Michael E. Porter's research while affiliated with Harvard Medical School and other places
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Publications (137)
The Roadmap report outlines policy principles and priorities for India as the country aspires to move towards middle-income and beyond over the next 2 years. The recommendations are anchored in an in-depth diagnostic of India's current competitiveness, applying the conceptual framework introduced by Michael Porter. Prof Amit Kapoor and his team at...
Health care delivery is broken. The cost of care continues to skyrocket and the outcomes most important to patients are often a mystery. Further, care is often delivered via a fee-for-service model where surgeons are rewarded for the quantity, not the quality, of services provided. Such a health care delivery system is not sustainable and does not...
Context
In response to growing concerns over rising costs and major variation in quality, improving value for patients has been proposed as a fundamentally new strategy for how healthcare should be delivered, measured, and remunerated.
Objective
To systematically review the literature regarding the implementation and impact of value-based healthca...
Purpose
This paper aims to review the evidence on Europe’s economic performance and on the role played by policies pursued at the European Union (EU) level, using the competitiveness framework as the conceptual lens.
Design/methodology/approach
Why has Europe not made more progress on upgrading its competitiveness over the past few decades, despit...
In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could improve the readiness of active duty personnel and lower the cost of delivering care t...
Combining data from the social progress index and measures of economic institutions and performance, our analysis focuses on how changes in economic institutions and performance are related to subsequent changes in social progress (noneconomic dimensions of societal performance). We document a positive relationship between improved economic perform...
THE CAPITALIST SYSTEM is under siege. In recent years business increasingly has been viewed as a major cause of social, environmental, and economic problems. Companies are widely perceived to be prospering at the expense of the broader community.
The transition of health care from volume to value is no longer theoretical, or wishful thinking.¹ The work is now under way. In this issue of JAMA, the article by Lee et al² from the University of Utah provides clear evidence that the work is doable and is worth doing. The report also points to additional steps that can take value improvement even...
Purpose:
The transformation from volume to value will require communication of outcomes and costs of therapies; however, outcomes are usually nonstandardized, and cost of therapy differs among stakeholders. We developed a standardized value framework by using radar charts to visualize and communicate a wide range of patient outcomes and cost for t...
The United States stands at a crossroads in how to pay for health care. Fee for service, the dominant payment model in the U.S. and many other countries, is now widely recognized as perhaps the single biggest obstacle to improving health care delivery. A battle is currently raging, outside of the public eye, between the advocates of two radically d...
Today's delivery of care to thyroid cancer patients is complex, and costly, with uneven outcomes that can be improved. The incidence of thyroid cancer is rising and requires coordinated, multidisciplinary care with high volume centers that is not always available in our current fragmented healthcare system. To address the needs of patients, provide...
Acceleration of outcomes measurement can unlock the potential of value-based health care for driving improvement. It requires a commitment to measuring a minimum sufficient set of outcomes for every major medical condition.
In a changing environment, health care organizations need to rethink the meaning of strategy and make the choices necessary to distinguish themselves in meeting customers' needs. Those choices revolve around six key questions, beginning with “What is our goal?”
Clusters are geographic concentrations of industries related by knowledge, skills, inputs, demand and/or other linkages. There
is an increasing need for cluster-based data to support research, facilitate comparisons of clusters across regions and support
policymakers in defining regional strategies. This article develops a novel clustering algorith...
Wirklicher Fortschritt im Gesundheitswesen beginnt mit der umfangreichen Messung medizinischer Ergebnisqualität. Medizinische Ergebnisqualität wird auf Ebene eines konkreten Krankheitsbildes gemessen. Statt sich auf bestimmte Prozeduren oder Fachgebiete einzuschränken, müssen medizinische Ergebnisdaten für jede Behandlungsmöglichkeit eines Krankhei...
Economic geography during an era of global competition involves a paradox. It is widely recognized that changes in technology and competition have diminished many of the traditional roles of location. Yet clusters, or geographic concentrations of interconnected companies, are a striking feature of virtually every national, regional, state, and even...
Initiatives to address the unmet needs of those facing both poverty and serious illness have expanded significantly over the past decade. But many of them are designed in an ad-hoc manner to address one health problem among many; they are too rarely assessed; best practices spread slowly. When assessments of delivery do occur, they are often narrow...
Primary care in the United States currently struggles to attract new physicians and to garner investments in infrastructure required to meet patients' needs. We believe that the absence of a robust overall strategy for the entire spectrum of primary care is a fundamental cause of these struggles. To address the absence of an overall strategy and vi...
We define foundational competitiveness as the expected level of output per working-age individual that is supported by the overall quality of a country as a place to do business. The focus on output per potential worker, a broader measure of national productivity than output per current worker, reflects the dual role of workforce participation and...
A location decision is, in many respects, a referendum on a nation's competitiveness. When a company decides, say, to build a new plant in China rather than in the United States, it is effectively voting on the question of which country can best enable its success in the global marketplace. Over the past three decades, business activities have beco...
The United States is a competitive location to the extent that companies operating in the U.S. are able to compete successfully in the global economy while supporting high and rising living standards for the average American. By this standard, U.S. competitiveness is in grave danger. The erosion of U.S. competitiveness began well before the Great R...
The Joslin Diabetes Center in Boston, Massachusetts is a leading center for diabetes care, clinician training, and research. The incidence of diabetes is rising precipitously worldwide, challenging quality of life with its complications and rapidly accelerating health care expenditures for employers and governments. The Joslin's multispecialty, tea...
The German health care system has achieved a great deal: universal health insurance for 84 million people, substantial choice of health plans regardless of financial means, a broad range of services covered, and free choice of providers. However, the system is clearly not achieving its full potential. No other part of Germany’s social security syst...
The German health care system is one of the most comprehensive and extensively developed systems in the world. In this chapter, we provide an overview of the system as it exists today and trace its historic development, which can be divided into a period of rapid expansion after World War II, followed by one increasingly centering on cost containme...
Germany has an extensive provider system with expertise in every medical field and with a density of providers among the highest of any country. Unlike many other countries, there is a strict separation among inpatient care provided by hospitals, outpatient care provided in physician’s offices, and rehabilitative care provided by separate instituti...
Universal measurement of patient health outcomes and costs is essential in a high-value health care system to inform and motivate improvements. Historically, however, neither providers nor health plans have measured outcomes or per-patient costs in Germany. Instead, physicians have assumed that their care was excellent and concentrated on growing p...
While the core of value creation in health care delivery takes place at the provider level, other stakeholders have crucial roles to play as well. Health plans, employers, and patients can all make a significant contribution to improving value. However, this opportunity is largely lost in Germany. Health plans have focused on insurance instead of h...
Health care is a daunting field to understand, with rapidly advancing medical sciences, a complex array of institutions, heavy government regulation, and numerous highly engaged stakeholders. The sheer complexity of the field has led to widely different opinions about the problems in health care and the many ill-advised “solutions” to these issues....
The German health care delivery system has achieved improved life expectancy, minimal wait times by international standards, free choice, and acceptable patient satisfaction. Many patients are cared for by dedicated and compassionate doctors, nurses, and other health care professionals.
In this chapter, we discuss the current German health insurance system, in which statutory health plans coexist with a smaller private system. Germany’s insurance system has produced nearly universal coverage and has many strengths compared to other countries, including one of the most comprehensive risk-adjustment systems to mitigate zero-sum cost...
National health system reform in Germany, as well as in many other countries, has historically been approached on an issue-byissue basis. Each reform has focused on solving individual problems such as rising costs, risk selection by insurance plans, or skewed reimbursement incentives. While many of these efforts involve desirable steps, an overall...
Deutschland verfügt über ein umfassendes System von Leistungserbringern mit Expertise auf jedem medizinischen Fachgebiet und einer Anbieterdichte, die zu den höchsten der Welt gehört. Anders als in vielen anderen Ländern besteht eine strikte Trennung zwischen stationärer Versorgung, die in Krankenhäusern erbracht wird, ambulanter Versorgung, die in...
Hohe Lebenserwartung, minimale Wartezeiten im Vergleich zu internationalen Standards, freie Arztwahl sowie akzeptable Werte in Sachen Patientenzufriedenheit – dies sind wichtige Errungenschaften der Gesundheitsversorgung in Deutschland. In vielen Fällen erhalten die Patienten eine Behandlung, die geprägt ist von Engagement und Zuwendung – auf Seite...
Ansätze zu einer nationalen Gesundheitsreform haben in Deutschland wie in vielen anderen Ländern die Probleme bislang nur fallweise je nach Dringlichkeit thematisiert. Jedes Reformvorhaben konzentrierte sich darauf, Einzelprobleme zu lösen wie z.B. Kostensteigerungen, die Beschränkung der Risikoselektion seitens der Versicherer oder verzerrte Anrei...
Die umfassende Messung von Ergebnisqualität und -kosten ist in einem Gesundheitssystem mit hoher Nutzenstiftung unerlässlich, um zu informieren und Anstöße zu Verbesserungen zu geben. Traditionell messen jedoch in Deutschland weder die Leistungserbringer noch die Krankenversicherer die Behandlungsergebnisse oder die Kosten je Patient. Stattdessen n...
In diesem Kapitel befassen wir uns mit dem heutigen deutschen Krankenversicherungssystem, in dem neben den gesetzlichen Krankenkassen ein kleineres privates System existiert. Deutschlands Versicherungssystem hat einen fast lückenlosen Versicherungsschutz geschaffen und besitzt im Vergleich zu anderen Ländern viele Vorzüge. Dazu gehört eines der umf...
Das Gesundheitswesen zu verstehen ist alles andere als einfach, vor allem angesichts der sich rapide fortentwickelnden medizinischen Fachdisziplinen, des komplexen Zusammenspiels der Institutionen, der intensiven staatlichen Regulierung sowie einer Vielzahl hochengagierter Interessengruppen. Aus der schieren Komplexität des Problemfelds resultieren...
In der Gesundheitsversorgung findet Nutzenstiftung hauptsächlich auf Seiten der Leistungserbringer statt. Gleichwohl fallen auch den anderen Stakeholdern hier wichtige Rollen zu: Krankenkassen, Arbeitgeber und Patienten – sie alle können einen wesentlichen Beitrag leisten, um den Patientennutzen zu verbessern.
Die Errungenschaften des deutschen Gesundheitssystems sind bemerkenswert: umfassender Krankenversicherungsschutz für 82 Millionen Menschen, eine große Auswahl an Krankenversicherern unabhängig von den eigenen finanziellen Möglichkeiten, ein breites Spektrum finanzierter Leistungen und eine freie Wahl der Leistungserbringer. Dennoch schöpft das Gesu...
Das deutsche Gesundheitssystem ist so umfassend und ausdifferenziert wie kaum ein anderes in der Welt. In diesem Kapitel bieten wir einen Überblick über das System, wie es heute besteht, und verfolgen, wie es sich historisch entwickelt hat: Auf eine Phase stürmischer Expansion nach dem Zweiten Weltkrieg folgte eine Phase wachsender Konzentration au...
Die Grundidee des „Shared Value“-Konzeptes (gemeinsamer Mehrwert für Unternehmen und Gesellschaft) liegt in der Annahme, dass die Wettbewerbsfähigkeit eines Unternehmens und der Wohlstand der Gesellschaft, in der das Unternehmen tätig ist, miteinander in Wechselwirkung stehen. Wer den Zusammenhang von gesellschaftlichem und wirtschaftlichem Fortsch...
The German health care system is on a collision course with budget realities. Costs are high and rising, and quality problems are becoming ever more apparent. Decades of reforms have produced little change to these troubling trends. Why has Germany failed to solve these cost and quality problems? The reason is that Germany has not set value for pat...
Environmental performance, encompassing the control of pollution and stewardship of natural resources, is of growing concern in both advanced and developing economies. Environmental quality plays a major role in quality of life, with a direct impact on the health and safety of a nation’s citizens as well as its attractiveness as a place to live. It...
Sweden's Highland District County Hospital, similar to a community hospital in the US, undertook a major restructuring to integrate care delivery for medical conditions served by the Department of Medicine. Each subspecialty within the Department would form a single, co-located unit with its own budget that encompassed both inpatient and outpatient...
U.S. health care costs currently exceed 17% of GDP and continue to rise. One fundamental reason that providers are unable to reverse the trend is that they don't understand what it costs to deliver patient care or how those costs compare with outcomes. To put it bluntly, few health care providers measure the actual costs for treating a given patien...
This case describes the Dutch Flower cluster, or the group of interconnected growers, suppliers, service providers, and flower-related institutions located in the Netherlands. It examines the role of the FloraHolland auction in the value chain and describes the flower clusters in China, Colombia, Ecuador, and Kenya, the four other major internation...
The concept of shared value—which focuses on the connections between societal and economic progress—has the power to unleash the next wave of global growth. An increasing number of companies known for their hard-nosed approach to business—such as Google, IBM, Intel, Johnson & Johnson, Nestlé, Unilever, and Wal-Mart—have begun to embark on important...
Benjamin F. Byrd, Theodore P. Abraham, Denis B. Buxton, Anthony V. Coletta, James H.S. Cooper, Pamela S. Douglas, Linda D. Gillam, Steven A. Goldstein, Thomas R. Graf, Kenneth D. Horton, Alexis A. Isenberg, Allan L. Klein, Joseph Kreeger, Randolph P. Martin, Susan M. Nedza, Amol Navathe, Patricia A. Pellikka, Michael H. Picard, John C. Pilotte, Tho...
This paper evaluates the role of regional cluster composition in the economic performance of industries, clusters and regions. On the one hand, diminishing returns to specialization in a location can result in a convergence effect: the growth rate of an industry within a region may be declining in the level of activity of that industry. At the same...
Looking through the lenses of both macro and micro economic policy, this case examines how Singapore has achieved such stellar success throughout its history, from independence through 2008. The case discusses the different policy choices the Singaporean government has made as well as how the government's structure has aided development.Learning Ob...
This article examines the role of regional clusters in regional entrepreneurship. We focus on the distinct influences of convergence and agglomeration on growth in the number of start-up firms as well as in employment in these new firms in a given region-industry. While reversion to the mean and diminishing returns to entrepreneurship at the region...
In 2009 Children's Hospital of Philadelphia (CHOP) had been recognized as the best children's hospital in the country for six years in a row; but leadership saw CHOP as more than the large main campus in Western Philadelphia. Beginning in the 1990s, CHOP had created a large network of Primary Care Providers, Specialty Care Centers, Ambulatory Surge...
Taiwan's Koo Foundation Sun Yat-Sen Cancer Center has developed an integrated, team-based care delivery model for breast cancer care that is being expanded to other cancer types in 2009. A decade earlier, President and CEO Dr. Andrew Huang and the Center had worked with the Taiwan National Health Insurance system to create a pay-for-performance rei...
To make best use of the new dollars available for the treatment of disease in resource-poor settings, global health practice requires a strategic approach that emphasises value for patients. Practitioners and global health academics should seek to identify and elaborate the set of factors that drives value for patients through the detailed study of...
The case is designed to explore the process of building competitiveness, particularly in an unstable environment, with a focus on organizations for competitiveness.
Richard, SullivanJeffrey, PeppercornKarol, SikoraJohn, ZalcbergNeal J, MeropolEitan, AmirDavid, KhayatPeter, BoylePhilippe, AutierIan F, TannockTito, FojoJim, SiderovSteve, WilliamsonSilvia, CamporesiJ Gordon, McVieArnie D, PurushothamPeter, NarediAlexander, EggermontMurray F, BrennanMichael L, SteinbergMark, De RidderSusan A, McCloskeyDirk, Verell...
Global Health Partner was founded in 2006 as a privately owned health care provider in Sweden serving both public and private paying patients. In contrast to most providers in the country, GHP organized around specific service lines where it saw the potential to provide the most value. This case details the GHP approach to both Spine Care and Obesi...
Describes the Spine Center at Dartmouth-Hitchcock Medical Center, a multidisciplinary unit that offers patients suffering from spinal problems 'one-stop' access to a range of providers including orthopedic surgeons, neurosurgeons, neurologists, medical specialists in physical medicine and pain management, mental health providers, and occupational a...
Pharmacy benefit managers (PBMs) have a unique opportunity to promote health and generate value in the healthcare system. Today, PBMs are largely evaluated on their ability to control costs rather than improve health. Pharmacy benefit managers should be evaluated along 3 dimensions in which they can increase value: (1) use of cost-effective medicat...
Value-based delivery principles have a series of implications for providers that I have begun to describe. Providers need to reorganize around IPUs, decide what services to offer in each facility, and integrate care in IPUs across geographic locations. To work effectively with other entities in the care cycle, providers need to move beyond arm's-le...
Research on the interactions among activities in firms and the extent to which these interactions help create and sustain competitive advantage has rapidly expanded in recent years. In this research, the two most common approaches have been the complementarity framework, as developed by Milgrom and Roberts (1990), and the NK-model (Kauffman, 1993)...
In 1979, a young associate professor at Harvard Business School published his first article for HBR, "How Competitive Forces Shape Strategy." In the years that followed, Michael Porter's explication of the five forces that determine the long-run profitability of any industry has shaped a generation of academic research and business practice. In thi...
01 La estrategia del océano azul (W. Chan Kim y Renée Mauborgne)$backslash$n10 Propósito estratégico (Gary Hamel y C. K. Prahalad)$backslash$n25 Estrategias regionales para el liderazgo global (Pankaj Ghemawat)$backslash$n37 Usar el Balanced Scorecard como un sistema de gestión estratégica (Robert S. Kaplan y David P. Norton)$backslash$n48 La venta...
The effects of climate change on companies' operations are now so tangible and certain that the issue is best addressed with the tools of the strategist, not the philanthropist.
Today's preoccupation with cost shifting and cost reduction undermines physicians and patients. Instead, health care reform must focus on improving health and health care value for patients. We propose a strategy for reform that is market based but physician led. Physician leadership is essential. Improving the value of health care is something onl...
Governments, activists, and the media have become adept at holding companies to account for the social consequences of their actions. In response, corporate social responsibility has emerged as an inescapable priority for business leaders in every country. Frequently, though, CSR efforts are counterproductive, for two reasons. First, they pit busin...
The Strategic Management Journal has published a series of articles on variation in business-segment performance. This comment addresses the insights and potential sources of confusion in the decomposition literature, with a particular focus on Ruefli and Wiggins (2003). We review the basic purpose of descriptive decomposition techniques and argue...
Efforts to identify the determinants of environmental policy success at the national level have largely been anecdotal and case study based. This article seeks to identify empirically the factors that drive environmental performance as measured by levels of urban particulates and sulfur dioxide and energy use per unit of GDP. Although the data are...
As a newly minted CEO, you may think you finally have the power to set strategy, the authority to make things happen, and full access to the finer points of your business. But if you expect the job to be as simple as that, you're in for an awakening. Even though you bear full responsibility for your company's well-being, you are a few steps removed...
The U.S. health care system is in bad shape. Medical services are restricted or rationed, many patients receive poor care, and high rates of preventable medical error persist. There are wide and inexplicable differences in costs and quality among providers and across geographic areas. In well-functioning competitive markets--think computers, mobile...
This article examines competition in Japan and its link to postwar economic prosperity. While Japan's industrial structure and competition policy seem to indicate that competition in Japan has been less intense, the empirical evidence does not support this conclusion. The sectors in which competition was restricted prove to be those where Japan was...
This paper examines the basic facts about the regional economic performance, the composition of regional economies and the role of clusters in the US economy over period of 1990 to 2000. The performance of regional economies varies markedly in terms of wage, wage growth, employment growth and patenting rate. Based on the distribution of economic ac...
Citations
... Spine surgeon leadership is vital for providing high-value care for spine patients; otherwise, suboptimal outcomes may result from isolated interventions of regulatory bodies or payer groups (98). Enhancing the safety, quality, and value based care of adults undergoing spine surgery is vital (99). Using lean methodology to stratify evidence around biologics and bone graft substitutes, Sethi et al. in 2017 concluded that rhBMP-2 was the best option to optimise the cost/benefit ratio of multilevel thoracolumbar fusion (96). ...
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... The presence of clusters-groups of closely related and complementary industries operating in a particular location-can play a role in the resilience of regional industry employment when faced with economic downturns. Thus, clusters could help to face the adverse effects of the COVID-19 crisis and improve firms' capabilities to survive in external markets, as recent studies have shown (for example, Dai et al., 2021;Delgado and Porter, 2021;Jun et al., 2021). However, clusters could also exacerbate existing vulnerabilities, facilitating the propagation of shocks across related industries and firms. ...
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... urinary, sexual, and bowel function), and health-related QoL (HRQoL). 9 Implementing a common set of patient-reported outcomes measures (PROMs) in clinical trials is a first step toward standardized comparative effectiveness research across trials and enables a holistic evaluation of disease-related outcomes that includes survival and QoL. Integrating PROMs into clinical practices similarly enables quality assessment and improvement for the outcomes that matter most to the patient within practices or healthcare systems. ...
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... Health care cost explosion and the emerging skills shortage require the development of a novel ecosystem, moving away from a legacy system to a value-based system, in which the patient's value is defined by the quality and outcome divided by the total costs over the full care cycle [4,[11][12][13][14]. Moreover, from this economic perspective, the definition of quality of sarcoma care is indispensable. ...
... Aiginger (2021) argued for setting strategic objectives with global perspectives. Ketels and Porter (2021) found Europe's sluggish performance to be driven by a failure to adjust the EU's policy approach to fundamental changes in global competitiveness and economic challenges. However, improving export quality could ensure higher economic growth and global competitiveness with practical innovation and technology development. ...
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... The successive sum of these waves or harmonics (integer multiples of the periodic function's fundamental frequency) constituting the overall PrMed and PubHealth waves allows the convergence or increasing approach toward the limit as the function or number of terms increases (as the function y = 1/x converges to zero as x increases). This healthcare delivery framework represents the operational function of healthcare systems whose central objective should be to deliver VBHC, whose seminal definition was provided by Porter and Teisberg as a cost-benefit function of health outcomes achieved through quality healthcare divided by the per-person costs to achieve those outcomes [82,83]. The European Commission's Expert Panel on Effective Ways in Investing in Health refined the definition of quality healthcare as consisting of equity, person-centeredness, social participation, and wellbeing with implied safety [84]. ...
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... Health care cost explosion and the emerging skills shortage require the development of a novel ecosystem, moving away from a legacy system to a value-based system, in which the patient's value is defined by the quality and outcome divided by the total costs over the full care cycle [4,[11][12][13][14]. Moreover, from this economic perspective, the definition of quality of sarcoma care is indispensable. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/278814178463752-1443485888267_Q64/Alice-Murray.jpg)
... The pandemic is gradually becoming the 'new normal' implying that we may have to live with it for an unknown period [20][21][22]. In the absence of adequate/ context-specific support programmes for our healthcare providers, their well-being may be adversely affected which can affect the overall availability of human resource and even translate to poor patient care [23][24][25]. ...
... Telemedicine services involve innovative solutions, and as any innovation, is exposed to risks and time to achieve a maturity 27,28 . The opportunity of continually measure costs and outcomes of a healthcare service is necessary to create a constant improvement cycle 29,30 . At this time, this study introduced a framework to assess costs incurred in teleconsultations, as well as the understanding that cost analysis per medical specialty can generate valid formation to guide future decisions on how resources can be better allocated. ...
... Other scholars have shown that, in addition to the ability to make comparisons across territories and build rankings, the measurement of social progress also provides a novel tool for assessing its interplay with institutional indicators, traditional economic metrics and more holistic measures of human fulfilment. Fehder et al. (2019) show that improving the rule of law can have effects on social progress through the dimensions of access to education and information, health and environmental quality. Other papers have focused on the link between social progress and the growth of GDPpc, finding that economic growth is instrumental to achieve basic needs, but less so for other dimensions of well-being such as inclusiveness (Fehder et al., 2018;Pritchett, 2022). ...
