On behalf of the editorial team – Regina Herzlinger, Kevin Schulman, Lawrence Van Horn, and myself – I am delighted to welcome you to Volume 4 of HMPI. We again have a strong set of new articles that are central to our core goal: drawing from the research and experience of scholars and practicing leaders to advance healthcare and health systems.
In this issue of HMPI, the authors report their research, insights, and case studies.
- Two research papers address important issues about healthcare insurance. First, they report evidence that suggests Medicare Advantage insurance may be “upcoding” services into higher paying categories. Second, they show that people in the healthier segments of insurance plans receive only limited value for their premiums.
- Two experience perspectives highlight key issues in healthcare management. First, we report a discussion of two ways in which artificial intelligence will deliver value to health plans, large employers, providers, and patients. Second, we offer lessons about how merging hospitals can remain innovative after consolidation.
- We report key insights from the recent University of Miami conference on the business of healthcare.
- We also provide two case studies. First, a thoughtful discussion highlights the idea that established retailers can support lifestyle management programs for needs such as diabetes prevention and care. Second, a case study of an early stage regenerative medicine venture, highlighting the value proposition that helped it raise Series A financing.
Healthcare in the United States and globally is generating robust and sometimes acrimonious debates. Costs of services and products are increasing – even as innovation creates new value and healthcare systems face real issues in paying for desirable innovation, giving rise to arguments about what services to provide. At the same time, different actors in systems across the world are debating their commitment to maintaining and increasing access to healthcare services, partly due to concerns about costs and partly, perhaps even more importantly, due to differing perspectives on equity. The articles in this issue of HMPI provide relevant tools and ideas that can support robust arguments within these debates.
The authors of the articles that we publish are committed to improving management practices in health systems around the world. We welcome your comments about the ideas that the articles spark and your ideas for subsequent articles. Please send us your comments to info@hmpi.org. We also welcome discussion on the BAHM Forum on LinkedIn [https://www.linkedin.com/groups/7042389] and on Twitter, https://twitter.com/HMPI_Journal.
If you have an idea that you would like to explore for HMPI, please send an outline of your article to our editorial team at info@hmpi.org.
Will Mitchell
Professor of Strategic Management
Anthony S. Fell Chair in New Technologies and Commercialization
Rotman School of Management, University of Toronto