinical Electrophysiology 45, no. 9 (September 2022): 1005–1179.
- Article
Advancing Digital Health Applications: Priorities for Innovation in Real-World Evidence Generation
By: Ariel Dora Stern, Jan Brönneke, Jörg F Debatin, Julia Hagen, Henrik Matthies, Smit Patel, Ieuan Clay, Bjoern Eskofier, Annika Herr, Kurt Hoeller, Ashley Jaksa, Daniel B Kramer, Mattias Kyhlstedt, Katherine T Lofgren, Nirosha Mahendraratnam, Holger Muehlan, Simon Reif, Lars Riedemann and Jennifer C Goldsack
In 2019, Germany passed the Digital Healthcare Act, which, among other things, created a “Fast-Track” regulatory and reimbursement pathway for digital health applications in the German market. The pathway explicitly provides for flexibility in how researchers can...
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Stern, Ariel Dora, Jan Brönneke, Jörg F Debatin, Julia Hagen, Henrik Matthies, Smit Patel, Ieuan Clay, Bjoern Eskofier, Annika Herr, Kurt Hoeller, Ashley Jaksa, Daniel B Kramer, Mattias Kyhlstedt, Katherine T Lofgren, Nirosha Mahendraratnam, Holger Muehlan, Simon Reif, Lars Riedemann, and Jennifer C Goldsack. "Advancing Digital Health Applications: Priorities for Innovation in Real-World Evidence Generation." Lancet Digital Health 4, no. 3 (March 2022): e200–e206.
- 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–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.
- 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).
- May 2021
- Article
Value-Based Healthcare in Urology: A Collaborative Review
By: Chanan Reitblat, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh and Boris Gershman
Context:
In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and... View Details
In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and... View Details
Keywords:
Value-based Healthcare;
Integrated Practice Units;
Outcome Measurement;
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Value;
Cost Management;
Strategy;
Outcome or Result;
Measurement and Metrics
Reitblat, Chanan, Paul A. Bain, Michael E. Porter, David N. Bernstein, Thomas W. Feeley, Markus Graefen, Santosh Iyer, Matthew J. Resnick, C.J. Stimson, Quoc-Dien Trinh, and Boris Gershman. "Value-Based Healthcare in Urology: A Collaborative Review." European Urology 79, no. 5 (May 2021): 571–585.
- April 2021
- Article
Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models
By: Susanna Gallani, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar and Frank Opelka
Modern medicine is undergoing a transformation that involves innovative surgical approaches, increased medical treatment options, clinical care pathways that require collaboration beyond hospital walls, and health data captured by electronic health records and other...
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Keywords:
Physician Compensation;
Surgeons;
Health Care and Treatment;
Business Model;
Compensation and Benefits
Gallani, Susanna, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar, and Frank Opelka. "Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models." Bulletin of the American College of Surgeons 106, no. 4 (April 2021): 33–39.
- January 2021
- Case
Value-Based Insurance Design at Onex
By: Joshua Schwartzstein, Amitabh Chandra and Amram Migdal
The operating executives of Health and Benefits for Onex Partners, Megan Jackson Frye and Sam Camens, faced a challenge: Healthcare costs for employees of Onex’s portfolio companies were continuing to rise above the consumer price index, reflecting broader trends...
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Keywords:
Decision Making;
Cost vs Benefits;
Decision Choices and Conditions;
Decisions;
Finance;
Behavioral Finance;
Insurance;
Health;
Health Care and Treatment;
Human Resources;
Compensation and Benefits;
Markets;
Demand and Consumers;
Consumer Behavior;
Social Psychology;
Behavior;
Interests;
Motivation and Incentives;
Perception;
Health Industry;
Insurance Industry;
North America;
United States
Schwartzstein, Joshua, Amitabh Chandra, and Amram Migdal. "Value-Based Insurance Design at Onex." Harvard Business School Case 921-023, January 2021.
- 2020
- Working Paper
Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities
By: David Cutler, Leemore S. Dafny, David Grabowski, Steven S. Lee and Christopher Ody
The landscape of the U.S. healthcare industry is changing dramatically as healthcare providers expand both within and across markets. While federal antitrust agencies have mounted several challenges to same-market combinations, they have not challenged any...
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Keywords:
Antitrust;
Health Care and Treatment;
Vertical Integration;
Organizational Structure;
Competition;
Health Industry;
United States
Cutler, David, Leemore S. Dafny, David Grabowski, Steven S. Lee, and Christopher Ody. "Vertical Integration of Healthcare Providers Increases Self-Referrals and Can Reduce Downstream Competition: The Case of Hospital-Owned Skilled Nursing Facilities." NBER Working Paper Series, No. 28305, December 2020.
- November 2020 (Revised April 2021)
- Case
Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care
By: Trevor Fetter and Kira Seiger
This case describes the increasing investment by private equity (PE) firms in patient care and other healthcare services. The case focuses on investments in physician staffing firms and roll-up strategy investments in physician practice management (PPM). Included in...
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Keywords:
Business Ventures;
Acquisition;
Mergers and Acquisitions;
Business Model;
Change;
Disruption;
Fluctuation;
Trends;
Customers;
Customer Value and Value Chain;
Ethics;
Fairness;
Finance;
Equity;
Insurance;
Private Equity;
Geography;
Geographic Scope;
Health;
Health Care and Treatment;
Markets;
Demand and Consumers;
Supply and Industry;
Industry Structures;
Ownership;
Ownership Type;
Private Ownership;
Relationships;
Agency Theory;
Business and Community Relations;
Business and Shareholder Relations;
Business and Stakeholder Relations;
Networks;
Strategy;
Competition;
Consolidation;
Expansion;
Integration;
Horizontal Integration;
Vertical Integration;
Value;
Value Creation;
Health Industry;
Insurance Industry;
United States
Fetter, Trevor, and Kira Seiger. "Roll-Ups and Surprise Billing: Collisions at the Intersection of Private Equity and Patient Care." Harvard Business School Case 321-049, November 2020. (Revised April 2021.)
- Article
Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries
By: Sara Gerke, Ariel D. Stern and Timo Minssen
Reimbursement is a key challenge for many new digital health solutions, whose importance and value have been highlighted and expanded by the current COVID-19 pandemic. Germany’s new Digital Healthcare Act (Digitale–Versorgung–Gesetz or DVG) entitles all individuals...
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Keywords:
COVID-19;
Reimbursement;
Digital Health Reforms;
Health Pandemics;
Health Care and Treatment;
Internet and the Web;
Governing Rules, Regulations, and Reforms;
Germany
Gerke, Sara, Ariel D. Stern, and Timo Minssen. "Germany's Digital Health Reforms in the COVID-19 Era: Lessons and Opportunities for Other Countries." Art. 94. npj Digital Medicine 3 (2020).
- Article
Quantifying the Benefits from a Care Coordination Program for Tracheostomy Placement in Neonates
By: Christen Caloway, Alisa Yamasaki, Kevin M. Callans, Mahek Shah, Robert S. Kaplan and Christopher Hartnick
Value-based care models are becoming instrumental in structuring clinical care delivery in our healthcare climate. Our objective was to determine the value associated with implementation of a Family-Centered Care Coordination (FCCC) program for neonates undergoing...
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Keywords:
Family-centered Care;
Value-based Healthcare;
Time-Driven Activity-Based Costing;
Health Care and Treatment;
Value;
Activity Based Costing and Management
Caloway, Christen, Alisa Yamasaki, Kevin M. Callans, Mahek Shah, Robert S. Kaplan, and Christopher Hartnick. "Quantifying the Benefits from a Care Coordination Program for Tracheostomy Placement in Neonates." International Journal of Pediatric Otorhinolaryngology 134 (July 2020).
- May–June 2020
- Article
The Agenda for the Next Generation of Health Care Information Technology
By: Thomas W. Feeley, Zachary Landman and Michael E. Porter
As the diffusion of value-based health care efforts accelerates globally, the need for interoperable information technology systems that support value-based care is essential. Such systems are needed to facilitate dramatic improvements in patient outcomes and...
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Keywords:
Value-based Health Care;
Health Care and Treatment;
Information Technology;
Integration;
Performance Improvement;
Performance Efficiency
Feeley, Thomas W., Zachary Landman, and Michael E. Porter. "The Agenda for the Next Generation of Health Care Information Technology." NEJM Catalyst Innovations in Care Delivery 1, no. 3 (May–June 2020).
- Article
Mandate Outcomes Reporting
By: Robert S. Kaplan and Michael E. Porter
Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to...
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Keywords:
Outcomes Reporting;
Outcomes Measurement;
Medicare;
Medicaid;
Health Care and Treatment;
Outcome or Result;
Measurement and Metrics
Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (December 2019).
- 2019
- Chapter
Characterizing the Drug Development Pipeline for Precision Medicines
By: Amitabh Chandra, Craig Garthwaite and Ariel Dora Stern
BOOK ABSTRACT: Personalized and precision medicine (PPM)—the targeting of therapies according to an individual’s genetic, environmental, or lifestyle characteristics—is becoming an increasingly important approach in health care treatment and prevention. The advancement...
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Chandra, Amitabh, Craig Garthwaite, and Ariel Dora Stern. "Characterizing the Drug Development Pipeline for Precision Medicines." Chap. 5 in Economic Dimensions of Personalized and Precision Medicine, edited by Ernest R. Berndt, Dana P. Goldman, and John W. Rowe, 115–158. University of Chicago Press, 2019.
- August 2017
- Case
RoboTech: Storming into the U.S. Market
By: Christopher A. Bartlett, Rachel Gordon and John J. Lafkas
This case describes the challenges facing the CEO of a small, Singapore-based industrial robotics company that decides to diversify away from its core industrial robot business by leveraging its expertise into the medical-devices industry. It launches an innovative...
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Keywords:
Market Entry and Exit;
Diversification;
Product Launch;
Competitive Strategy;
Globalized Firms and Management;
Medical Devices and Supplies Industry;
Technology Industry;
Singapore;
United States
Bartlett, Christopher A., Rachel Gordon, and John J. Lafkas. "RoboTech: Storming into the U.S. Market." Harvard Business School Brief Case 918-501, August 2017.
- January 2017
- Supplement
Intrapreneurship at DaVita HealthCare Partners: Cash Flow Tool
By: Joseph B. Fuller and Christopher Payton
DaVita Healthcare Partners Inc. (DaVita) is one of the U.S.'s leading dialysis providers, a process whereby persons with end-stage renal disease (ESRD) are connected to a machine that performs the functions of a healthy kidney. Kent Thiry, DaVita's CEO, has expanded...
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- Article
Adding Value by Talking More
By: Robert S. Kaplan, Derek A. Haas and Jonathan Warsh
The prevailing fee-for-service payment model has led health care administrators and physician practices to impose severe constraints on the time physicians spend talking, for which they are reimbursed poorly or not at all. New value-based reimbursement models, however,...
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Keywords:
Value Creation;
Cost Management;
Health Care and Treatment;
Customer Focus and Relationships;
Health Industry
Kaplan, Robert S., Derek A. Haas, and Jonathan Warsh. "Adding Value by Talking More." New England Journal of Medicine 375, no. 20 (November 17, 2016): 1918–1920.
- October 2016 (Revised March 2019)
- Case
Carrum Health: Scaling Bundled Payments
By: Robert S. Huckman and Sarah Mehta
Founded in 2014, Carrum Health helped self-insured employers located in three markets (San Diego, California; Seattle, Washington; and San Francisco, California) save money on their employees’ planned surgeries. It did so by contracting directly with top-quality...
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Keywords:
Health Financing;
Health Insurance;
Value-based Healthcare Reimbursements;
Bundled Payments;
Innovation;
Scale;
Health;
Health Care and Treatment;
Cost Management;
Growth and Development Strategy;
Decision Choices and Conditions;
Health Industry;
California;
San Francisco;
San Diego;
Seattle
Huckman, Robert S., and Sarah Mehta. "Carrum Health: Scaling Bundled Payments." Harvard Business School Case 617-017, October 2016. (Revised March 2019.)