Health Care
Health Care
Over the past several decades, HBS has built a foundation in health care research, from Clayton Christensen's application of disruptive innovations and Regina Herzlinger's concept of consumer-driven health care to Michael Porter's use of competitive strategy principles. Today our research focuses on
- how management principles and best practices from other industries can be applied;
- how the process of innovation can be improved;
- how principles of strategy and consumer choice can be utilized;
- how information technology can expand access, decrease costs, and improve quality;
- how new approaches in developing nations can impact global health.
Initiatives & Projects
The Health Care Initiative and the Social Enterprise Initiative connect students, alumni, faculty, and practitioners to ideas, resources, and opportunities for collaboration that yield innovative models for health care practice.
Health CareSocial EnterpriseRecent Publications
Value-Based Insurance Design at Onex
By: Joshua Schwartzstein, Amitabh Chandra and Amram Migdal
- January 2021 |
- Case |
- Faculty Research
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 across employer-sponsored health insurance in the U.S. Against this backdrop, Frye and Camens considered recommending that Onex’s portfolio companies adopt value-based insurance design (VBID) principles to encourage employees to take high-value medications, for example by reducing copays for drugs managing diabetes or heart conditions. The case encourages students to put themselves in the shoes of Frye and Camens, who were grappling with evidence promoted by VBID’s proponents on its potential to simultaneously improve employee health and curb employer costs. The case includes content on employer-provided health insurance in the U.S., as well as the consequences of cost-sharing on consumer behavior, health, and spending.
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
Hester Pharmaceuticals (A): A Pricing Dilemma
By: Dante Roscini and John Masko
- January 2021 |
- Case |
- Faculty Research
In August 2019, the leadership of Hester Pharmaceuticals (Hester) had a problem. Italy promised to be a key market for their new breakthrough oncology drug Akrozumab, but for almost two years, its single-payer healthcare system had been unable to agree with Hester on a price. With only a few years before a competing drug to Akrozumab was due to hit the market, company leaders felt mounting pressure to compromise with Italian negotiators. At the same time, they realized that compromising on a low price might jeopardize the higher prices Hester had already negotiated with other European nations, if these countries bought up extra supply from Italy or referenced Italy’s low price when they renegotiated their own prices the following year. Should Hester settle for a low price, stall for more time, or walk away? This case introduces students to the process of bringing new prescription drugs to market and the factors that go into pricing drugs in both single-payer and multi-payer healthcare systems. Students will wrestle with the complex strategy behind pricing their drugs internationally.
Keywords: Macroeconomics; Trade; Price; Global Range; Global Strategy; Globalized Markets And Industries; Health Care And Treatment; Patents; Monopoly; Negotiation; Business And Government Relations; Risk And Uncertainty; Human Needs; Business Strategy; Commercialization; Pharmaceutical Industry; Italy
mPharma (A)
By: Rembrand Koning, John D. Macomber, Pippa Tubman Armerding and Wale Lawal
- January 2021 |
- Case |
- Faculty Research
mPharma pioneered electronic prescriptions in Ghana, and aimed to increase drug affordability and accessibility in Africa, but the company remained unprofitable. Following investor concerns about mPharma's business, CEO Gregory Rockson considered alternative business models and services that could increase mPharma's profitability and impact.
Keywords: Strategy; Entrepreneurship; Acquisition; Health; Health Industry; Technology Industry; Ghana
Food and Drug Administration Guidance Documents and New Medical Devices: The Case of Breast Prostheses
By: Rachel E. Weitzman, Ariel Dora Stern and Daniel B. Kramer
- January–February 2021 |
- Article |
- American Journal of Therapeutics
As pressure mounts on the Food and Drug Administration (FDA) to speed its review process for novel devices, and budgetary pressures further strain its resources, the critical role of guidance documents in assuring consistent, rigorous, and scientifically grounded review across device types has never been more important. In this article, we use the regulatory experience of one medical device class, specifically implantable breast prostheses, to illustrate the crucial role of FDA guidance documents. We find that the emergence of FDA guidance preceded significant growth of scientific publications around breast prostheses, with 0.30 +/- 0.57 papers/year published in the period 1987–2006 compared with 2.27 +/- 1.56 papers/year in the period 2007–2017, P=0.0017. This illustrates the importance of supporting the FDA to enhance guidance document drafting, revision, publication, and updating to reflect evolving scientific consensus and the needs of sponsors, regulators, and patients for transparent and consistent standards in a broad range of fields.
COVID-19 Hasn't Been a Tipping Point for Value-Based Care, but It Should Be
By: Thomas W. Feeley
- January 2021 |
- Article |
- NEJM Catalyst Innovations in Care Delivery
Four out of five health care provider organizations are suffering ongoing losses as a result of the
COVID-19 pandemic, according to the recent NEJM Catalyst Insights Council survey on value-based
payment and care. Yet Council members, who are still largely entrenched in a fee-for-service
world, don’t believe the pandemic will be the tipping point toward value-based care.
IBM Watson at MD Anderson Cancer Center
By: Shane Greenstein, Mel Martin and Sarkis Agaian
- December 2020 |
- Case |
- Faculty Research
After discovering that their cancer diagnostic tool, designed to leverage the cloud computing power of IBM Watson, needed greater integration into the clinical processes at the MD Anderson Cancer Center, the development team had difficult choices to make. The Oncology Expert Advisor tool used a combination of machine learning and the latest cancer care research to make recommendation to clinicians in the field. Was automated cancer diagnosis the future of cancer care? The development team, comprised of clinicians and data scientists, reviewed the results of their experiment to augment their implementation plan and better evaluate the efficacy of the analytics tool.
Keywords: Decision Making; Innovation Strategy; Knowledge Management; Knowledge Use And Leverage; Operations; Failure; Technology; Information Technology; Software; Health Care And Treatment; Product Development; Health Industry; Information Technology Industry; Technology Industry; United States; Houston; Texas
India's Food Supply Chain During the Pandemic
By: Matt Lowe, V G Nadhanael and Benjamin N. Roth
- 2020 |
- Working Paper |
- Faculty Research
We document the impact of India’s COVID-19 lockdown on the food supply chain. Food arrivals in wholesale markets dropped by 62% in the three weeks following the lockdown and wholesale prices rose by 8%. Six weeks after the lockdown began, volumes and prices had fully recovered. The initial food supply shock was highly correlated with early incidence of COVID-19. We provide evidence that this correlation is due more to state-level lockdown policy variation than local responses of those in the food supply chain. Finally, during the recovery phase, the correlation between the food supply disruption and COVID-19 exposure disappeared, suggesting uniform recovery.
Want to See the Future of Digital Health Tools? Look to Germany
By: Ariel Dora Stern, Henrik Matthies, Julia Hagen, Jan B. Brönneke and Jörg F. Debatin
- Article |
- Harvard Business Review (website)
A new law will make it easier to introduce and determine the benefits of new tools. Perhaps its most important provisions are its formalization of “prescribable applications,” which include standard software, SaaS, and mobile as well as browser-based apps, and the creation of the Fast-Track Process, an accelerated regulatory path for companies to take their digital health applications to market. With at least 50 apps currently already in the Fast-Track process and hundreds expected over the coming years from manufacturers worldwide, evaluation studies will create a wealth of data on how digital tools for remote patient care work in practice, which other payers and health systems can learn from. They will also be valuable in convincing health care providers—for whom evidence is of paramount importance—of the value of digital tools, both generally and in particular use cases.
What Has Changed? The Impact of COVID Pandemic on the Technology and Innovation Management Research Agenda
By: Gerard George, Karim R. Lakhani and Phanish Puranam
- December 2020 |
- Article |
- Journal of Management Studies
Whereas the pandemic has tested the agility and resilience of organizations, it forces a deeper look at the assumptions underlying theoretical frameworks that guide managerial decisions and organizational practices. In this commentary, we explore the impact of the COVID-19 pandemic on technology and innovation management research. We identify key assumptions, and then, discuss how new areas of investigation emerge based on the changed reality.
Value of New Performance Information in Healthcare: Evidence from Japan
By: Susanna Gallani, Takehisa Kajiwara and Ranjani Krishnan
- Article |
- International Journal of Health Economics and Management
Mandatory measurement and disclosure of outcome measures are commonly used policy tools in
healthcare. The effectiveness of such disclosures relies on the extent to which the new information produced by the mandatory system is internalized by the healthcare organization and influences its operations and decision-making processes. We use panel data from the Japanese National Hospital Organization to analyze performance improvements following regulation mandating standardized measurement and peer disclosure of patient satisfaction performance. Drawing on value of information theory, we document the absolute value and the benchmarking value of new information for future performance. Controlling for ceiling effects in the opportunities for improvement, we find that the new patient satisfaction measurement system introduced positive, significant, and persistent mean shifts in performance (absolute value of information) with larger improvements for poorly performing hospitals (benchmarking value of information). Our setting allows us to explore these effects in the absence of confounding factors such as incentive compensation or demand pressures. The largest positive effects occur in the initial period, and improvements diminish over time, especially for hospitals with poorer baseline performance. Our study provides empirical evidence that disclosure of patient satisfaction performance information has value to hospital decision makers.