Resources

Activity Based Costing: Overview | USAID Global Health Supply Chain Program.

Applying Activity-Based Costing and Management to HIV Services in Tanzania. (2022) by Bryant Lee (Palladium), Huiling Pan (Palladium), George Ruhago (MUHAS), Mucho Mizinduko (MUHAS), Dickson Peter (TACAIDS), Carlyn Mann (USAID), and Steven Forsythe (Avenir Health) of the Health Policy Plus project.

Activity-based costing for HIV, primary care and nutrition services in low- and middle-income countries: A systematic literature review and synthesis. (2021) by Diana Bowser, Anna Sombrio, Neto Coulibaly, Noah Mark.

A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018. (2021) by Chirenda, J., B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison, and R. S. Kaplan. 

Using Time-Driven Activity-Based Costing as a Key Component of the Value Platform: A Pilot Analysis of Colonoscopy, Aortic Valve Replacement and Carpal Tunnel Release Procedures. (2018) by Jacob A. Martin, Christopher R. Mayhew, Amanda J. Morris, Angela M. Bader, Mitchell H. Tsai, & Richard D. Urman.

Improving healthcare performance through Activity-Based Costing and Time-Driven Activity-Based Costing. (2021) by Angels Niñerola, Ana-Beatriz Hernández-Lara, & Maria-Victòria Sánchez-Rebull. 

Activity-based Costing of Health-Care Delivery, Haiti. (2018) by Ryan K. McBain, Gregory Jerome, Fernet Leandre, Micaela Browning, Jonathan Warsh, Mahek Shah, Bipin Mistry, Peterson Abnis-Faure, Claire Pierre, Anna P. Fang, Jean Claude Mugunga, Gary Gottlieb, Joseph Rhatigan, and Robert S. Kaplan.

Using a Time-Driven Activity-Based Costing Model to Improve Healthcare Resource Utilization in Mirebalais, Haiti. (2015) co-authored by Morgan Mandigo, Kathleen O’Neill, Bipin Mistry, Bryan Mundy, Christophe Milien, Yolande Nazaire, Ruth Damuse, Claire Pierre, Jean Claude Mugunga, Rowan Gillies, Franciscka Lucien, Karla Bertrand, Eva Luo, Ainhoa Costas, Sarah Greenberg, John Meara, Robert Kaplan.

A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal. (2021) by Xue, Jiayin, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg, and Kevin Schulman.

Advances in Value-Based Healthcare by the Application of Time-Driven Activity-Based Costing for Inpatient Management: A Systematic Review. (2020) by Ana Paula Beck da Silva Etges, Karen Brasil Ruschel, Carisi Anne Polanczyk, & Richard D. Urman.

A standardized framework to evaluate the quality of studies using TDABC in healthcare: The TDABC in Healthcare Consortium Consensus Statement. (2020) by Ana Paula Beck da Silva Etges, Carisi Anne Polanczyk, & Richard D. Urman.

How to Solve the Cost Crisis in Health Care. (2011) by Robert S. Kaplan and Michael Porter & HBR Porter-Kaplan video 

Rethinking the cost of healthcare in low-resource settings: The value of time-driven activity-based costing. (2016) by Ryan K. McBain, Gregory Jerome, Jonathan Warsh, Micaela Browning, Bipin Mistry, Peterson Abnis-Faure, Claire Pierre, Anna P. Fang, Jean Claude Mugunga, Joseph Rhatigan, Fernet Leandre & Robert Kaplan.

Improving value with TDABC. (2014) by Robert S. Kaplan

Hôpital Universitaire de Mirebalais: Partners In Health in Haiti

Abstract

The case describes the application of time-driven activity-based costing (TDABC) at a new tertiary hospital operated by Partners-in-Health in Mirebelais, Haiti. A project team mapped the clinical processes for use in estimating the direct costs of personnel, equipment, and facilities for obstetric and breast cancer care. The accurate cost information revealed opportunities to optimize resource-utilization and reduce costs by establishing more efficient sterilization procedures and task-shifting administrative responsibilities away from high-cost physicians. It would also potentially be used for budgeting and to propose new payment models with Haiti's Ministries of Health and Finance.

Partners In Health: Costing Primary Care in Haiti

Abstract

Partners in Health, a global NGO focused on delivering health care to residents of rural underserved communities, conducts a project on the cost of primary care at five sites in the Central Highlands of Haiti. It devises a simple approach for tracking the resources used by patients being treated for diverse medical conditions, as an input to a time-driven activity-based costing model. The results show considerable cost diversity across the five sites, but organizational leaders differ on the interpretation and action implications of the findings.

Process Map Example

Interview Guide for Process Mapping Example

Instruction Manual for TDABC Cost Estimation

Policymaker's Guide

ABC/M Implementation Video with Dr. George Ruhago (MUHAS)

Overview of ABC/M Applications with Prof. Robert S. Kaplan

Strengths and Drawbacks of TDBAC with Ms. Kate Harris

ABC/M Policymaker’s Guide with Dr. Steven Forsythe

ABC/M Use Cases with Dr. Ryan McBain

ABC/M Findings in Uganda and Tanzania with Collins Gaba

• Jordan M, Ekirapa E, Marton T, Karegyeya G, Maina T, Ssebagereka A, Ssempala R, Ross R, Nandakumar A, & McBain R. Mapping care pathways: Clinical providers’ perspectives on process maps of HIV service delivery in Uganda. Global Public Health. 2025 Mar 20; 20(1), 2479660. doi.org/10.1080/17441692.2025.2479660
• Ekirapa E, Jordan M, Nong T, Marton TE, Balidawa H, Ssempala R, Ssebagereka A, Kagaayi J, Nandakumar A, & McBain RK. Costs and resource distribution of direct services for HIV in Uganda. BMJ Open. 2024 Oct 9; 14:e082062. doi: 10.1136/bmjopen-2023-082062.
• McBain RK, Jordan M, Mann C, Ruhago GM, Lee B, Forsythe S, Stewart K, Brown J, Nandakumar A. National Evaluation of HIV Service Resource Allocation in Tanzania. AIDS and Behavior. 2023 Oct;27(10):3498-3507. doi:10.1007/s10461-023-04065-5.
• McBain RK, Jordan M, Kapologwe NA, Kagaayi J, Kiracho EE, Nandakumar AK. Costing of HIV services, Uganda and United Republic of Tanzania. Bull World Health Organ. 2023 Oct 1; 101(10):626-636. doi: 10.2471/BLT.22.289580. 
• Ruffner M, Morrison L, Hijazi M, Semini I, & McBain RK. A new initiative to track HIV resource allocation. The Lancet. 2022 Jul; 9(7):e458-e459. doi:10.1016/S2352-3018(22)00159-X. 
• McBain R, Nandakumar AK, Ruffner M, Forsythe S, et al. A new initiative to track HIV resource allocation and costs. Bull World Health Organ. 2022 June 1;100(6):358-358A. doi: 10.2471/BLT.22.287818. 
• Tanzania Process Maps Report
• Comparison of Resource Allocation at HIV Facilities in Tanzania