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
How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?
By: Leemore S. Dafny, Kate Ho and Edward Kong
- August 2024 |
- Article |
- American Economic Journal: Economic Policy
Drug copayment coupons to reduce patient cost-sharing have become nearly ubiquitous for high-priced brand-name prescription drugs. Medicare bans such coupons on the grounds that they are kickbacks that induce utilization, but they are commonly used by commercially-insured enrollees. We estimate the causal effects of coupons for branded drugs without bioequivalent generics using variation in coupon introductions over time and comparing differential responses across enrollees in commercial and Medicare Advantage plans. Using data on net-of-rebate prices and quantities from a large Pharmacy Benefits Manager, we find that coupons increase quantity sold by 21-23% for the commercial segment relative to Medicare Advantage in the year after introduction, but do not differentially impact net-of-rebate prices, at least in the short-run. To quantify the equilibrium price effects of coupons, we employ individual-level data to estimate a discrete choice model of demand for multiple sclerosis drugs. We use our demand estimates to parameterize a model of drug price negotiations. For this category of drugs, we estimate that coupons raise negotiated prices by 8% and result in just under $1 billion in increased U.S. spending annually. Combined, the results suggest copayment coupons increase spending on couponed drugs without bioequivalent generics by up to 30 percent.
Providing Value and Equity in Medicare's Dementia Care Is a Must
By: Susanna Gallani and Lidia Moura
- July 24, 2024 |
- Article |
- Newsweek
Keywords: Health Care and Treatment
Aidoc: Building a Hospital-Centric AI Platform
By: Ariel D. Stern and Susan Pinckney
- June 2024 |
- Case |
- Faculty Research
In 2023, Israel-based AI health care company Aidoc evaluated its future. The company, founded in 2016, had grown from commercializing a single AI product for radiologists to a software platform that could detect 20 conditions and immediately notify care teams of critical results for priority patients. Aidoc’s products detected over 75% of common acute pathologies visible on CT scans. The company had 20 algorithms used by over 900 global hospitals and had 17 FDA clearances—the highest number of any clinical AI company at the time. The company, which had initially produced point solutions, had evolved to manage a multisided network platform that hosted its own as well as its partners’ algorithms. Aidoc had a rich history of producing highly accurate AI products, but partnership allowed it to bring more innovative products to market. The company needed to determine how to continue to grow. Should it focus more on developing highly technical AI health care solutions or on developing and managing a platform to bring other company’s products to its growing customer base?
Keywords: Business Growth and Maturation; Business Model; Business Organization; Business Startups; Disruption; Cost vs Benefits; Decision Choices and Conditions; Decisions; Private Sector; Entrepreneurial Finance; Global Range; Global Strategy; Globalized Markets and Industries; Governance Compliance; Governance Controls; Governing and Advisory Boards; Policy; Growth and Development; Health; Medical Specialties; AI and Machine Learning; Digital Platforms; Digital Transformation; Technology Adoption; Disruptive Innovation; Innovation and Management; Innovation Strategy; Laws and Statutes; Growth and Development Strategy; Growth Management; Distribution; Product Development; Success; Performance Efficiency; Strategic Planning; Research and Development; Risk and Uncertainty; Business Strategy; Competitive Advantage; Value Creation; Health Industry; Israel
Lana Ghanem: Pushing the Boundaries of Health Care through Venture Capital
By: Joshua D. Margolis and Ahmed Dahawy
- June 2024 |
- Case |
- Faculty Research
Lana Ghanem, managing director of Hikma Ventures, the corporate venture arm of larger pharmaceutical group Hikma, is considering how to grow the venture arm as well as progress her own career. Over the past few years Hikma's executive team had been pressuring the venture arm to make strategic investments in line with Hikma's strategy, however, Ghanem saw the future of the venture arm as a tool for accessing technologies and areas not currently within Hikma's scope. Ghanem now faced a decision whether she should follow suit with the executive team's vision? Or should she spin off the venture arm into an independent venture firm? In paralel, Ghanem had her own career to worry about. She once had dreams of climbing the executive ladder at Hikma, but would that be possible if she decided to spin out the venture arm? Might she be better off taking on a more operational role within Hikma? Or did it make more sense for Ghanem to pursue other opportuntieis in the VC space outside of Hikma?
SnapTravel: Betting on 'Super.com'
By: Reza Satchu and Tom Quinn
- June 2024 |
- Case |
- Faculty Research
This case explores SnapTravel, a travel startup offering discounted hotel rooms, and its founders’ desire to pivot to a “super app” that saved customers money across many different purchase types. During the COVID-19 pandemic, Hussein Fazal and Henry Shi saw SnapTravel nearly go bankrupt as people stopped traveling, but the crisis led to a discovery: their customers were lower-income and more cost-conscious than they had realized. The founders debated doing more customer discovery, and whether it was the right time to expand their ambitions.
Keywords: Business Growth and Maturation; Business Plan; Business Startups; Change Management; Disruption; Transformation; Volatility; Customer Focus and Relationships; Customer Value and Value Chain; Decisions; Income; Entrepreneurship; Geographic Scope; Cross-Cultural and Cross-Border Issues; Health Pandemics; Surveys; Knowledge Acquisition; Knowledge Use and Leverage; Leading Change; Crisis Management; Goals and Objectives; Risk Management; Consumer Behavior; Game Theory; Risk and Uncertainty; Adaptation; Diversification; Expansion; System Shocks; Accommodations Industry; Technology Industry; Canada; United States; Las Vegas
Mass General Brigham’s Patient-Reported Outcomes Measurement System: A Decade of Learnings
By: Jason B. Liu, Robert S. Kaplan, David W. Bates, Mario O. Edelen, Rachel C. Sisodia and Andrea L. Pusic
- July 2024 |
- Article |
- NEJM Catalyst Innovations in Care Delivery
This article describes the strategies that leaders at the Mass General Brigham (MGB) health system have used in launching a standardized patient-reported outcome measure (PROM) collection program in 2012, a major step in the value-based transformation of health care. This article documents many benefits to patients, clinicians, and payers from the effective design, collection, and use of PROMs. These benefits include shared decision-making aligned to patients’ goals; improving patient expectations about their likely experiences and outcomes from treatment; empowering patients to self-monitor during recovery; facilitating communication between physicians and patients about what matters most to patients; enhancing treatment by having PROMs embedded in the patients’ electronic health record; and reducing disparities in access, treatment, and outcomes for previously underserved racial and ethnic groups. For payers, PROMs allow payments to be based on patient outcomes. By continuously answering each stakeholder’s “what’s in it for me” question, MGB has taken an important step toward building a learning health system to equitably achieve health outcomes that align with patients’ goals for their health. Working together, the MGB PROMs Program and the Brigham and Women’s Hospital’s Patient-Reported Outcomes, Value, and Experience Center, a transdisciplinary PROMs research hub, plan to continue their efforts to improve and expand the use of PROMs to accelerate the shift toward accountable, patient-centered care.
Health, Human Capital Development and the Longevity of Japanese Elites Since 710
By: Tom Nicholas and Hiroshi Shimizu
- 2024 |
- Working Paper |
- Faculty Research
We examine the lifespan of over 40,000 elites in Japan born between 710 and 1912, including samurai warriors, feudal lords, business, political, cultural, and religious leaders at the apex of the social hierarchy. Japanese elites experienced increases in lifespan about 200 years after the European elite, coinciding with the transition to sustained economic growth. After more than a millennium of stagnation, lifespans increased by an unprecedented 2.4 years every decade during the Meiji modernization era, when mortality patterns also became disconnected from weather cycles. College-educated elites benefitted the most, consistent with theories suggesting health improvements are largest as the economy shifts towards a reliance on human capital development. We also find substantial heterogeneity in the longevity returns to a college education, with null effects among women and in occupational categories where access to health knowledge, ascetic lifestyles, or cognitive capacity were prevalent.
Hospital for Special Surgery: Returning to a New Normal? (A)
By: Robert S. Huckman, Michael Lingzhi Li and Camille Gregory
- June 2024 |
- Case |
- Faculty Research
Early on the morning of April 27, 2020, Justin Oppenheimer stood outside the entrance to the lobby of the Hospital for Special Surgery (HSS) Pavilion Building with mixed emotions. On one hand, Oppenheimer, HSS’ Enterprise Chief Operating Officer and Chief Strategy Officer, was excited that HSS was only two weeks away from resuming in-person outpatient office visits (i.e. physician visits not requiring admission to the hospital). Since the middle of March 2020, the global COVID-19 pandemic had forced HSS and other hospitals in New York to suspend nearly all outpatient office visits in an effort to slow the spread of respiratory illness.
The Outpatient Care Task Force (OCTF) chaired by Oppenheimer had anticipated the difficulty of reopening while the future of the pandemic was still uncertain and made various accommodations, including dramatically limiting physicians’ schedules. Simulations run by the OCTF, however, suggested that even with these accommodations, several patients would be forced to wait outside of the Pavilion building. Given HSS’ reputation for patient experience and that many patients seen at HSS suffered from ailments that made it painful to stand, Oppenheimer knew that asking people to wait outside of the building would not (and should not) be tolerated for long, particularly during inclement weather. Oppenheimer opened his phone and sent an urgent meeting request to OCTF to see what further adjustments could be made to alleviate this problem.
Inflation with COVID Consumption Baskets
By: Alberto Cavallo
- June 2024 |
- Article |
- IMF Economic Review
The Covid-19 pandemic led to changes in expenditure patterns that introduced significant bias in the measurement of Consumer Price Index (CPI) inflation. Using publicly-available data on card transactions, I updated the official CPI weights and re-calculated inflation with Covid consumption baskets during 2020. I show that the U.S. CPI underestimated the Covid inflation rate, as consumers spent relatively more on food with positive inflation, and less on transportation and categories experiencing deflation. The bias peaked in May, when US Covid annual inflation was 1.02% compared to just 0.13% in the CPI and low-income households were experiencing nearly twice as much inflation as those at the top of the income distribution. I find similar evidence of higher Covid inflation in 14 of 19 additional countries.
SofMedica Group: Managing Growth
By: Boris Groysberg and Sarah L. Abbott
- May 2024 |
- Case |
- Faculty Research
SofMedica Group had expanded from its origins as a medical equipment distributor in Romania to a holding company with four business lines operating in six countries. This expansion had been driven by SofMedica’s mission: to make cutting edge medical technology available to the remotest patient by enabling healthcare professionals through education and access to innovation. As the company marked its 30-year anniversary Georgios Sofianos, SofMedica’s CEO and owner, considered the many opportunities and challenges facing SofMedica.
Keywords: Growth; Strategy; Healthcare Access; Healthcare; Medical Devices; Medical Equipment & Devices; Medical Care; Developing Countries; Eastern Europe; Organization Change And Adaptation; Quality Management System; Health Care and Treatment; Growth Management; Education; Organizational Change and Adaptation; Quality; Leadership; Health Industry; Europe