Harvard Kennedy School Healthcare Policy Program
Discovering solutions and providing leadership for unprecedented problems in healthcare is the mission of the Healthcare Policy Program at Harvard’s Kennedy School of Government. The program draws on the tremendous expertise of Harvard’s schools— Harvard Medical School, Harvard Business School, Harvard Law School, Harvard Chan School of Public Health, the Faculty of Arts and Sciences — and leverages the role of Boston as a center of research, medical innovation, and far-sighted public-policy. The program has three aims: research, on access, innovation, and value in healthcare; establishing conversations between researchers, government, and industry; and preparing future generations of leaders through educational programs. The Program’s approach is multidisciplinary, engaging people from medicine, law, economics, and the natural sciences, and those with experience in business and government.
The Challenge: A combination of factors – from the growing number of elderly Americans, expanding government spending on healthcare, increasing market-power, and a new wave of innovations – portends that healthcare could become the defining issue for the United States. Innovation in immunotherapy for cancer, gene-therapy, and Alzheimer’s breakthroughs offer hope for millions. Access to innovations and providers has been shown to improve outcomes and reduce financial uncertainty. But the nation’s ability to ensure access for the poor, the sick, and the elderly will be compromised if we do not devise the appropriate regulatory and reimbursement policies to grapple with this challenge. Indeed, the long-term fiscal health of the United States depends on our ability to find the balance between paying for innovation in healthcare with continued access to these innovations.
Discovering Solutions: Innovation in new medicines and devices depends on regulation and pricing, while access depends on the generosity of public programs, tax policy, and the cost of delivering care. More generous access is valuable and creates incentives for even greater innovation. But this poses a challenge for public payers who now constitute the largest payers. Sustainable answers to this dilemma require balancing innovation and access with solutions that emphasize competition, value-based pricing, improvements in the productivity of the delivery system, premium-support in Medicare, tax-reform, and redesigning plans to offer value-based insurance. The program envisages a bold research program that covers three research initiatives:
Access: Insurance Expansions and Plan Design
What are the benefits of expanded access to patients and society, and what are ways in which these reforms can be preserved?
- Valuing the benefits of more generous insurance and insurance reforms on patients;
- Optimal plan design for health-insurance offerings;
- Premium support for slowing cost-growth in Medicare and exchange plans;
- Long-term care in the United States; and
- Reforms to eliminate the regressive nature of health-insurance financing.
Innovation: Market Size and Regulatory Policy
What is the responsiveness of the speed and type of innovation to market size and regulatory policy?
- Responsiveness of innovation to market size, regulation, and exclusivity periods;
- Agglomeration economies in the creation of life-science innovation;
- National Institute of Health funding and its role in new medical discoveries; and
- Novel pricing mechanisms for cures and breakthrough treatments.
Delivery System Reform: Payment policy and Value Based Care
Physicians, hospitals, and the delivery system are central to delivering high-value care that is low-cost and high-quality. Government payment policy, through payments and regulation, is central to this enterprise.
- Reforming the delivery system, through reimbursement reform, bundled payments;
- Regulatory and competitive solutions for market-power as a result of consolidation;
- Consumer decision making and knowledge about high-value providers;
- Role of employers and health plans in encouraging value-based healthcare; and
- Medical malpractice and its effects of defensive medicine.
Location: The Harvard Kennedy School is uniquely positioned to be the home of this multi-disciplinary undertaking. It is ranked as the #1 health policy program in the nation. The program’s faculty affiliates and alumni are immersed in actual policy design and not simply the study of it; they have led the Food and Drug Administration, Congressional Budget Office, Centers for Medicaid and Medicare Services, and served in the White House. The student interest group on health policy at the Kennedy School is now the largest student group at the School and demonstrates the extent to which future leaders and generations care about health policy. Finally, Harvard is in Boston, which is an unparalleled location to study US healthcare and the opportunities and challenges that it presents for the future. Boston has emerged as a center of innovation for biotechnology and devices, as well as for hospital care and public policy in healthcare. Massachusetts insured the uninsured before the rest of the nation in 2006; it experimented with alternative payment systems for physicians; it is where novel treatments for disease are discovered; and it is the largest training location for physicians in the world.
Leadership: The Program is directed by Professor Amitabh Chandra, Malcolm Wiener Professor of Social Policy at the Harvard Kennedy School. The program is anchored by faculty and clinical affiliates from the Harvard’s Kennedy School of Government, Medical School, School of Public Health, Business School, the Department of Economics, as well as the Brigham and Women’s Hospital and Massachusetts General Hospital.
Sponsors: The Healthcare Policy Program is sustained through the numerous organizations and individuals who invest in the Program. These include support from: