Health Care

Health Care is a featured research topic and an initiative at Harvard Business School.
 
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.

Featured Works

 

  1. Case | HBS Case Collection | March 2018

    University Hospitals Cleveland Medical Center: Managing Capacity in Neurology

    Joel Goh, Robert S. Huckman and Nikhil Sahni

    In December 2014, Dr. Anthony Furlan, chair of the Department of Neurology at University Hospitals Cleveland Medical Center (UH), faced a mandate from the hospital’s executive leadership team. Specifically, all UH departments were directed to take steps within six months to reduce the waiting time for outpatient appointments—measured as the time to first available outpatient appointment—to no more than 15 days. For Furlan and his colleagues in neurology, achieving this target was a significant challenge, as the department’s current time to first available appointment was 93 days. The case considers several alternatives for reducing waiting time in outpatient neurology without increasing the total clinical staff. The case allows students to evaluate opportunities for expanding the effective capacity of a complex service operation and to understand the tradeoffs between customer service and labor utilization.

    Keywords: health care; Hospitals; capacity planning; scheduling; Health Care and Treatment; Service Operations; Performance Capacity; Health Industry; North America; United States; Ohio; Cleveland;

    Citation:

    Goh, Joel, Robert S. Huckman, and Nikhil Sahni. "University Hospitals Cleveland Medical Center: Managing Capacity in Neurology." Harvard Business School Case 618-062, March 2018.  View Details
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  2. Article | JAMA, the Journal of the American Medical Association

    Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System

    Phillip Tseng, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah and Kevin A. Schulman

    The federal government mandated adoption of certified electronic health record systems (EHR), at least in part, to reduce administrative costs for physicians. This study used time-driven activity-based costing to determine the administrative costs associated with billing and insurance activities at a large academic health care center that had a certified EHR system. The center enjoyed economies of scale by concentrating its bill paying functions within a single, dedicated unit. The study found that costs for processing a single bill ranged from $20 for a primary care visit, about 20% of revenues, up to $215 for an inpatient surgical procedure. The high costs were not caused by wasteful, inefficient processes, duplicate or redundant tasks, or the inappropriate use of high-wage personnel to perform low-skilled tasks. Rather, they were driven by the heterogeneous payment requirements across the multiple payers and health plans contracting with the academic health center.

    Keywords: Health Care and Treatment; Cost Management; Insurance; Problems and Challenges;

    Citation:

    Tseng, Phillip, Robert S. Kaplan, Barak D. Richman, Mahek A. Shah, and Kevin A. Schulman. "Administrative Costs Associated with Physician Billing and Insurance-Related Activities at an Academic Health Care System." JAMA, the Journal of the American Medical Association 319, no. 7 (February 20, 2018): 691–697.  View Details
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  3. Case | HBS Case Collection | February 2018 (Revised April 2018)

    Yunnan Baiyao: Transforming a Chinese State-Owned Enterprise

    Michael Chu, William C. Kirby, Nancy Hua Dai and Yuanzhuo Wang

    This case tells the story of how Wang Minghui, Chairman of Yunnan Baiyao Group since 1999, transformed a single-product traditional Chinese medicine (TCM) state-owned enterprise (SOE) into a major diversified consumer health player in China's highly competitive fast-moving consumer goods market. The case also traces the development of the company from a private business to a SOE and then to a SOE under mixed state-private ownership.

    Keywords: state-owned enterprise (SOE); competition; traditional chinese medicine; Yunnan; Yunnan Baiyao; consumer health; enterprise transformation; Transformation; Health; Business History; State Ownership; Private Ownership; Business Strategy; Commercialization; Competition; Consumer Products Industry; Health Industry; Pharmaceutical Industry; China;

    Citation:

    Chu, Michael, William C. Kirby, Nancy Hua Dai, and Yuanzhuo Wang. "Yunnan Baiyao: Transforming a Chinese State-Owned Enterprise." Harvard Business School Case 318-078, February 2018. (Revised April 2018.)  View Details
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  4. Case | HBS Case Collection | February 2018

    Health Savings Accounts: Enabling Consumer Participation

    Regina E. Herzlinger and James Wallace

    Health savings accounts (HSAs), a creation of the 2003 Medicare Modernization Act, had become an integral part of the drive toward consumer-driven health care. Coupled with high-deductible health plans, HSAs allowed consumers to directly control a significant part of their annual health care spend, and the tax-advantaged nature of the accounts made them an attractive investment vehicle as well. Several thorny questions remained, however. For instance, would insurers and employers embrace the accounts for the customers they influenced? Would financial professionals see the relatively small accounts as a valuable component for their clients? In this context the mobile app HSA Coach was developed. The Health Savings Accounts case presents the challenges facing new innovations in mature sectors, with particular emphasis on technology and finance concerns of Prof. Herzlinger’s Six Factors of the Innovating in Health Care framework.

    Keywords: health care; healthcare costs; health care and treatment; health insurance; Health Care and Treatment; Cost; Insurance; Innovation and Invention; Health Industry; United States;

    Citation:

    Herzlinger, Regina E., and James Wallace. "Health Savings Accounts: Enabling Consumer Participation." Harvard Business School Case 318-110, February 2018.  View Details
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  5. Case | HBS Case Collection | February 2018

    Aetna and the Transformation of Health Care

    Rebecca M. Henderson, Russell Eisenstat and Matthew Preble

    Mark Bertolini, chairman and CEO of the health insurer Aetna, faces a number of questions as he seeks to transform Aetna from a classic insurance company into a business that will engage much more deeply with its members around their personal health goals. His strategy depends on Aetna’s ability to facilitate behavioral changes amongst its members to live healthier lives and requires very significant investments in digital capabilities and on-the-ground community-orientated health care resources. Will it work? Can he implement it? The case explores both the strategic issues inherent in this potential transformation and the organizational and leadership questions that it raises. Bertolini is a highly purpose-driven leader, and the case allows for a rich discussion of the degree to which this changes both his strategic and his organizational options.

    Keywords: Health Care and Treatment; Insurance; Transformation; Behavior; Leading Change; Strategy; Insurance Industry; Health Industry; United States; Connecticut;

    Citation:

    Henderson, Rebecca M., Russell Eisenstat, and Matthew Preble. "Aetna and the Transformation of Health Care." Harvard Business School Case 318-048, February 2018.  View Details
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  6. Article | Journal of Oncology Practice | February 2018

    Development and Feasibility of Bundled Payments for the Multidisciplinary Treatment of Head and Neck Cancer: A Pilot Program

    Tracy Spinks, Alexis Guzman, Beth M. Beadle, Seohyun Lee, Ron Walters, Jim Incalcaterra, Ehab Hanna, Amy Hessel, Randal Weber, Sandra Denney, Lee Newcomer and Thomas W. Feeley

    Purpose: Despite growing interest in bundled payments to reduce the costs of care, this payment method remains largely untested in cancer. This 3-year pilot tested the feasibility of a 1-year bundled payment for the multidisciplinary treatment of head and neck cancers.

    Methods: Four prospective treatment-based bundles were developed for patients with selected head and neck cancers. These risk-adjusted bundles covered 1 year of care that began with primary cancer treatment. Manual processes were developed for patient identification, enrollment, billing, and payment. Patients were prospectively identified and enrolled, and bundled payments were made at treatment start. Operational metrics tracked incremental effort for pilot processes and average payment cycle time compared with fee-for-service (FFS) payments.

    Results: This pilot confirmed the feasibility of a 1-year prospective bundled payment for head and neck cancers. Between November 2014 and October 2016, 88 patients were enrolled successfully with prospective bundled payments. Through September 2017, 94% of patients completed the pilot with 6% still enrolled. Manual pilot processes required more effort than anticipated; claims processing was the most time-consuming activity. The production of a bundle bill took an additional 15 minutes versus FFS billing. The average payment cycle time was 37 days (range, 15 to 141 days) compared with a 15-day average under FFS.

    Conclusion: Prospective bundled payments were successfully implemented in this pilot. Additional pilots should study this payment method in higher-volume cancers. Robust systems are needed to automate patient identification, enrollment, billing, and payment along with policies that reduce administrative burden and allow for the introduction of novel cancer therapies.

    Keywords: Health Care and Treatment; Cost Management;

    Citation:

    Spinks, Tracy, Alexis Guzman, Beth M. Beadle, Seohyun Lee, Ron Walters, Jim Incalcaterra, Ehab Hanna, Amy Hessel, Randal Weber, Sandra Denney, Lee Newcomer, and Thomas W. Feeley. "Development and Feasibility of Bundled Payments for the Multidisciplinary Treatment of Head and Neck Cancer: A Pilot Program." Journal of Oncology Practice 14, no. 2 (February 2018): e103–e121.  View Details
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  7. Case | HBS Case Collection | January 2018 (Revised March 2018)

    Wenzhou Kangning Hospital: Changing Mental Healthcare in China

    William C. Kirby, Wei Zhang, Yuanzhuo Wang and Nancy Hua Dai

    The city of Wenzhou in the Province of Zhejiang, long known in China for entrepreneurship, now hosts the country’s largest privately owned mental health hospital group. This case traces the development of Wenzhou Kangning Hospital Co, Ltd. from founding to just before its initial public offering to illustrate the extraordinary entrepreneurship happening in China’s healthcare space. It highlights the challenges of China’s mental health sector and the means company founder Guan Weili employed to address some of them. How will the hospital grow in the future?

    Keywords: mental health; hospital; IPO; China; Zhejiang; Wenzhou; private healthcare; private hospital; Health Care and Treatment; Private Ownership; Corporate Governance; Growth and Development; Entrepreneurship; Health Industry; China;

    Citation:

    Kirby, William C., Wei Zhang, Yuanzhuo Wang, and Nancy Hua Dai. "Wenzhou Kangning Hospital: Changing Mental Healthcare in China." Harvard Business School Case 318-054, January 2018. (Revised March 2018.)  View Details
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  8. Case | HBS Case Collection | January 2018 (Revised February 2018)

    Giving Birth to Ovia Health

    Jeffrey J. Bussgang and Julia Kelley

    In late 2016, Paris Wallace, the CEO of Ovia Health, and the rest of the company’s co-founders faced a difficult decision about the best way to grow Ovia Health’s revenue. Founded in 2012, Ovia Health specialized in mobile and web applications in the women’s health space. After building a strong user base with its original app, Ovia Fertility (which helped women conceive by tracking ovulation and other factors), the young company launched a second app, Ovia Pregnancy (which helped women have a healthy pregnancy by tracking various health metrics). Ovia Health’s apps were free to use, and most of the company’s revenue came from charging advertisers to host ads on its native advertising platform. Wallace believed that the family benefits market was a promising growth area, but he was not sure of the best way to enter the market. Recently, a top health benefits provider had offered Ovia Health a multi-million-dollar contract, but Wallace wondered whether Ovia Health could create a better family benefits solution by turning down the contract and selling directly to employers’ HR departments. Participants will need to examine how Ovia Health evolved its strategy over time and decide which growth opportunity was the better choice.

    Keywords: Growth and Development Strategy; Market Entry and Exit; Health Care and Treatment; Health Industry;

    Citation:

    Bussgang, Jeffrey J., and Julia Kelley. "Giving Birth to Ovia Health." Harvard Business School Case 818-004, January 2018. (Revised February 2018.)  View Details
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  9. Case | HBS Case Collection | January 2018 (Revised March 2018)

    ZappRx

    Jeffrey J. Bussgang and Olivia Hull

    In October 2015, ZappRx founder Zoe Barry is deciding between two business models for her health technology start-up. Her product, a software application that aims to expedite the prescription fulfillment process for patients with rare diseases, has attracted interest from specialty drug manufacturers who wish to build an exclusive platform for patients taking their medications. But Barry, against the advice of her management team, is considering an alternative business model, which would open the platform up to all manufacturers in a given disease area. Instead of financing product development through individual contracts, the comprehensive platform would be free to doctors and pharma alike and financed via an aggressive fundraising strategy and through the sale of the prescription data collected on the app. Barry is willing to take the risk, but her management team is staunchly opposed. Which path should ZappRx take? The case is a window into the early go-to-market and business model decisions that an entrepreneur must make, in this case in the face of pushback from her own management team. The case also provides a detailed picture of the specialty pharmaceutical industry and challenges students to think about target customer identification and talent management in a start-up environment.

    Keywords: Speciality Drugs; Hub Services; business model; Pivot; Speciality Prescriptions; Health Care and Treatment; Customization and Personalization; Online Technology; Business Model; Decision Choices and Conditions; Pharmaceutical Industry; Massachusetts;

    Citation:

    Bussgang, Jeffrey J., and Olivia Hull. "ZappRx." Harvard Business School Case 818-001, January 2018. (Revised March 2018.)  View Details
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  10. Case | HBS Case Collection | January 2018 (Revised April 2018)

    Adeo Health Science: Turning a Product into a Brand

    Elizabeth A. Keenan and Jill Avery

    For decades, American parents were warned to avoid introducing potential allergens to their babies prior to their first birthday. But two influential clinical studies caused the medical establishment to radically reverse their position. Parents were now warned that delaying the introduction of these types of foods increased a baby's risk of food allergies. Adeo Health Science was ready, with patents filed for a baby food that made it simple for parents to introduce allergens. Now, the new company had to turn its product into a brand and map its go-to-market strategy, including creating a compelling value proposition, choosing a path to market that was either direct-to-consumer, through grocery retailers, or via the physician channel, and planning its marketing communications and sales strategy. As a new startup with constrained resources, the company knew its marketing decisions would make or break the new product.

    Keywords: marketing; Startup; entrepreneurship; health care; consumer; consumer products; branding; brands and branding; marketing strategy; Marketing communications; Distribution; retailing; go to market strategy; Marketing; Marketing Channels; Marketing Communications; Brands and Branding; Marketing Strategy; Entrepreneurship; Health Care and Treatment; Consumer Products Industry; Health Industry; United States; North America;

    Citation:

    Keenan, Elizabeth A., and Jill Avery. "Adeo Health Science: Turning a Product into a Brand." Harvard Business School Case 518-065, January 2018. (Revised April 2018.)  View Details
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    11.  
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Initiatives & Projects

  • Health Care

    The Health Care Initiative serves as a gateway for health care research, educational programs, and collaboration across all sectors of the health care industry.

  • Social Enterprise

    The Social Enterprise Initiative at HBS applies innovative business practices and managerial disciplines to drive sustained, high-impact social change.

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Faculty

HBS Working Knowledge

Pic
re Ariel D. Stern
Ariel Stern discusses her recent case study about creating a new type of clinical trial designed to deliver life-enhancing drugs to patients more quickly.
PicPic
re Robert S. Kaplan and Kevin A. Schulman
Digitizing patient information promised to cut health care costs by driving down administrative expenses. So why can it cost a doctor more than $200 to process a single bill? New research by Robert K
Pic
re Reshmaan N. Hussam
Reshmaan Hussam and colleagues used experimental interventions to determine if people could be persuaded to develop a healthy habit. Potentially at stake: the lives of more than a million children.

More »

Harvard Business Publishing

Article
by Nitin Nohria
Case
by Rebecca M. Henderson, Russell Eisenstat and Matthew Preble

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