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Health Care

Health Care

    • February 2015
    • Supplement

    The Affordable Care Act (A): Legislative Strategy in the House of Representatives

    By: Joseph L. Bower and Michael Norris

    In early 2009, the Obama administration and the Democratically-led Congress began working on what would eventually become the Affordable Care Act. The (A) case in this series discusses the legislative strategy in the House of Representatives, where three different committees each had jurisdiction over health care legislation.

    • February 2015
    • Supplement

    The Affordable Care Act (A): Legislative Strategy in the House of Representatives

    By: Joseph L. Bower and Michael Norris

    In early 2009, the Obama administration and the Democratically-led Congress began working on what would eventually become the Affordable Care Act. The (A) case in this series discusses the legislative strategy in the House of Representatives, where three different committees each had jurisdiction over health care legislation.

    • Blog Post

    Innovation in Health Care Education: A Call to Action

    By: Regina E. Herzlinger, Vasant Kumar, Kevin Schulman and Karen Staman

    Health care administration educators are at a crossroads: the health care sector is rife with inefficiencies, erratic quality, unequal access, and sky-high costs, complex problems which call for innovative solutions, and yet, according to our content analysis of top U.S. health administration schools and a recent article in the Lancet, our educational systems focus their curricula on isolated,theoretical subjects, such as analytics and quantitative problem solving, rather than the team-oriented, practical problem-solving skills required for innovation. All too often, when graduates of these programs enter the workforce, they find themselves unequipped to meet the challenges for innovation of 21st century health care.

    • Blog Post

    Innovation in Health Care Education: A Call to Action

    By: Regina E. Herzlinger, Vasant Kumar, Kevin Schulman and Karen Staman

    Health care administration educators are at a crossroads: the health care sector is rife with inefficiencies, erratic quality, unequal access, and sky-high costs, complex problems which call for innovative solutions, and yet, according to our content analysis of top U.S. health administration schools and a recent article in the Lancet, our...

    • December 2014
    • Article

    No Margin, No Mission? A Field Experiment on Incentives for Public Services Delivery

    By: Nava Ashraf, Oriana Bandiera and B. Kelsey Jack

    A substantial body of research investigates the effect of pay for performance in firms, yet less is known about the effect of non-financial rewards, especially in organizations that hire individuals to perform tasks with positive social spillovers. We conduct a field experiment in which agents recruited by a public health organization to sell condoms are randomly allocated to four groups. Agents in the control group are hired as volunteers, whereas agents in the three treatment groups receive, respectively, a small monetary margin on each pack sold, a large margin, and a non-financial reward. The analysis yields three main findings. First, non-financial rewards are more effective at eliciting effort than either financial rewards or the volunteer contract and are also the most cost-effective of the four schemes. Second, non-financial rewards leverage intrinsic motivation and, contrary to existing laboratory evidence, financial incentives do not appear to crowd it out. Third, the responses to both types of incentives are stronger when their relative value is higher. Indeed, financial rewards are effective at motivating the poorest agents, and non-financial rewards are more effective when the peer group is larger. Overall, the findings demonstrate the power of non-financial rewards to motivate agents in settings where there are limits to the use of financial incentives.

    • December 2014
    • Article

    No Margin, No Mission? A Field Experiment on Incentives for Public Services Delivery

    By: Nava Ashraf, Oriana Bandiera and B. Kelsey Jack

    A substantial body of research investigates the effect of pay for performance in firms, yet less is known about the effect of non-financial rewards, especially in organizations that hire individuals to perform tasks with positive social spillovers. We conduct a field experiment in which agents recruited by a public health organization to sell...

    • August 2001 (Revised January 2015)
    • Case

    SonoSite: A View Inside

    By: Clayton Christensen and Jeremy Dann

    After its spin-off from one of the world's largest ultrasound makers, Sonosite attempts to popularize a new kind of handheld ultrasound units. Sonosite needs to decide if it should focus on new markets that will value the portability and ease of use of its products, or if it should evolve its offerings so that they appeal to radiologists and cardiologists, the largest purchasers of ultrasound systems.

    • August 2001 (Revised January 2015)
    • Case

    SonoSite: A View Inside

    By: Clayton Christensen and Jeremy Dann

    After its spin-off from one of the world's largest ultrasound makers, Sonosite attempts to popularize a new kind of handheld ultrasound units. Sonosite needs to decide if it should focus on new markets that will value the portability and ease of use of its products, or if it should evolve its offerings so that they appeal to radiologists and...

    • March 2014 (Revised December 2014)
    • Case

    Vision 2020: Takeda and the Vaccine Business

    By: John A. Quelch and Margaret L. Rodriguez

    In 2014, Yasuchika Hasegawa was orchestrating the transformation of Takeda from a Japanese pharmaceutical company with a global footprint into a global company with a Japanese heritage. A 33-year veteran of Takeda, Hasegawa-san was appointed president of Takeda in 2003 and chief executive in 2009. By 2013, Takeda was in the midst of implementing its new Vision 2020 plan, a strategic plan for the evolving global corporation, which included developing a global vaccine business.

    • March 2014 (Revised December 2014)
    • Case

    Vision 2020: Takeda and the Vaccine Business

    By: John A. Quelch and Margaret L. Rodriguez

    In 2014, Yasuchika Hasegawa was orchestrating the transformation of Takeda from a Japanese pharmaceutical company with a global footprint into a global company with a Japanese heritage. A 33-year veteran of Takeda, Hasegawa-san was appointed president of Takeda in 2003 and chief executive in 2009. By 2013, Takeda was in the midst of implementing...

    • August 2015 (Revised August 2015)
    • Case

    Hoag Orthopedic Institute

    By: Robert S. Kaplan and Jonathan Warsh

    Two groups of orthopedic surgeons form a joint venture with a community hospital to establish Hoag Orthopedic Institute, a for-profit hospital and two ambulatory service centers. By controlling and integrating all aspects of the patients' medical treatment, the physicians deliver superior outcomes, which they communicate with an annual public outcomes report. They also introduce bundled payment contracts with three insurers for orthopedic surgeries, and join a multi-hospital study for applying time-driven activity-based costing to identify process improvement and cost reduction opportunities. The case concludes with HOI leaders examining several options for expansion and growth.

    • August 2015 (Revised August 2015)
    • Case

    Hoag Orthopedic Institute

    By: Robert S. Kaplan and Jonathan Warsh

    Two groups of orthopedic surgeons form a joint venture with a community hospital to establish Hoag Orthopedic Institute, a for-profit hospital and two ambulatory service centers. By controlling and integrating all aspects of the patients' medical treatment, the physicians deliver superior outcomes, which they communicate with an annual public...

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 Care
Social Enterprise

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 Care
Social Enterprise

Recent 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
Citation
Educators
Related
Schwartzstein, Joshua, Amitabh Chandra, and Amram Migdal. "Value-Based Insurance Design at Onex." Harvard Business School Case 921-023, January 2021.

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
Citation
Educators
Related
Roscini, Dante, and John Masko. "Hester Pharmaceuticals (A): A Pricing Dilemma." Harvard Business School Case 721-001, January 2021.

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
Citation
Educators
Related
Koning, Rembrand, John D. Macomber, Pippa Tubman Armerding, and Wale Lawal. "mPharma (A)." Harvard Business School Case 721-428, January 2021.

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.
Keywords: Medical Devices; Fda; Health Care And Treatment; Government Administration; Information; Standards
Citation
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Related
Weitzman, Rachel E., Ariel Dora Stern, and Daniel B. Kramer. "Food and Drug Administration Guidance Documents and New Medical Devices: The Case of Breast Prostheses." American Journal of Therapeutics 28, no. 1 (January–February 2021).

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.
Keywords: Value-based Health Care; Health Pandemics; Health Care And Treatment; Cost
Citation
Find at Harvard
Read Now
Related
Feeley, Thomas W. "COVID-19 Hasn't Been a Tipping Point for Value-Based Care, but It Should Be." NEJM Catalyst Innovations in Care Delivery 2, no. 1 (January 2021).

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
Citation
Educators
Related
Greenstein, Shane, Mel Martin, and Sarkis Agaian. "IBM Watson at MD Anderson Cancer Center." Harvard Business School Case 621-022, December 2020.

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.
Keywords: Covid-19; Health Pandemics; Food; Supply Chain; India
Citation
Read Now
Related
Lowe, Matt, V G Nadhanael, and Benjamin N. Roth. "India's Food Supply Chain During the Pandemic." Harvard Business School Working Paper, No. 21-070, December 2020.

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.
Keywords: Health Care And Treatment; Transformation; Online Technology; Technological Innovation; Germany
Citation
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Stern, Ariel Dora, Henrik Matthies, Julia Hagen, Jan B. Brönneke, and Jörg F. Debatin. "Want to See the Future of Digital Health Tools? Look to Germany." Harvard Business Review (website) (December 2, 2020).

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.
Keywords: Covid-19; Health Pandemics; Technology; Innovation And Management; Research
Citation
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Related
George, Gerard, Karim R. Lakhani, and Phanish Puranam. "What Has Changed? The Impact of COVID Pandemic on the Technology and Innovation Management Research Agenda." doi:10.1111/joms.12634. Journal of Management Studies 57, no. 8 (December 2020).

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.
Keywords: Value Of Information; Feedback; Patient Satisfaction; Healthcare; Health Care And Treatment; Satisfaction; Information; Measurement And Metrics; Performance Improvement
Citation
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Related
Gallani, Susanna, Takehisa Kajiwara, and Ranjani Krishnan. "Value of New Performance Information in Healthcare: Evidence from Japan." International Journal of Health Economics and Management 20, no. 4 (December 2020): 319–357.
More Publications

Faculty

James E. Austin
Amy C. Edmondson
Thomas W. Feeley
Ray A. Goldberg
Richard G. Hamermesh
Regina E. Herzlinger
Robert S. Huckman
Robert S. Kaplan
Michael E. Porter
John A. Quelch
Alvin E. Roth
Ariel D. Stern
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HBS Working Knowlege

    • 06 Jan 2021

    Unexpected Exercise Advice for the Super Busy: Ditch the Rigid Routine

    Re: John Beshears
    • 04 Jan 2021

    Hospital Allocation and Racial Disparities in Health Care

    Re: Amitabh Chandra
    • 14 Dec 2020

    What Does December's Drug-Approval Dash Mean for COVID-19 Vaccines?

    Re: Lauren H. Cohen
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Harvard Business Publishing

    • January – February 2012
    • Article

    What Business Schools Can Learn from the Medical Profession

    By: Nitin Nohria
    • November 2020
    • Case

    Creating a Virtual Internship at Goldman Sachs

    By: Prithwiraj Choudhury, Iavor Bojnov and Emma Salomon
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