Regina Herzlinger

Regina Herzlinger
Harvard University | Harvard · Accounting and Management Unit

About

105
Publications
4,586
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1,311
Citations

Publications

Publications (105)
Article
Full-text available
The most popular parts of the Affordable Care Act (ACA) are the most expensive. Universal coverage is a top priority not only for Democrats but also for President Trump. Both Republicans and Democrats want to preserve many costly coverage features of the ACA, including those that prevent insurers from precluding people with preexisting conditions a...
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Full-text available
Because current tax laws exclude employer-paid health insurance premiums from employees’ taxable wages and income, employer-sponsored insurance remains the primary source of health insurance for most employed Americans. Economists have long blamed the employer-based insurance tax exclusion for inflating health care costs, and, more recently, for co...
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This Viewpoint discusses the use of health insurance retail stores in Florida as a way for insurance carriers to reach uninsured populations. Although brick and mortar stores are a ubiquitous feature of the US consumer landscape, health insurance for individuals is typically sold via phone, mail, computers, brokers, or, newly, “exchanges.” However,...
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This Viewpoint discusses the use of bundled payment programs organized around procedures or diseases as a means of addressing the challenges of implementing integrated models of health care delivery.To enable improved cost control, quality, and access, US health care delivery is moving from fragmented fee-for-service delivery into various innovativ...
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Full-text available
Health care consumers won a significant victory when Massachusetts Suffolk County Superior Court Judge Janet Sanders blocked a settlement that would have allowed Partners HealthCare, the system that dominates the Boston area, to acquire three additional health care providers in eastern Massachusetts. Sanders concluded that the acquisitions "would c...
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Full-text available
Defined-contribution programs are becoming increasingly prevalent in employer-sponsored health insurance and may ultimately bring about substantial changes in U.S. health care. This shift will have both short- and long-term consequences for providers.
Article
Current public and private healthcare information technology initiatives have failed to achieve secure integration among providers. Applying the "keep it simple, stupid" principle offers key guidance for solving this problem.
Article
This case, the denouement to "PAREXEL International Corp. (A)," describes developments at PAREXEL and the biopharmaceutical industry from 2002 to 2011. Through an investment of $365 million over 10 years, PAREXEL has built a strong technology services business which is its key differentiator, although clinical trials remain its most lucrative segme...
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This note provides background in all the modalities of telemedicine. It accompanies the cases "Medtronic: Patient Management Initiative" (A) and (B), HBS Nos. 302-005 and 309-064.
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Dr. Edson Bueno created Amil, Brazil's largest health insurer. Unlike many others, it is vertically integrated. Dr. Bueno has two opportunities for growth. Which, if any, should he pursue?Learning Objective:1.) Opportunities for health care innovation in developing countries. 2.) Pros & cons of vertical integration in health care delivery & insuran...
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After its successful new UK venture, the Hospital for Special Surgery wants to do more of the same, without decimating its core New York City facility. The case provides considerable details about the different options it is exploring. Learning Objective: Challenges of growing medical delivery ventures.
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How to replicate a 'one of' social entrepreneurship effort: To cure blindness, Seva took the Aravind Eye Hospital & scaled it up to 100 hospitals globally.Learning Objective:This case explains how they did it. How do you replicate successful, "one of" nonprofit social entrepreneurship efforts? This case is meant as companion reading for the "Hospit...
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Cathy Hoffmann has rapidly grown her novel facilities for day care therapy for elders with mild cognitive and physical problems. But she needs to decide whether to franchise or own the next expansion.Learning Objective:This entrepreneur faces the classic problem franchise vs. own future growth in a novel setting; long-term elder day care, in a diff...
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Vitality is part of a $2 billion start-up South African and U.K. health insurance firm. It has achieved excellent results in rewarding people for promoting their health. It is now contemplating how to enter the U.S. market.Learning Objective: Innovating in health care.
Article
U.S. healthcare is currently a poor value proposition in relation to its cost. This must change. Driven by the fundamental forces of financing, consumer preferences, and technology, the U.S. is heading for a profound revolution in healthcare, one that will affect not only the system itself but also the larger U.S. business community. This new healt...
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To the Editor: In their Commentary, Drs Berenson and Cassel1 argued against the use of high-deductible health plans and tax-advantaged health savings accounts. They contended that such policies “plac[e] increased reliance on commercial ethics while eroding professional ethics as the guiding force for patient-physician interactions.” A physician's f...
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Regina E. Herzlinger is the Nancy R. McPherson Professor of Business Administration Chair at the Harvard Business School, Cambridge, MA. She received her bachelor's degree from MIT and her doctorate from the Harvard Business School The first woman to be tenured and made a chair at Harvard Business School, she is widely recognized for her innovative...
Article
Winter issues of The American Heart Hospital Journal traditionally focus on health care policy issues. As health care reform in the United States is a topic of major importance in the upcoming presidential election, we invited Dr Regina E. Herzlinger, the Nancy R. McPherson Professor of Business Administration at Harvard University and a noted expe...
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Regina Herzlinger catalyzed a national dialogue with the publication of her book Market-Driven Health Care in 1997. Her core argument is that health care should resemble other retail markets, where unleashing consumer choice results in competition and innovations that improve value. In an often pitched debate, critics contend that health care is fa...
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Health care in the United States--and in most other developed countries--is ailing. Medical treatment has made astonishing advances, but the packaging and delivery of health care are often inefficient, ineffective, and user unfriendly. Problems ranging from costs to medical errors beg for ingenious solutions-and indeed, enormous investments have be...
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In Reply: Suppose Americans spent vastly more than residents of other countries on personal computers (PCs) and networking. Few would argue that the US government should limit PC spending. Personal computers result in increased productivity, people buy them because they want them, and unique US characteristics, such as low density of population, re...
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Switzerland's consumer-driven health care system achieves universal insurance and high quality of care at significantly lower costs than the employer-based US system and without the constrained resources that can characterize government-controlled systems. Unlike other systems in which the choice and most of the funding for health insurance is prov...
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Ken Iverson, a technology entrepreneur, almost single-handedly revived the moribund US steel industry. His success contains important lessons for health care. Nucor, the steel-focused factory Iverson managed, differed from the everything-for-everybody steel behemoths of yore, like Bethlehem Steel, with its specialty steel products and relatively sm...
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Corporate entrepreneurs drive improvements in a productive economy and are rewarded financially. The U.S. healthcare industry, on the other hand, allows payers to dictate prices and punishes any providers that try to create better, cheaper goods and services. The result is missed opportunities for innovation. Consumer-driven health care (CDHC), how...
Article
Businesses spend billions on health insurance. And what do they get for their money? A lot of unhappy employees. Workers fret about the quality of the care they receive, the burden of their out-of-pocket expenses, and the gaps in their coverage. For businesses, health care has become a lose-lose proposition: They pay way too much, and they get way...
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The revival of the economy in the US holds 2 powerful lessons for its healthcare system: know your customers and focus on their needs. Widespread inefficiency and inconvenience characterise the current healthcare system because it has failed to heed these lessons so far. Making the necessary changes will require substantial modifications by both go...
Article
The revival of the economy in the US holds 2 powerful lessons for its healthcare system: know your customers and focus on their needs. Widespread inefficiency and inconvenience characterise the current healthcare system because it has failed to heed these lessons so far. Making the necessary changes will require substantial modifications by both go...
Article
The U.S. health care sector is following the path of the revitalized U.S. economy with the creation of focused health care factories that provide coordinated care primarily for high-cost chronic diseases, disabilities, and surgical procedures, and with increased response to the demands of hard-working, well-educated Americans for convenience and su...
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Are you ready to take your organization into the 21st century? Do you fully grasp the implications of current and emerging trends in the field? Healthcare Executive talked with six healthcare experts and asked them what they saw as the greatest challenge for both executives and their organizations in the new millennium. Although the experts' opinio...
Article
The U.S. health care sector is following the path of the revitalized U.S. economy with the creation of focused health care factories that provide coordinated care primarily for high-cost chronic diseases, disabilities, and surgical procedures, and with increased response to the demands of hard-working, well-educated Americans for convenience and su...
Article
What would it be like if "we the people" could make the behavioral healthcare system work for us? Perhaps we can! With the advent of networked online multimedia technology, standardized quality measurement systems, behavioral risk assessment and management methods, and other innovations, direct consumer control of behavioral healthcare is within ou...
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The fundamental economic, social, and technological forces currently reshaping the health care system will have a profound impact on managed health care. The successful organization of the future will implement procedures now that respond to these forces.
Article
Discusses how entrepreneurs have helped reduce costs in health care and examines the major changes in the health care system that are simultaneously lowering costs and increasing quality. The author then explains how current reform proposals might affect these entrepreneurial innovations. (GLR)
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Could national health insurance (NHI) cap the explosive rise in medical costs and at the same time give everyone access to health care? More and more people believe so, and for the first time in 20 years NHI proposals are being taken seriously in Washington. But the author contends NHI proponents have misread the causes for America's health-care cr...
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The decade of the 1980s held promise that at last the health care industry would begin to cut the acceleration of costs and improve service noticeably. Moreover, technology, moving at a fast pace, promised a flood of new devices and disease fighters that would greatly help the well-being of Americans. That was the promise, but something happened on...
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As corporations look for ways to cut the rising costs of health care, they direct most of their efforts at modifying the demand for services. Some have attempted to effect changes in the health care system as a whole, and a smaller number have instituted programs to attack the problem at its source by improving the health of their employees. This a...
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In this continuing examination of responses to the growing costs of health care, based on a survey of more than 200 large companies, the author discusses the results of employers' efforts to trim these expenses. Most companies have chosen to meet the cost-cutting challenge by changing demand--that is, by redesigning their health insurance policies-...
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From the experience of a cross-section of Fortune "500" companies and top nonindustrials, these authors develop a profile of the newer types of health plans and benefits designed to cut health care costs. After examining the various plans, their funding, and their results, however, the authors conclude that another form of health insurance, more li...
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What were the key developments in hospital financial management in 1981? What will be the major trends in this area over the next five years? We asked these questions of more than 30 health care leaders from major proprietary and not-for-profit chains, large teaching hospitals, the fields of consulting and economics, and the Executive and Legislati...
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The large gap between the tuition charged by public colleges and universities and private ones is likely to cause severe disruptions to the private sector institutions of higher education. If it continues, private sector institutions may once again become bastions for students who can afford their services, rather than for those who merit them, and...
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Motivated by the financial difficulties that have beset city governments and some private nonprofit organizations, the accounting profession and other circles are urging these organizations to conform to business accounting practices. (See Robert N. Anthony's article on p. 83 of this issue.) Fund accounting, these reformers claim, is too complex, t...
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The growing effects of inflation and changing values of society have increased the vulnerability of nonprofit organizations. Thus, these organizations need sound financial management and planning— yet they are often deficient in just this area of management. This article provides anecdotes and detailed prescriptions for the improvement of the finan...
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The implementation of a zero-base budgeting system in Federal government agencies, instituted by President Carter in 1977, yielded quite different results, not only among the agencies but within specific departments as well. The experience of the Public Health Service with this budgeting process is documented and analyzed in this article. Though th...
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Fiscal management is a key managerial activity often neglected. Yet without top management of a sound fiscal process, managers have no insurance that they will be able to carry out their programs. Here is a guide to sound fiscal process and what managers must do to most effectively insure its execution.
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The health care system will never go bankrupt, the author of this article asserts. But the expense of maintaining it is putting such a strain on our resources that bankruptcy sometimes seems not so far off. The controls and devices we use, like certificate-of-need requirements and health management organizations, obviously have not slowed the rise...
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Fiscal management is a key managerial activity often neglected. Yet without top management of a sound fiscal process, managers have no insurance that they will be able to carry out their programs. Here is a guide to sound fiscal process and what managers must do to most effectively insure its execution. (C) 1977 Aspen Publishers, Inc.
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The health care manager is often an unwitting accomplice in the creation of noninformation systems because he fails to assume leadership in designing, installing and operating the system. There's also strong evidence that many managers could use a good course in basic accounting.
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I. INTRODUCTION 1. The Management Control Function 2. Characteristics of Nonprofit Organizations II. MANAGEMENT CONTROL PRINCIPLES 3. General Purpose Financial Statements 4. Analyzing Financial Statements 5. Full-Cost Accounting 6. Measurement and Use of Differential Costs 7. Pricing Decisions III. MANAGEMENT CONTROL SYSTEMS 8. The Management Contr...
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A management control system was adapted from its applications in the business world to a neighborhood health center. The system was planned, then implemented in the health center, and management control data were collected and used for a study period of 1 year. The system proved acceptable to the professionals in the health center and was associate...

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