Case: The Himalayan Cataract Project (Stanford GSB Case A-237. Date: 07/12/21. 15 pages)
Authors: Summer Hu, Jiayin Xue, Susan Qi and Professor Kevin Schulman, Stanford University
Background: The Himalayan Cataract Project (HCP) began with a mission of curing cataract blindness in Nepal. Cataracts occur more frequently due to high UV light exposure of the population, especially for substance farmers in rural regions. However, the traditional surgery was lengthy, and the country lacked the time and resources to address the population in need. The HCP was developed to address this challenge – could they reduce the cost and increase capacity to meet the unmet needs. In this case study, we illustrate a time-driven activity-based cost (TDABC) study of the cataract surgery program that was developed to solve this problem. The case illustrates a strategic challenge of health care service delivery constrained by resources, and uses the TDABC approach to better understand the solution.
The case focused on five questions:
- The literature describes “Focused Factories” in health care as an opportunity to improve clinical outcomes and reduce costs of care for patients. How does the HCP story support this concept?
- Imagine that TIO has a goal of a 5 percent improvement in efficiency over the next 12 months. How could you use this TDABC study to measure performance improvement at TIO?
- You are a hospital CEO and read about this TDABC study at TIO. You were very excited by the approach and the findings. You would like to compare the results at TIO with the results at your hospital. Of course, you’d like to compare both the estimates of direct and indirect costs. What would be the response of the Chief Financial Officer to this suggestion? How robust would the estimates be for direct and indirect costs of the procedure?
- You have a meeting with your leadership team—what would you consider key takeaways from this TDABC study of TIO for your team?
- How does lower cost care translate into lower price care for patients under a fee-for-service payment model? Under a case-rate payment model? Under a capitated payment model?
Download the case here: The Himalayan Cataract Project