Health Care Provider Micro-Foundations
The levers for improving the efficiency of health care delivery are multi-faceted. This session will investigate three different types of policy levers that are micro-founded at the level of individual health care providers, with a focus on drawing causal inferences, by exploiting quasi-experimental methods and natural experiments. The first presentation examines the potential tradeoff to coordination by studying whether horizontal integration of physicians leads to higher prices. It extends a well-known literature on market power for hospitals to provider consolidation from the formation of Accountable Care Organizations (ACOs). The second presentation then explores how workplace design can influence health care delivery through physician behavior, independent of financial incentives. It studies the strategic effect of shiftwork on physician behavior, given that physicians would like to go home at the end of their shifts, and finds that patients are discharged more quickly when arriving near the end of a physician’s shift but also receive more costly care. The third presentation investigates the role of communication between health care providers in improving outcomes. It exploits a natural experiment in which communication between visiting nurses and physicians are more likely at certain times of the day, and evaluates the effect of communication on the important outcome of hospital readmission.